Mobility and Transport for Elderly and Disabled Persons 9782881247637

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MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

TRANSPORTATION STUDIES A series edited by NORMAN ASHFORD, Loughborough University of Technology W ILLIAM G. BELL, Florida State University Volume 1

Volume 8

CAR OWNERSHIP FORECASTING By E.W. Allanson

HANDBOOK OF ROAD TECHNOLOGY (in 2 volumes) By M.G. Lay

Volume 2

MOBILITY AND TRANSPORT FOR ELDERLY AND HANDICAPPED PERSONS Edited by Norman Ashford, William G. Bell and Tom A. Rich Volume 3

SEAPORTS AND DEVELOPMENT The Experience of Kenya and Tanzania By B.S. Hoyle Volume 4

APPLIED TRANSPORT ECONOMICS A Practical Case Studies Approach By K.J. Button and A.D. Pearman Volume 5

THE SHIPPING INDUSTRY The Technology and Economics of Specialisation By Edmund J. Gubbins Volume 6

TRANSPORTATION NETWORKS A Quantitative Approach By Dusan Teodorovic Volume 7

ROAD VEHICLE PERFORMANCE Methods of Measurement and Calculation By G.G. Lucas

Additional volumes in preparation

Volume 9

TRANSPORT CARRIER COSTING By Wayne Kenneth Talley Volume 10

AIRLINE OPERATIONS RESEARCH By Dussan Teodorovic Volume 11

TWO-LANE HIGHWAY TRAFFIC Theory and Practice By John R. McLean Volume 12

OPEN REGISTRY SHIPPING A Comparative Study of Costs and Freight Rates By S.R. Tolofari Volume 13

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS (in 2 parts) Edited by C.-E. Norrbom and A. Stahl Volume 14

UNCONVENTIONAL AND COMMUNITY TRANSPORT IN THE UNITED KINGDOM By Stephen D. Nutley

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS Proceedings of a Conference held at Stockholmsmassan, Alvsjo, Sweden, 21-24 May 1989, organized by the Swedish Board of Transport in co-operation with the Department of Traffic Planning and Engineering, Lund Institute of Technology.

Edited by Claes-Eric Norrbom Swedish Board o f Transport, Sweden and Agneta Stahl Lund Institute o f Technology, Sweden

First published 1991 by Gordon and Breach Science Publishers Published in 2021 by Routledge 2 Park Square, Milton Park, Abingdon, Oxon 0 X 1 4 4 R N 605 Third Avenue, New York, N Y 10017 Routledge is an imprint of the Taylor & Francis Group, an informa business Copyright © 1991 Taylor & Francis A l l rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. Notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. Disclaimer The publisher has made every effort to trace copyright holders and welcomes correspondence from those they have been unable to contact. I S B N 13: 978-2-88124-763-7 (hbk)

Publisher's Note: The publisher has gone to great lengths to ensure the quality of this book, but points out that some imperfections from the original may be apparent.

CONTENTS

INTRODUCTION TOTHE SERIES PREFACE ACKNOWLEDGEMENTS OPENING SPEECH C.-E. Norrbom

xvii xix xxi xxiii

PLENARY SESSION I: EXPECTED CHANGES: SOCIETY, INDIVIDUAL. INDUSTRIALIZED AND DEVELOPING NATIONS The Elderly in Past and Future Perspectives B. Oden

1

Expected Changes in the Health Situation for the Elderly B. Steen

9

Expected Changes in the Health Situation for the Disabled: Increasing Numbers? P. Minaire

15

Expected Changes in Technology and Transportation P.R. Oxley

20

PLENARY SESSION II: APPROACHES - A STATE OF THE ART Towards Mobility as a Human Right: Sweden’s Policy on Mobility for the Disabled C. -E. Norrbom

28

The Situation in Europe A. Frye

37 V

VI

CONTENTS

The US Approach to the Needs of the Elderly and Disabled S. Rosenbloom

49

Towards a Doctrine of Mobility as a Human Right D.L. Lewis and L. Suen

61

Transport for Elderly and Disabled People in Developing Countries M. Heraty 107 Towards Mobility as a Human Right B. Carlsson

121

PLENARY SESSION III: A CONFERENCE SUMMARY OF WORKSHOP SESSIONS N. Ashford

125

PLENARY SESSION IV: WHERE TO GO FOR THE NEXT DECADE - PANEL DISCUSSION Bengt Lindqvist

132

SESSION A: POLITICAL PERSPECTIVES AND POLICIES Al: MOBILITY AS A HUMAN RIGHT: EUROPE AND NORTH AMERICA Freedom of Movement: A Positive Concept R . Belli

149

Principles Supporting an Integrated Model of Municipal Transportation J.D. Baker

156

The Voluntary Sector Contribution P. Beecham

165

A 1987 Trip-based Urban Transportation Strategy - Still Ignoring the Needs of Elderly and Disabled People I. Lavery and P. Anderson 175

CONTENTS

vii

A2: MOBILITY AS A HUMAN RIGHT: AFRICA AND LATIN AMERICA Mobility - A Human Rights Issue J.T. Malinga

184

Public Transport in Latin America P.R, Cruz

188

A3: MISCELLANEOUS PERSPECTIVES Healthy Public Policy for the Autonomous Living, Moving and Transportation of People with Special Needs A.B. Leventi

200

Planning, Disabled to Enjoy Facilities and How to Fund Organization Projects W.K. Anyanzwa Amatekwa

212

Innovative private Sector Roles in Transportation E. Johnson and S. Stiles

223

Mobility Assistance for Disabled People in the UK A. V. Stokes

234

A4: REGIONAL STRATEGIES Transportation for Disabled Persons in Ontario: Towards a Strategy for the 1990s D.L. Lewis, B.M. Guthrie and P. Friedrichs

240

Improving Opportunities for Statewide Travel in Massachusetts D. Karuth and R.H. Thatcher

252

Community Transport Marketing and Its Effect on Elderly Persons: Policies, Strategies and Implications J. Abbiss, S. Cassidy, D. Gillingwater and S. Swift

265

Transport for Mobility Handicapped People: The Scottish Experience A. Rees and H. Howatt

277

viii

CONTENTS

A5: OTHER STRATEGY ISSUES Municipal Policy and Stimulation of Mobility of Elderly and Disabled Persons P. Snoeren

289

Guide as Tools for Better Mobility and Transport T. Roll-Hansen

299

SESSION B: ENHANCED MOBILITY

Bl: TRAFFIC SAFETY

Problems of Elderly Road Users: A Matter of Changing Persons or Correcting the System? R. Risser

311

The Elderly in Traffic: Mobility and Road Safety P.I.J. Wouters

323

B2: TRAFFIC SAFETY Differential Response by Elderly and Other Pedestrians to Two Safety Campaigns A. Katz

332

Improving the Mobility and Road Safety of Elderly People (New Planning Strategies in Amsterdam) J. Wolters

344

Study of Human Factors of Elderly and Handicapped Passengers in Public Transportation Safety K. M. Hunter-Zawors/ci

351

Accidents among Elderly People and Their Experience of Having Met with an Accident E. Petersson

360

B3: ADAPTATION OF THE INFRASTRUCTURE Architecturally Conditioned Protection of Elderly and Disabled Pedestrians ion Urban Areas A .E. Gaiko wski

363

Providing for People with a Mobility Handicap N. W. Lee

372

CONTENTS

IX

Providing Safer Urban Streets for Elderly and Handicapped Pedestrians C. V. Zegeer and S.F. Zegeer

378

Access to Heritage Areas - Is It Possible? R. A. Fern

390

Expo ’86, Vancouver: A Model for Accessibility L. Suen

397

B4: TARGET GROUP NEEDS AND CAPACITIES The Concept of Need in Social Policy P.-E. Liss

414

Control and Policy in London’s Dial-A-Ride P. Cordwell

426

B5: LOCATING THE TARGET GROUP A Study of Handicap with the Elderly and Their Trip Characteristics in Japanese Case T A ki ya m a

437

Transportation and Disabled Persons: A Canadian Profile L. Suen and T. Geehan

448

SESSION C: PRIVATE TRANSPORTATION

Cl: ADAPTATION OF PRIVATE VEHICLES

Personal Mobility for Disabled and Elderly People J. White

460

The Efforts Required to Control Cars S. W. Tonkin

472

Determining the Wheelchair Storage Capability of Personal Passenger Vehicles D. Lewis and P. Friedrichs

484

Vehicle Inboard Device for Wheelchair Storing M. Gou, F. Cardolles and H . Bouchard

495

X

CONTENTS

C2: THE DISABLED DRIVER An Evaluation of the Benefits from Increasing the Mobility of Disabled People through Car Adaptations and Driver Training M. Heraty and P.R. Oxley

501

The Forum of Driving Assessment Centres in the United Kingdom M. Cornwell

513

The Development, Aims and Function of Banstead Mobility Centre M. Cornwell 525 The Integrated Approach of Traffic Instruction H. Lalkens

535

Aging, Disability and Driving Performance B. Simms

538

Seat Belts and Disabled People B. Massie

549

C3: THE ELDERLY DRIVER An Evaluation of Mature Driver Performance S.J. Flint, K.W. Smith and D.G. Rossi

555

Driver Licensing for the Elderly P.F. Waller

567

The Performance of Drivers with Physical Limitations at T-intersections K.M. Hunter-Zaworski

576

Optimizing Night-time Sign Performance for Older Drivers P.L. Olson

592

On Travel Behavior of the Elderly and Some Problems on Driving Cars by Elderly K. Shimizu, K. Kimura and M. Furuyama

602

C4: THE ELDERLY DRIVER Elderly Car Drivers: Social Factors Influencing Risk Exposure and Risk Perception P.-E. Barjonet and J.-P. Cauzard

612

CONTENTS

xi

Mobility for an Aging Society: Issues and Challenges S.R. Godwin and W.G. Bell

623

Traffic Accidents Involving Elderly Drivers - Types and Circumstances M. Berntman and A. Stahl

641

Age-related Changes in Accident Causation as a Guide to Countermeasures L.R. Matthews and W.R. Jones

648

C5: EDUCATION AND TRAINING The Disabled Learner Driver B. Simms

660

The Cerebral Palsied Driver: Can You Drive with Involuntary Movements? A.-S. Ponsford

669

SESSION D: PUBLIC TRANSPORTATION

DI: ADAPTATION OF PUBLIC TRANSPORTATION SYSTEMS Application of Ergonomics to Transportation Systems and Technology for the Elderly and Disabled R. M. Heron

681

Public Transport on Ground for Elderly and Disabled Persons: Development and Measures in FRG D. Sack

689

Polish Experiences in Solving the Problems Concerning the Barriers in Urban Transport Systems L. Schwartz

700

D2: ADAPTATION OF PUBLIC TRANSPORTATION SYSTEMS A Bus System with Elevated Bus Stops S. Stare and A. Stahl

711

Service Routes in Boras S. Forsberg and A. Stahl

721

xii

CONTENTS

New Roles for the Intercity Bus in North America: The Prospect for Elderly and Disabled Travellers F. D. Fravel and P.M. Lebeaux

732

Socio-economic Implications of Accessible Intercity Bus Services B. M. Guthrie

744

D3: ADAPTATION OF PUBLIC TRANSPORTATION SYSTEMS A Twenty Year Plan to Achieve Fully Integrated Accessible Transport T. Meadows

755

Efficient Use of Bus and Taxi in the Country-Transport Service and “ Travelling Service” in Coordination G. Lundborg and S. Lundberg

770

The Bus Buddy Program of the Handicapped Action Committee of Victoria, British Columbia, Canada J. Neubaeur

775

D4: ADAPTATION OF PUBLIC TRANSPORTATION VEHICLES Features on Buses to Assist Passengers with Mobility Handicaps C. G.B. Mitchell

780

Physically Handicapped Persons in Public Transportation: Guidelines for Vehicle Design J. Petzall

791

D5: ADAPTATION OF PUBLIC TRANSPORTATION VEHICLES Modifications of a Bus to Demonstrate Design Features to Assist Elderly and Ambulant Disabled Passengers E.F. Stait and C.G.B. Mitchell

800

Special Vehicles and Taxis for the Elderly and the Disabled J. Petzall

810

Efforts on Human Public Transport C. Jervang

817

CONTENTS

xiii

SESSION E: SPECIAL TRANSPORTATION SYSTEMS

El: SPECIAL TRANSPORTATION SYSTEMS

The Redevelopment of Transport for People with Disabilities in New Zealand since 1981 D. Henderson

828

Special Transportation Systems in Sweden: An Evaluation of the Effects of Changed Quality of Service L.-G. Krantz

842

Greater Manchester Passenger Transport Authority towards an Integrated Accessible Transport Network S. Wright

850

E2: SPECIAL TRANSPORTATION SYSTEMS Specialized Transportation for Total Mobility B.J. Singleton

868

Community Transport: The London Experience S. Kearns

879

Transportation of Minority Elderly Population: A New Area for Special Service Expansion L. Sen and A. Radhakrishna

889

E3: OPERATION OF SPECIAL TRANSPORTATION SYSTEMS The Development and Implementation of Information Technology Applications in Community Transport: A Case Study of the ‘Multi-Trip’ Integrated, Modular Database Management System S. Bennett

900

Computer-assisted Management of Special Transit Services for the Disabled B. Chown

913

Experience of Cost-reduced Handicap Transports with Maintained Level of Service H . Arnbert

920

XIV

CONTENTS

A Model Program for the Cost-effective Delivery of Transportation Services for Elderly and Disabled Persons R.L. Martin

928

E4: OPERATION OF SPECIAL TRANSPORTATION SYSTEM Conducting Needs Based Planning and Service Evaluation G.J. Kane

936

A Mandated Statewide Program of Coordinated Specialized Transportation: The Florida Experience W.G. Bell

947

How to fill up Your Bus: The Readibus Experience P. Absolon and S. Bowlby

953

Demonstration Project: DATS Brokerage Revisited, Edmonton, Canada G.R. Latham

965

E5: TECHNICAL DEVICES Evaluation of Audible Pedestrian Traffic Signals N. Valerio and A. Y.R. Szeto

978

Low Cost Mobility Devices T.G. Krishna Murthy, P.K. Sethi and A. Ward

988

Evaluation of Portable Ramps - Selection and Use G.M. Sweeney, A.K. Clarke, S J . Bulstrode and R.A. Harrison

995

SESSION F: TRAVEL NEEDS AND TRAVEL PATTERNS FI: TRAVEL NEEDS AND TRAVEL PATTERNS Long Distance Mobility of the Elderly E. Chaigneau and J.F. Lefol

1006

Travel Activities of the Elderly in Sweden - Changing Patterns and Needs B. Vilhelmson

1019

Car Ownership and Travel Patterns among Elderly People S. 0lnes and J. V. Haukeland

1031

CONTENTS

xv

F2: TRAVEL NEEDS AND TRAVEL PATTERNS Needs and Travel Habits among the Transportation Handicapped in Montreal J.-P. Belisle

1041

The Role of London’s Transport Services in Catering to the Needs of Elderly and Disabled People P.R. Oxley, M. Heraty and T. Shaw 1053 Travellers with a Mental Handicap in Urban Areas of France: A Series of Research Studies 1984-1988 D. Velche

1061

F3: TRAVEL NEEDS AND TRAVEL PATTERNS A Study on the Mobility of the Elderly in Changsha, China Z. Yiwu and T. Shumei

1073

F4: EVALUATION METHODS The Benefits of Providing Appropriate Accessible Transport P.R. Oxley

1083

The Role of Approximate Analytic Models in the Planning of Specialized Transportation Systems J.-P. Belisle and F. Soumis

1099

Evaluating the Quality Provided by Private Sector Special Service Contractors A.M. Pagano and C.E. McKnight

1108

Travel Choice and the Transport Disadvantaged: An Activity Analysis of Dial-A-Ride Users. Preliminary Findings J. Sutton

1119

F5: TECHNICAL DEVICES Ergonomics of Translaid, a Transportation Terminal Check-in Device for Travellers with Hearing Speech or Language Difficulties R.M. Heron, U. Rutenberg, C. Dickson and J.H. Morgan 1128 Elderly and New Technology: Analysis of Behavior in Front of an Automatic Information System for Public Transport Network A. Pauzie and M. Dejeammes 1139

INTRODUCTION TO THE SERIES This broad-ranging series of books will cover many of the varied aspects of transportation. The subject area will be generally divided into two parts: the first deals with planning and technological aspects of transportation, the second with specialised transportation. Within the context of this series, technology and planning will include the wide spectrum of various aspects of the design and planning of vehicles and infrastructure for the transport of freight and passengers, as well as operational and management considerations. The general aim of the planning and technology series is to inform readers of the state of the art and to summarize the status of transportation. The second part of the series will seek to generate monographs dealing with improving the mobility of those groups in society increasingly characterized as the transportation disadvantaged, particularly, but not exclusively, the elderly, the disabled and families with low incomes. It is anticipated that the content of these books will be derived largely from research, policy analysis and documental field experience. The subject matter will include advances in the relevant technology, service and methods demonstration, improved planning and methodology, major or proposed changes in the public policy and innovative proposals for the development or change of systems. Occasionally, more specific monographs will be published, presenting the results of individual studies in areas of special interest to planners and technologists. As with any monograph series, the emphasis is on current information, and the material will be of interest to the transport practitioner, the postgraduate student and the academic working in the field. NORMAN ASHFORD WILLIAM G. BELL It is with great sadness that we record the death of Dr. William G. Bell in April 1990. Co-editor of this series, Dr. Bell, in a relatively short period of activity in the area of transportation, materially improved the access of elderly and handicapped persons to public and private transportation. We have all benefited from his life’s work and there is no better memorial to his life. NORMAN ASHFORD XVII

PREFACE

As hosts, we at the Swedish Board of Transport and the Lund Institute of Technology were most pleased with the outcome of the Fifth International Conference on Mobility and Transport for Elderly and Disabled Persons. Over 380 delegates, representing some 40 countries, attended the conference. Many of the delegates came from developing countries. Speakers from 26 nations contributed with presentations. We were particularly pleased to welcome a large number of disabled people. We were also pleased to be able to contribute toward travel expenses and conference registration fees for several participants. The conference motto “ Towards Mobility as a Human Right” is grounded in the belief that mobility is, in fact, a human right. The conditions for social equality, life quality and full participation on equal terms are implied in “ mobility as a human right” . Conference delegates arrived at several conclusions, including the following: Political decisionmakers have become more actively involved in working towards better transportation opportunities for the disabled and elderly. Vehicle manufactureres must become more aware that making a product more attractive also means that it must be accessible and usable for all groups of people. Traffic planners must become more attuned to the importance of developing an unbroken chain of transportation. Traffic operators must assume greater social responsibility. The research in this field must intensify. We need to continue working on a wide front, and the intensity of this work must increase. Each of us must assume greater responsibility. It is with high expectations that we look forward to the next conference in Lyon, France, July 1992.

CLAES-ERIC NORRBOM Conference Chairman

XIX

ACKNOWLEDGEMENTS

A great many individuals and organizations helped make the conference a success. The Swedish Board of Transport and the Lund Institute of Technology are grateful to the Conference Steering Committee and the Technical Committee for the many hours that they spent in organizing the program to ensure that the best possible contributions were reflected. The committees were made up of the following individuals. Conference Officers Claes-Eric Norrbom, Conference Chairman Agneta Stahl, Conference Coordinator Bengt Holmberg, Chairman, Technical Committee Eva Vowden, Secretary Conference Steering Committee Norman Ashford, UK William Bell, USA Ingemar Backstrom, UITP (Sweden) Barbro Carlsson, NASD (Sweden) Ann Frye, UK Lars Sandberg, NOP (Sweden) Jack Short, CEMT Ling Suen, Canada

XXI

Technical Committee David Lewis, Canada Joshua T. Malinga, Zimbabwe C.G.B. Mitchell, UK Sonneve 01nes, Norway Ewald Pajonk, FRG Jan Petzäll, Sweden Joseph T. Revis, USA Stephen R. Stiles, USA Bertil Vilhelmson, Sweden

OPENING SPEECH BY MR. CLAES-ERIC NORRBOM, CHAIRMAN OF THE ORGANIZING COMMITTEE FIFTH INTERNATIONAL CONFERENCE ON MOBILITY AND TRANSPORT

It is a great honour to welcome you all here on behalf of the Organizing Committee. It is a great privilege to see the Swedish Minister of Transport and the President of the Stockholm City Council among us, and I also feel very pleased to be able to welcome so many prominent speakers. We have received many valuable papers - we are happly to see between 300-400 highly qualified delegates from 39 countries here. In Vancouver, when I first had the honour of inviting you to this conference in Stockholm, I emphasized the importance of a continued wide discussion on a broad international basis on how to improve the means of mobility for the disabled and the elderly. I also emphasized the importance of a continued discussion about the adaptation of public transport and the creation of complementary systems. I also stressed the importance of improving the situation both for the disabled and the elderly. Mobility has become a prerequisite for growth in society, perhaps even for its prosperity. Several factors affect the need to travel; Expanding labour markets, accessibility to social service, a concentration and specialization of different social functions, urbanization. Mobility naturally appears to be even more important to the disabled, who are often isolated. The demand for good transport facilities is further increased by the fact that in many places the rise in population is much more rapid among really old people, and their lifestyle is considerably more active than earlier. The possibility to travel and move around is of basic importance to the life quality of each individual. This means that questions of transportation are of the utmost importance in a process which aims to realize targets within the policy for the disabled as regards full participation on equal terms. This is the reason for choosing the motto “ Towards Mobility as a Human Right” . X X lll

XXIV

OPENING SPEECH

In Vancouver I also mentioned the importance of discussing questions concerning the mobility problems of the elderly and the disabled both in industrialized and developing countries. In view of this I am especially pleased to see representatives from several developing countries here. It is of course important that we learn from one another. I am also happy to see the participation of the disabled and the elderly organizations. The responsiblity for a development which makes Mobility a Human Right lies in many hands. The politicians have a great responsibility as well as decision makers on different levels in society, researchers, manufacturers of transport modes, transport operators. But the work, which these people carry out, must take place in open dialogue with the organizations for the disabled and the elderly in society, a dialogue which must be based on a genuine understanding of the problems. It is, therefore, a great pleasure to see so many representatives here from the already mentioned groups. As far as political decisions are concerned I would like to emphasize the importance of action both within the field of handicap policy as part of the social welfare system as well as decisions within the framework of transport policy as a whole. In my opinion every transport political decision should include the mobility aspect for the elderly and the disabled to ensure adequate supply of transport for its citizens. In principle, I think we should adapt the concept of integration and normalization which implies that traffic facilities are adapted to human beings and not vice versa. Public transport modes should be designed so that people with special mobility problems can also use the system on equal terms. This means that public transport should be available to all categories of passengers, but it is also important that people who cannot use public transport should be helped by special service systems not only for shorter trips but also over large distances. We also have to consider the use of private cars. The outline of the programme for the conference means to create a picture of the changes in society, changes in the social structure and in human behaviour, which lead to the need for increased mobility. The second part of the programme aims to discuss the policies and measures of different countries. This will show how the social responsibility of different countries have been designed, how legal measures, financial measures are used in some countries, while other countries rely more on voluntary measures and recommendations. We will also discuss how much adaptions to the needs of the disabled and the elderly should be allowed to cost. The question of good intentions will be balanced against financial realities. Day 2 will deal with problems, needs, measures and case studies in paper

OPENING SPEECH

XXV

sessions and work-shops for urban and regional, interregional and long distance traveling. The plenary session in the morning of Day 3 is called “ Where to go for the next Decade” . It will deal with the policies of today/tomorrow and the experiences we have achieved during this conference; How to approach our problems, research needs, the implementation of different adaption alternatives and how to evaluate these alternatives. During the afternoon we will discuss “ The next decade - Possible trends and solutions” with a panel of politicians, experts from both the industrialized and the developing countries and the disabled and the elderly organizations. It is my hope and belief that the Conference will form a constructive dialogue between all who have come here; That we are better motivated at the end of this Conference to take steps and measures towards improved transport for the elderly and the disabled, that we have reached a better understanding of the elderly and the disabled and their need of - and indeed right to transportation on the same conditions as other groups in society. I further hope that we all leave the Conference with concrete ideas of how to implement this knowledge.

PLENARY SESSION I: EXPECTED CHANGES: SOCIETY, INDIVIDUAL. INDUSTRIALIZED AND DEVELOPING NATIONS

The Elderly in Past and Future Perspectives Birgitta Odén The task I have been given at this conference is to describe the situation of the elderly in the perspectives of the past and the future. As a historian I can present the past, but since I am not a statistician, I have to rely on other people's results when presenting the future. The four themes which I shall treat today are: • • • •

the number of old people the relations of old people to their families old people and institutions. transportation

1. The number of old people My first question is: were there many old people in the past, and how many will there be in the year 2000 and the following decade? A historian has good reason to be fairly confident when tackling the question of the number of old people in historical times. In Sweden we have unusually good source material, which enables us to determine how many old people there have been since the eighteenth century down to the present. Moreover, the evidence exists in such a long series that it allows us to make relatively certain forecasts for the next few decades. We who shall be old in 1990, 2000, and 2010 have already been born, so we can be relatively certain in our estimates of how many of us will be alive at the turn of the century. Let us first of all see the historical development of the proportion of old people: Table 1.

Percentage of people over 65

Date

Number

1750 1850 1900 1950 1970 1980

110,000 168,000 430,000 721,000 1,113,000 1,362,000

% 6.2 4.8 8.4 10.2 13.6 16.4

We can see, first of all, that the number of old people has grown rapidly in the last 200 years. This increase was heaviest in the 1880s, when the number of old people more than doubled. Another point revealed by the table is that there were relatively few old people in the eighteenth century - 6 per cent in Sweden - as in most European countries in the mid-eighteenth century. It is not until our own times that the proportion rises significantly.

1

2

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

But does this mean that old people in the past were a negligible problem? That there actually were not so many to be supported and cared for? A look at the historical sources will show that old people were to be found in every parish, in every town, and that they could sometimes be a great problem both for themselves and for the authorities. Yet they were also a resource, a surplus labour force that could be used for light work and at times when agricultural jobs had to be done quickly - as at harvesting and potato digging. More can be said about this elderly group of 6 per cent which the statistics present. Old age came earlier in the past. The parish registers of deaths often describe people in their fifties as feeble, sickly, crippled, old. This was especially true of the lower classes in society, those who were most severely afflicted by occupational injuries and by working in injurious environments . Death in the past could afflict all age groups in a way different from today, when most people can count on experiencing old age before they die. In former times the age group with the highest death rate were the infants, but even young people were vulnerable, especially to tuberculosis and epidemics. Those who did reach the age of 50 were the strongest or the most privileged. And they could count on quite a long "average remaining lifetime". But it is not until our own times that medical and social progress has increased the possibility of attaining this long life as an old person. Today we who are around 65 can reckon with a third life - 15 years as pensioners. What will the future be like? Taking the past and the present as a starting point, statisticians make population forecasts for tomorrow’s groups of old people. This is done on the basis of various assumptions, which sometimes have to be modified. The current view is that the survival potential of old people particularly men - has hitherto been underestimated. This means that figures for the proportion of old people in the future should probably be higher rather than lower. Table 2 Date 1980 1990 2000 2010 2020

Percentage of people over 65 Number 1,360,000 1,491,000 1,397,000 1,470,000 1,631,000

% 16.4 17.9 16.8 17.9 19.5

The heavy increase in the number of old people which we have seen in the last two decades, culminating in 1990, will subsequently level out to a certain stagnation, but a new peak will be reached between 2010 and 2020 as a result of the high birthrates of the 1940s. It is estimated that in 2025 one person in five in Sweden will be a pensioner. But these variations in the number of old people in the future are not the most dramatic prospect. What is most dramatic is the

THE ELDERLY IN PAST AND FUTURE PERSPECTIVES

3

relative proportion of younger and older pensioners. The number of 90-year-olds will be many times greater in the first decades of the twenty-first century. This peak corresponds to the high birthrate of the 1920s. The baby boom of the 1940s will then have its effect after 2025. By 2040, when the number of old people will be at its maximum, there will be about 1.6 million people over 65; 600,000 of them will be over 80. When those aged 90 and over are at their maximum, around 2000, there will be about 65,000 of them. Today we know that old people over 80 are those who require most care, consume most medicines, and need doctors most. This is especially true of old women. The crucial problem is therefore how the health and living conditions of the very old will develop. The project in which I am involved - and which Bertil Steen will no doubt tell you more about - is working for an improvement in the health of the very old and for their integration in society. So, the answer to my first question - about the number of old people in the past and in the future - is that we are facing a future problem which is large but not insuperable. Much depends on how we can handle the political problem - the elderly in society. 2. Old people and their networks This brings me to my second question: the relation of old people to their families, the immediate group in the social network. It is important to distinguish between three different types of family relationships: • • •

husbands and wives children and grandchildren brothers and sisters, their families, and other relatives.

This division is necessary because the responsibility for care is very different for these different degrees of relationship. Let us begin by looking at the responsibility for the elderly in historical times. Responsibility was dictated in the medieval laws of Sweden. It was primarily the children, and secondly the heritable relatives, who were obliged to care for the old master and mistress of the household when they became ill or disabled and no longer able to work for their food. These laws, as you observe, applied to those who owned something, primarily those who had farms to work or who owned property in the towns. This corresponded closely to the medieval production structure. Most of the population - and those who enjoyed power - were farmers. In the Middle Ages and the sixteenth century the result of this was that aged parents lived in the households of their children. As late as the eighteenth century, calculations show that 70 per cent of old people were living with their children when they died. Other old people could also be kept in the household through boarding agreements. Gradually, however, another system was developed - the undantag or retreat. This meant that old people moved out into their own little household, where they were provided by contract with food and fuel by the person who

4

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

had taken over the farm. This may sound like an ideal arrangement, but it involved conflicts between the generations. The young people who farmed the land, and whose duty it was to reproduce the family, had the burden of supplying the food stipulated in the contract. Contemporary observers complained that the young people wished the old people dead. There are even tales of how they murdered them with arsenic or powdered glass, but there is no reliable evidence for this. We now know fairly well how many old people lived along with their children around 1900. It was most usual for old people to live alone or with their spouse. Only a few aged couples lived with the children's families, but rather more widowed parents. The most common form of cohabitation was for an unmarried son or daughter to live on with the parents. This pattern is noticeably different from the myth of the extended family, but not very different from today's living patterns. Nowadays 6 per cent of old people live with their grown-up children or other family, whereas 89 per cent live alone or with their spouse. What we can observe, then, is that the cohabitation of grownup children and aged parents, which was considered normal in medieval and early modern times, was replaced in the course of the nineteenth century by the separation of these generations. At the same time, the ties of responsibility began to weaken. Liberal ideas of social politics caused people to question whether children really ought to have responsibility for the care and financial support of their aged parents. Self-help became the watchword. It was only with the development of the pension system that it became possible to realize this ideal. The passing of the Social Services Act of 1956 ended the formal legal responsibility of grown-up children for their aged parents. It goes without saying that this did not put an end to informal care and voluntary responsibility based on reciprocality and love. A recently published study shows that a deeply rooted system of solidarity is still functioning, especially in the working class. People may not live with their parents, but they still help them when they need it. Let us now look at the development of the most common dwelling form for old people - alone or in couples. An essential aspect of marriage has been for spouses to help and care for each other in their old age. In former times it was only death which brought an end to this. The few studies of skeletons which have been made show us that there were more men than women among the elderly. Malnutrition and frequent childbearing raised the mortality rate for women. Yet by the eighteenth century, when we have our earliest population statistics, this had changed. There were now more women than men in the oldest cohorts. In the twentieth century the life expectancy of women has increased dramatically. The mean life expectancy for women today is 79.7, as against 73.8 for men. Moreover, since women are often younger than men, this means that the group of lone old women is extremely large. The forecast is that this tendency will increase, partly as a consequence of a higher divorce rate. In 2000 there will be 58,000 more single than married old people, and 79 per cent of them will be women. Single women over 80 will be the demographic

THE ELDERLY IN PAST AND FUTURE PERSPECTIVES

5

risk group of the future. Let us finally broaden the concept of kinship by going beyond the nuclear family to ask whether more distant relatives have been responsible for old people. The historian David Gaunt has shown that an old person at the end of the eighteenth century and the beginning of the nineteenth had few living relatives. On top of this, migration increased in the nineteenth century, spreading brothers, sisters, nephews, nieces, and cousins beyond parish boundaries and often to foreign countries. Gaunt also shows that people nowadays have more living relatives than has ever been the case, and by simulation he calculates that people who reach pension age in 2000 will have between 11 and 15 close relatives still alive. Since geographical distances today are not as significant as in the nineteenth century, many of them will probably be living near their aged relatives. Two of my colleagues have conducted a comparable simulation study for women only. They have shown that, despite the large number of living relatives, the group of very old women will nevertheless have few or no close relatives. Before I leave the responsibility of the family for providing care, I would like to consider for a moment yet another responsible circle: the neighbours. In the villages of the sixteenth and seventeenth centuries, before the enclosures, a great deal of the work was done collectively. In addition, households were closely linked by ties of marriage and kinship. Work and kinship were the basis for a culture of community. The enclosures broke up the villages and the collective working methods, and kinship relations were severed when people moved apart. Work was less frequently communal. Nevertheless, a culture of community survived, and even today we can still find neighbour networks in the countryside: although they do not really provide care, they do function as a safety alarm for old people and people living on their own. Throughout this time from the Middle Ages down to the sixteenth, seventeenth, and eighteenth centuries, society had a decidedly patriarchal mentality: giving care was the duty of the family, or rather the family household. In the mid-nineteenth century, however, this ideology began to break up, as the ancient tradition of care in the family and the kindred found itself in a severe crisis. As often happens when a problem begins to be visible in society, the entire question became politicized. This brings us to the third form of responsibility for old people: the collective society as a whole. 3. The responsibility of the community The idea that the collective is responsible for people in need can be traced back to the first Christian communities. These often consisted of single men and women who had left their families. The collective took the place of the kindred. Various forms of institutional care were established within the sphere of the church, which also preached the responsibility of every individual for his neighbour - by giving alms one could be sure

2

6

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

of a reward in the life to come. What sort of care was given in the collective forms of the hospital, the poor-house, the workhouse, and the old people's home? Who were the old people who were cared for there? The hospital or asylum was originally an ecclesiastical institution under state control and with financial support from the state. Old people here were one group among several others: the mentally ill, the lepers, and the severely handicapped. It was state policy to reduce the proportion of old people here by moving them home to their local authority. The old people who remained were given the same care as the sick. The food was not so bad, but the staff was quite inadequate. In some rich towns the hospitals developed in quite a different way. Here the urban authorities assumed responsibility for the hospitals, organizing them in such a way as to provide rich citizens and their wives with good care in their old age: plenty of food, a place of their own, and the right to have their own servants. Thus arose a strictly class-segregated form of care for the aged, since poor relief was often part of the same organization . In the countryside, the elderly poor, unable to work and lacking relatives, were, cared for in the cheapest possible way: they were boarded in households, either permanently or by rotation, or they wandered around begging. However, a certain degree of institutionalization began to emerge as early as the seventeenth century in some parishes. In poor-houses and other charitable institutions, old people could find a bed, but they were not fed or cared for. Each person was given food and firewood and expected to cook for himself. As for care, the old people looked after each other. From the end of the eighteenth century the parish had the right to impose a tax to pay the costs of poor relief. The Poor Relief Act of 1846 made it the duty of the local authorities to provide for old people who had no relatives to fall back on. When the number of old people increased heavily in the latter half of the nineteenth century, chiefly in the unpropertied groups who were born around 1800, the collective had to intervene with new forms of care. Workhouses were established, run by superintendents and financed by the inmates' own labour. The idea came from England, and the guiding principle was that everyone should work. At the beginning of this century, when the care of the elderly became a prominent political problem, new forms of care were developed, which distinguished old people from other categories: old people's homes emerged. They were different from the workhouses in that there were more nursing personnel and the old people were no longer obliged to contribute anything. It is often said that old people were turned into objects, things to be looked after. The old people's homes had developed out of the poor-houses, of which they still bore the stigma: they were felt to be a dumping ground for the very poorest. Moreover, the institutional model was the hospital: shared bedrooms, nursing staff, discipline. The clientele continued to be heterogeneous. What they had in common was that none of them wanted to be there. We all know that our increased prosperity and our ideological

THE ELDERLY IN PAST AND FUTURE PERSPECTIVES

7

welfare state has gradually changed the institutional forms. People with mental illnesses and senile dementia have been moved from the old people's homes into other forms of care. Old people's homes have been replaced by service blocks and other collective dwelling arrangements. Long-stay hospitals have been established. At present the organization is under total review. Instead of going into the alternatives available, I shall merely summarize the trend: from the middle of the twentieth century, institutional care of the elderly has ceased to be seen as a form of care for the poor, the social outcasts. Institutional care has been accepted throughout society for all those in need of care, regardless of their social class and income. Needless to say, there are higher expectations as regards both the availability of places and the quality of care. In the 1970s the cost to the state of care for the elderly rose much more quickly than the number of old people. This was because the quality of care had been improved. It is unreasonable, undesirable, and improbable that the level of quality can be reduced. It is from this point of view that the future of the care of the elderly appears to be in crisis. The very old, whose number will increase dramatically towards the end of the century, must have the opportunity of receiving adequate care without having to stand on long waiting lists. They should also have the possibility of choosing their own form of care, which means that the state must provide flexible alternatives. 4. Transportation Let me finish this presentation of the elderly - past, present, and future - by asking a question which is relevant to this conference: what are the transport needs of old people in the past, the present, and the future? It is obvious that old people in a sparsely populated country like Sweden, with its great distances, needed transport in the past. Few traces of this appear in our historical sources. In some cases, however, this need was publicly regulated and recorded, thereby becoming accessible to historians. This applies chiefly to old farmers who left their land to their children or else sold it off, while retaining the right to support during their lifetime. The contracts for this purpose generally included stipulations that the old people were entitled to transport using the farm wagons and draught animals to get to church and on other essential errands. We also know that sick people who received poor relief to enable them to obtain treatment at a distant spa could also be helped with transport there. Our modern Social Services Acts of 1956 and 1980 emphasize the obligation of the local authorities to "ensure that elderly people have the opportunity of living independently and enjoying an active and meaningful existence in community with others." To attain this goal Sweden has introduced a transport service for the old and disabled. Since 1974 the state has been contributing funds to the local authorities to encourage the establishment of transport services. The right to this service is due to people with impaired functions, so that those who cannot use public

8

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

transport are granted cheap travel by taxi, not only or even primarily for medical care, but to maintain their network of social contacts and for recreational purposes. The rules and content of the transport service are determined individually by each local authority, which means that there are great variations from place to place. This was still the case in 1968, when only 54 local authorities out of about 250 had established a transport service (SOU 1979:64). A survey of the quality of this service, recently conducted by P. G. Edebalk, has found that the development has been highly diverse. More and more people have access to a transport service, but increased costs have led to certain restrictions, such as the obligation to book in advance or to share a car. If we disregard the quality and confine ourselves to the number of people who have the right to the transport service, we can see that the considerable differences that existed between local authorities in 1976 have been significantly smoothed out. At the same time, the proportion of old people (over 65) entitled to the service has risen from 9 per cent to 19 per cent. This is probably due in part to the increasing proportion of people in the very highest age groups, where mobility is greatly reduced. What does the future hold? With growing groups of old people and increasing lonesomeness for old women, we can reckon that a transport service with an undiminished quality will mean greatly increased costs for local authorities. There is then the risk that the local authorities will control the budget by being more restrictive in granting entitlement to the transport service or in the number of journeys they permit. Another way out is to raise the old people's own contribution to the transport costs, which would probably reduce the demand. It is obvious, however, that if the requirement of the Social Services Act is to be fulfilled, then Sweden's local authorities must continue to offer old people the opportunity to obtain help with transport - to day centres, to friends, to bingo halls, and to polling stations.

EXPECTED CHANCES IN THE HEALTH SITUATION FOR THE ELDER LY B e rtil Steen Professor, p h ysic ia n -in -c h ie f Gothenburg U n ive rsity, Vasa H ospital, Gothenburg, Sweden

1.

INTRODUCTION

Recent longitudinal studies have in many aspects been able to c o n trib u te to new knowledge about norm al ageing and to knowledge regarding the uncertain border-land between health and disease in higher age groups. A vailable data show also very c le a rly th a t the need fo r q u a lita tiv e ly high-standing diagnostic and th e ra p e u tic a c tiv itie s are necessary in the higher age groups. The a c tiv itie s by so cie ty fo r the e ld e rly must not be lim ite d to d iffe re n t kinds o f services, but very much also include specialized g e ria tric m edicine. This presentation is based m a in ly on the gerontological and g e ria tric population studies in Gothenburg which s ta rte d in 1971 (1) and which are s till (1989) on th e ir way. The aims o f these studies are to o ffe r health controls, to study norm al ageing and disease in old age, to fin d reference values, to develop and evaluate m edical and social in te rve n tio n , and to prevent disease and handicap. About 3000 people in three d iffe re n t cohorts have been studied since 1971 at ages 70, 75, 79, 81, 82, 83, and 85, making both longitudinal observation and cohort studies possible. 2.

NORM AL AGEING

2.1

Age and ageing

An im p o rta n t in fo rm a tio n fro m longitudinal studies o f the ageing process is fo r example th a t ageing does not necessarily mean a continuous decrease o f fun ctio n s fro m the mom ent m a tu rity is reached at age 20-25 and forw ards - as is o fte n claim ed in e a rlie r lite ra tu re . In fa c t it seems as i f very many functions are re la tiv e ly unchanged to about 75 years o f age when they on average s ta rt to decrease more m arkedly. And in fa c t the marked reserve ca p a city o f many organs and functions seems to be accompanied by a ra th e r slight d e te rio ra tio n in most e ld e rly. G enerally speaking, disease seems to be o f much more im portance to most e ld e rly than norm al ageing per se. A nother observation is th a t the younger e ld e rly o f today (age 65-75) seem to be m e n ta lly and p hysically somewhat more v ita l than persons at the same age just a few decades ago. Examples o f th is w ill be given below. But there are also opposite tendencies w ith an increase o f the incidence o f some diseases. It seems, however, th a t young e ld e rly up to about age 75 are a group o f individuals where the designation "e ld e rly" m ight be inappropriate. On the o th e r hand, the much discussed compression o f disease and handicap tow ards the very last p a rt o f 9

10

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

life seems to be a re a lity . Both these circum stances have o f course to be taken into consideration in planning o f health care o f the e ld e rly. A nother very im p o rta n t in fo rm a tio n is th a t fu n c tio n a l v a ria tio n is very large at one and the same chronological age. In fa c t we are o f the opinion th a t fu n ctio n a l age a t the chronological age o f 70 shows variations o f alm ost 20 years upwards and downwards in healthy in d ivid uals! And chronological age in fa c t seems to become increasingly less valuable as an in fo rm a tio n about the individual's fu n ctio n a l a b ility w ith advancing age. A very im p o rta n t question is c e rta in ly i f the m anifestations o f ageing are possible to influence and i f it is possible to get results o f tra in in g also in higher age groups. It seems now to be evident th a t it is possible also in high age to observe e ffe c ts o f tra in in g in fo r example skeletal muscle and regarding skeletal strength a fte r an increased physical a c tiv ity . There is also evidence th a t changes o f d ie t and stop-sm oking a c tiv itie s have a good e ffe c t also in the highest age groups. As discussed below, there is much indication th a t persons who are a c tiv e and have d iffe re n t interests keep th e ir in te lle c tu a l fu n ctio n s more easily during ageing. Such pre ve n tive lines o f thought must get more understanding w ith in the fie ld o f health care o f the e ld e rly. 2.2

Sociopsychological ageing

Psychological ageing has its basis in both biological and environm ental processes, but the proportions between the tw o are impossible to express more e x a c tly . Most fa c ts ind ica te , however, th a t the s tr ic tly biological changes are ra th e r in s ig n ific a n t as long as the general sta te o f health is s a tis fa c to ry . A common change w ith advancing age is a decreasing psychom otoric speed, i.e. rea ctio n tim e becomes longer. Regarding the im portance o f health in this respect it has been shown a re la tio n sh ip between cardiovascular disease and longer re a ctio n tim e . In very many p ra c tic a l situations the increasing re a ctio n tim e is o f small im portance. However, in situations covered by th is conference, nam ely in tr a ff ic , it may be o f utm ost im portance to re a liz e . It is a common b e lie f th a t in te lle c tu a l a b ilitie s , such as in te llig e n ce , m em ory and a b ility to solve problems, d e te rio ra te because o f norm al ageing. Results fro m investigations where the same cohort o f individuals were follow ed during a long period o f tim e show, however, only a slight decrease and, fu rth e rm o re , most pronounced in the very late part o f life . A number o f studies have shown th a t the results fro m m ental tests are worse in individuals w ith bad health than in healthy e ld e rly . C ardiovascular diseases are a group o f diseases which may give these e ffe c ts . Age dem entia syndromes, such as a rte rio s c le ro tic dem entia and A lz heim er's disease which have d ire c t e ffe c t on the neurons in the brain, influence o f course the m ental a b ility ve ry m arkedly, which is one

CHANGES FOR THE ELDERLY

11

o f many fa c ts showing th a t age dem entia syndromes are not p a rt o f physiological ageing. A social fa c to r o f utm ost im portance to the developm ent o f mental a b ility during ageing is m ental in a c tiv ity . Very many fa c ts indicate th a t a ctive individuals w ith d iffe re n t interests such as reading and p a rtic ip a tin g in courses re ta in th e ir in te lle c tu a l fun ctio n s much b e tte r during the ageing period than m e n ta lly in a ctive people. It is also a common b e lie f th a t ageing necessarily means d e te rio ra tin g m em ory. However, studies where the same persons are fo llo w e d during a long period o f tim e show no or only a slight decrease in mem ory a b ility w ith advancing age. Concerning s h o rt-te rm m em ory it seems th a t there is no change at a ll, while slight d e te rio ra tio n s can be seen regarding long-te rm m em ory. Individuals w ith a m arkedly disturbed m em ory are lik e ly to s u ffe r fro m diseases, most im pressively seen in age dem entia. R e la tiv e ly few people fe e l th a t th e y re a lly s u ffe r fro m loneliness. Some studies have shown th a t about one te n th o f people 65 years o f age and older o fte n experience loneliness. This is especially tru e among the very old. Social isolation is c e rta in ly one fa c to r re la te d to subjective loneliness. However, the most im p o rta n t reason is loss o f spouse. Loneliness has been shown to result in an increased need o f care. Despite th a t those experiencing loneliness have not more and not more serious diseases than o th e r e ld e rly, th e y fe e l more tire d and more ill, and pay more visits to doctors and nurses, have more drug m edication, and need more hom e-help services. It has also been shown th a t lonely e ld e rly have a higher m o rta lity , especially e ld e rly males. Regarding livin g conditions e ld e rly in the Scandinavian countries live under re la tiv e ly good circum stances. A big problem is, however, th a t an e ld e rly person may have d iffic u ltie s to manage a c tiv itie s o f d a ily life also w ith a re la tiv e ly sm all physical handicap. Lack o f e le va to r or a d if fic u lt staircase situ a tio n may lead to a situ a tio n where e ld e rly w ith w alking d iffic u ltie s w ill be e n tire ly house-bound. Younger e ld e rly have, however, few such problems. However, our studies show th a t about h a lf o f people in th e ir eighties have some kind o f w alking d iffic u lties. 3.

HEALTH OR DISEASE IN HIGH AGE

Knowledge is s till lacking regarding disease c rite ria in the higher age groups, which has an obvious bearing to both health screening and health care. The diagnostic d iffic u ltie s have many reasons. Knowledge about reference values and norm al values is s till incom plete. To be able to determ ine norm al values and disease c rite ria longitudinal populatio n studies are necessary, and such studies are lengthy and expensive. The lack o f disease c rite ria in high age leads to tw o consequences, nam ely over-diagnosis and o v e r-tre a tm e n t on one hand, and underdiagnosis and u n d e r-tre a tm e n t on the oth e r. Example o f over-diagnosis

12

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

is hypertension in e ld e rly women, and cardiac in s u ffic ie n c y in both sexes. However, also the risk o f under-diagnosis calls fo r a tte n tio n . It may be easy to in te rp re t symptoms o f disease as "only" signs o f norm al ageing. In th a t way the p a tie n t may miss his investigation and tre a tm e n t o f curable disease. Examples o f under-diagnosis and undertre a tm e n t are urin a ry incontinence in e ld e rly women, depression, states o f anxiety, and hearing in a b ility . The need fo r both gerontological and g e ria tric knowledge in health care o f the e ld e rly is, thus, obvious. There is a risk i f g e ria tric m e d icine is focusing too much on nursing, a c tiv itie s which, o f course, are also very im p o rta n t. However, e ld e rly p atients have to be diagnosed properly as well as younger p atients. This is a q u a lita tiv e problem as well as a q u a n tita tiv e one. As an example can be mentioned th a t a Swedish study showed th a t g e ria tric long-term care patients very often had hearing in a b ility and th a t this was o fte n under-diagnosed. Technical aids were not very common at th a t hospital, and the conclusion is th a t much more education and diagnostic a b ility are necessary. A nother example is a Swedish study where we examined in d e ta il all patients coming to hospital because o f "dem entia", where only 8996 o f the patients had an organic dem entia. As much as 1196 had curable conditions. The conclusion is th a t diagnostic sharpness must be encouraged in g e ria tric m edicine! Only a fte r an adequate and d e ta ile d diagnostic procedure the d iffe re n c e between norm al ageing and disease can be revealed. A fte r th a t tre a tm e n t and re h a b ilita tio n may bring the patients back to independent lives in th e ir own homes. 4.

HEALTH OF THE ELDER LY - BEFORE, NOW AND IN THE FUTURE

The im provem ent o f general v ita lity and health in 70-year-olds belonging to d iffe re n t cohorts during the period 1971-1982 can be observed fro m results showing im provem ent o f in te lle c tu a l a b ility , b e tte r oral state, decreased prevalence o f many diseases, and m arkedly low er m o rta lity . The proportion o f 70-year-olds livin g in in s titu tio n s decreased during th a t period o f tim e fro m 3.1 to 2.596. A t the same tim e the conditions o f livin g im proved, and so did the econom ical s itu a tio n . The decrease o f m o rta lity in old women in Sweden was more marked than expected during the 1970s. The proportion o f very old w ill be larger in the year 2000 than was expected as late as in the beginning o f the 1980s. From the 1960s the continuing increasing life expectancy in fem ales can be explained to not less than one h a lf by the decreasing m o rta lity in e ld e rly women. From the beginning o f the 1980s this is true also fo r males. This developm ent was unexpected, and seen in a h isto rica l perspective the life expectancy in 65-year-old women increased more m arkedly fro m 1960 and onwards than fro m 1750 to 1950. A 65-year-old Swedish woman in the year o f 2000 is expected to live u n til the age o f 86.4.

CHANGES FOR THE ELDERLY

13

The causes o f death which show the most marked decrease are the most common, i.e. cardiovascular diseases such as m yocardial in fa rc tio n and stroke. The m o rta lity o f stroke in 70-80-year-oId women decreased w ith 2% annually during the 1970s. H ealth and v it a lity is increasing in young e ld e rly in Sweden. On the oth e r hand, increasingly more individuals w ill reach ages where a so called incompensated ageing is common, and - as said before -th e number o f cases o f ce rta in diseases increases in high age. More than 60% o f males and alm ost 8096 o f fem ales at age 70 consumed on average 3.1 and 3.4 drugs, re sp e ctive ly, in the population studies in Gothenburg. A t age 82 9096 o f the males and 97% o f the fem ales consumed on average 3.9 and 5.4 drugs, re sp e ctive ly. A t age 82, thus, only 396 (!) o f the fem ales had no drug tre a tm e n t, and 5696 used 5 or more drugs. The most common drugs were analgetics, sedatives, d iu re tics and d ig ita lis . The extensive drug consumption leads to problems o f drug com pliance and in fo rm a tio n . Changes o f body com position w ith advancing age, and age-related changes in the organs, also com plicate drug tre a tm e n t. The high consumption o f drugs depends to some e xte n t on over-diagnosis and o v e r-tre a tm e n t, but also cases o f under-diagnosis and u n d e r-tre a tm e n t are hidden behind the figures. In 1958 20 000 patients w ith cancer were diagnosed annually in Sweden compared to the expected number o f 40 000 annually at the tu rn o f the century. Only a m inor p roportion o f this increase depends on an increased risk. The population developm ent is the dom inating cause. Hip fra c tu re s show also a ve ry strong age-dependent increase. The risk to acquire a hip fra c tu re is s till low at age 70, only to increase very m arkedly a fte r age 80. A dem ographical developm ent w ith an increased number o f 80-year-olds and older, who fu rth e rm o re live s till longer, means obviously an increased number o f hip fra c tu re s . Regarding changes o f the disease panorama in e ld e rly observed and expected changes are o fte n d iffic u lt to in te rp re t, and th e ir e ffe c ts on the need o f health care are uncertain. One o f the fie ld s where positive cohort e ffe c ts have been observed most c le a rly is oral health including dental health, where a d ra m a tica l im provem ent has occurred during the last tw o decades. Thus, 5296 o f 70-year-olds were edentulous in Gothenburg in 1972, w hile there were only 3496 o f 70-year-olds who were edentulous ten years la te r. A prognosis shows th a t between 10 and 1596 o f 70-year-olds w ill be edentulous in the m iddle o f the 1990s. This means th a t more e ld e rly must get a q u a lifie d oral tre a tm e n t in the fu tu re compared to at present. This means also a marked im provement o f q u a lity o f life and in ce rta in instances the d ie ta ry situ a tio n . As m entioned the incidence o f hip fra c tu re s increased more than expected at the m om ent. A t the same tim e com parative studies between ru ra l and urban areas in Sweden show th a t the ru ra l population is more w ell o f f in th is respect. This fa c t points tow ards pre ve n tive perspectives in the areas o f fo r example physical a c tiv ity , stop-sm oking and im provem ent o f the d ie ta ry s itu a tio n .

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5.

REFERENCE

1.

Rinder L, Roupe S, Steen B, Svanborg A (1975). 70-yearold people in Gothenburg. A population study in an industrialized Swedish c ity . Aca med Scand 198:397-407

Pierre MINAIRE * Department of Rehabilitation Medicine University Hospital Bellevue F-42023 SAINT ETIENNE 2

EXPECTED CHANGES IN THE HEALTH SITUATION FOR THE DISABLED : INCREASING NUMBERS ? The question in the title is in fact misleading, and it is not possible to give it one single answer. "Number of disabled" means a lot, or nothing. It depends on the various definitions and analysis of the process of disablement. We will try here not only to disclose figures, but also to show the salient features of the new scene of disablement, as it is clearly foreseen and actively prepared by the World Health Organization in the targets of the Health For All in 2 000 program. 1 - THE PROCESS OF DISABLEMENT The World Health Organization has proposed in 1980 a tridimensional approach to the consequences of diseases, with a complete new set of definitions, which certainly helps clarifying the process along the following scheme : Disease or Disorder (diagnosis) #

Impairment

Disability

Handicap

In the context of health experience, an im p a ir m e n t is any loss or abnormality of psychological, p hysiological, or anatomical structure or function. A d i s a b i lit y is any restriction or lack of ability, resulting from an impairment, to perform an activity in the manner or within the range considered normal for a human being. A h a n d ica p is a disadvantage for a given individual, resulting from an impairment or a disability, that limits or prevents a role that is normal (according to age, sex, social, and cultural factors) for that individual. From these concepts, it is important to note that : - handicap is influenced by both : personal standards and expectations, and norms in society ; - handicap is self-perceived as well as normative, and probably less normative than self-perceived ; * 5th International Conference on Mobility and Transport for Elderly and Disabled Persons - Stockholm, 21-24/05/89. 15

16

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

- handicap is consequently largely situational. It is certainly related to medical diagnosis, but only partly, and sometimes, variably in time ; - there is no deep gap between "the disabled” and "the others", but a continuum of more or less adapted people to given situations. Then, figures about the disabled should be considered also in relation to situations, like transportation, housing, schooling, driving, employment, etc ... rather than only to medical diagnosis. A lso, we should make a careful distinction between primary prevention (i.e. : prevention of disease or accident), secondary prevention (prevention of residual impairment and disability), and tertiary prevention (prevention of handicap, which takes into account, among others, the situations of collective and individual transportation). Finally, it is clear that doctors and health professionals will remain one important aspect of the societal resources for the disabled, but certainly not the only one. 2 - THE FIGURES OF DISABLEMENT An outline of some available figures is proposed in Table 1. It should be noted that the systems of data collection remain highly variable according to the countries, and that some countries or even some parts of the world, little or no information is available. We can expect an increase in the figures for different reasons. First, an increase in incidence of potentially disabling diseases or conditions is likely to happen due to better initial care and survival, in children, as well as in younger adults and elderlies. The extension of medical rescue units, of intensive care units, and more generally of medical services, will provide more countries, more medical conditions, and more people, with the advanced m edical technologies and hygiene. Then, the increase in the quality and number of rehabilitation services (m edical as w ell as psycho-social) will turn out people with increased demands on mobility for work, school, or leisure activities. Finally, on the already already

the changes in the age structures w ill have a considerable impact demands of the population : general ageing of the population obvious in western industrialized countries, but also ageing of disabled people.

3 - NEW EXPECTATIONS AND NEW BEHAVIORS We have experienced for the past 10 or 15 years a growing concern of the disabled and elderlies for better services, including transportation, and

CHANGES FOR THE DISABLED

17

their rights in these fields are being recognized. The disabled are consumers not only of health, but also of other societal resources, and they behave as such. In the scheme already presented, they start from different prem ises than the health professionals : from the experienced and se lf-p erceiv ed handicap rather than from the underlying m edical condition.

N°1 N°2 N°3

Health Professionals’ evaluation

Lay people's evaluation

Impairment Disability Handicap

Handicap Disability Impairment

Patient > consumer or user

Consumer or user > patient

It is interesting to observe the changes in mentalities, covering gradually the world from the North to the South, and also from the West to the East. This evolution is particularly significant in the European Community, where the same movements as in Scandinavia are seen in France, and more recently in Italy, Greece, Spain, and Portugal. 4 - MOBILITY IS ONE OF THE BEST INDICATORS OF INDEPENDENCE Overall mobility could be defined as making all transfers at home, getting in and out of home, and going to chosen places in a comfortable and timely way. There is a good correlation between mobility and the general health conditions of the individuals. Independent people have generally a satisfactory mobility. Conversely, the improvement or the maintenance of mobility brings about a better physiological studies and psychological state to the person. Many epidemiological studies have underlined how sensitive the m obility indices are of the morbidity and even of the predicted mortality. On the other hand, everyone knows how mobility is sensitive to environm ental conditions. Then, it is understandable that individual and public transportations are considered as major elem ents of m obility, and consequently somehow related to the health situation of individuals and communities, and even more so in the future. 5 - A MICRO-SURVEY IN A COMMUNITY : FOR A NEW EPIDEMIOLOGY OF DISABLEMENT Such a survey has been conducted in a French village, associating the

18

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

direct observation of the performance of the population at various ergonom ical tests, and the comparison between the self-assessm ent of their function with the observed performances. The results give a very interesting picture of the overall functional abilities of the population. The applicability of theses results to the environment of public transportation is demonstrative (INRETS report 1988). It was also possible 1/ to study the effects of the age on the functional abilities, and 2/ to calculate the Life Expectancy Free of Disability, a good indicator sensitive to both individual and environmental characteristics. There is a good correlation between self-assessm ent and performances, which confirms, if really necessary, the need for observations and interviews as well. To put it simply : OBSERVE AND LISTEN. In the future, a proper epidemiology of disablement should survey larger segm ents of the population considered as a w hole, and not only the individuals "labelled" disabled through ad hoc com m issions or simply through their numbers of years of life. Such surveys should associate, if possible, valid questionnaires, interviews, and direct observations. In conclusion, in the near future, there should be more emphasis on the handicap itself, according to its social definition, with the view that everyone, being more or less disabled, is bearing a medical and social identity within a given so c ie ty .

REFERENCES - International Classification of Impairments, Disabilities, and Handicaps. WORLD HEALTH ORGANIZATION, Geneva, 1980. - International Disability Studies. A quarterly Journal, 1987-1990 - World Health Statistics Quarterly. (WHO) Vol. 42, n° 3,1989 "The Consequences of disease and their measurement".

*(1986)

TYPE OF ACTIVITY

1.7 % of men, and 1.2 % of women recorder as being disabled 5.1 % of men, and 2.6 % of women recorded as being disabled 11.8 % of men, and 23.3 % of women recorded as being disabled 21 % (both sexes) recorded as being disabled

Total

15 +

Total

16-79

*** (1986/7)

** * (1975)

** * (1981)

Turkey

Ireland

15 % had some disability over 5 years

No limitation with ADL for more than hall a day over previous 4 weeks

Spain

Population

Total

Daily shopping Clean flat/house Undress

Total

Norway * (1987)

• (1982)

Independence in ADL

Switzerland

|

Without great difficulty/inability to see, hear, speak, climb stairs, carry loads, walk

Independence in ADL

60 +

Israel

** *

(1976)

Country reports ; 1987/1988 HFA monitoring. Encuesta sobre discapacidades, deficiencias y minusvalías, Instituto Nacional de Estadística, 1987, Spain. *** UN disability statistics data base.

A ustria

FR Germany *** (1983)

* **

|

0.6 % totally dependent (need help to eat/ bedridden) 1.5 % almost totally dependent (need help to Non institutionalised dress) 7.5 % somewhat dependent (need help for population 15 + cooking, shopping, walk 400 m) total with some dependency = 9.6 % assuming mutually exclusive categories)

16 +

Total

POPULATION

* (1985)

Finland * (1987)

Denmark * (1986/7)

Czechoslovakia

COUNTRY

Table 1 : SUMMARY DATA ON PREVALENCE OF DISABILITY

98.5 %

85%

86.3 %

93% 91% 98%

91.6 %

90.4 %

87%

96%

% INDEPENDENT

|

EXPECTED CHANGES IN TECHNOLOGY AND TRANSPORTATION Philip R Oxley, Director of Research Centre for Transport Studies Cranfield Institute of Technology Cranfield, Bedford, Great Britain This is a very wide topic and to make any sense of it within a comparatively short paper requires a theme around which to centre it. The chosen theme is that of appropriate technology. ‘Appropriate’ can be defined in several ways: -

in meeting the needs of elderly and disabled people in cost in performance and reliability in acceptability (not necessarily just to elderly and disabled people but more widely in society).

Technological development is often an incremental process, though still with major breakthroughs from time to time. In general, however, a leap in the dark is more likely to end with a dull thud than an exultant cry of ‘eureka’. Significant technical developments in transport (apart from the discovery of the wheel) have been made largely within the last 200 years - essentially since the discovery of the use of steam as a mobile motive power. Those developments have been paralleled by an increase in actual travel and in expectations of the ability to travel. That increase in mobility for the population at large has only comparatively recently given birth to the recognition that better mobility for the majority still leaves some people seriously disadvantaged. This may have been unfortunate for many disabled people in the past but it has, I would suggest, some real benefits in the present and in the future. Many of the developments in transport technology from which disabled people can benefit, were initially intended for wide use by the able-bodied element in the population. What is often required is relatively minor modification to an existing technology which enables disabled people to use it : not major new technology. Before considering some examples it is worthwhile looking at the clientele. The relationship between age and disability is well documented. The recent OPCS survey1 in Britain showed that among young adults (16-29 years) two to three per cent had some degree of disability. Among those in late middle-age (50-59) the figure was around 13 per cent and among the very elderly (85 and over) almost 78 per cent. Turning these figures around shows that of all the disabled people in Britain 60 to 65 per cent are over retirement age : no doubt this pattern is found in other countries. The commonest result of disability is impairment in walking : the majority can still walk with varying degrees of difficulty, only a minority need a wheelchair. Other frequent causes of impairment are loss of hearing, reduced dexterity and poor sight. Thus a ‘typical’ disabled person is elderly, probably using a walking stick, likely to be somewhat hard of hearing and with less than perfect sight. These factors, together with the likelihood that many elderly people will be 20

CHANGES IN TECHNOLOGY AND TRANSPORTATION

21

nervous about using any transport technology which is new or unusual, underline the importance of the appropriateness - in this sense the user friendliness - of any system or service. There are many examples of developments in ordinary transport for the population at large which have a particular relevance to disabled and elderly people. Demand-responsive transport - Dial-a-Ride - is a commonplace form of transport for disabled people in much of Europe and north America. It was originally developed - in some respects in a much more sophisticated way by sicientists who had worked in the American space/nuclear research programmes in the ’sixties. It was conceived as a general local public transport system that would arrest the decline in the use of ordinary local bus services by offering an on-demand service that had many of the qualities of a taxi service. It was thought - inaccurately as it happened - that it would reduce the likelihood of people using their cars. Many of those early, general Dial-a-Ride services have now disappeared, but the principles of operation re-emerged in the later ‘seventies in the demandresponsive systems targeted at disabled and elderly people. World-wide there are many hundreds of these services and there can be little doubt that they form a major element in the provision of mobility for disabled people. A different example can be drawn from the private car. For many people disabled or otherwise - the car offers the best form of transport. For many less severely disabled people, two of the more tiring tasks in driving are steering, especially at low speeds, and frequent gear changing. Automatic gear boxes and power-assisted steering have both been available for a long time, but until comparatively recently they were mainly limited to larger and more expensive cars and were only available at extra cost. In a paper prepared in 1988 for the ECMT an analysis of cars available on the UK market showed that 20 years ago there were approximately 60 models (excluding cars imported from the USA) listed as available with automatic transmission. Most of these were medium or large (and expensive) cars though there were some automatics available at the lower end of the market, including the three Daf models and models around the 1 to 1.1 litre engine size from major manufacturers such as Ford, BLMC, Renault and GM. Power assisted steering was confined to the larger and more expensive cars. Ten years later (1978) there were just over 100 models listed as available with automatic transmission of which 25 were cars with an engine size below 1.6 litres. By this time the small Japanese models such as the Honda Civic and Datsun Cherry had begun to have an important impact and more European manufacturers were introducing automatics as an option further down their model range. In 1988 there are some 45 models listed of less than 1.6 litres engine size with automatic transmission : eight of these are listed as standard with automatic transmission. Power assisted steering is now much more widely available with over 20 models below 1.6 litre engine size listed as having it either as standard (11 models) or an extra cost option. The relevance of

22 MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

smaller cars being increasingly available with automatic transmission and power-assisted steering is that both elderly people and disabled people tend to buy cars at the medium/small end of the market. Recent analysis^ of the driving modifications recommended to some 1500 clients assessed by the Banstead Mobility Centre showed that 99 per cent were advised to drive an automatic car and 15 per cent to have standard power-assisted steering. The latter modification is most frequently needed by people with rheumatoid arthritis, itself a common cause of disability. The changes in the availability of automatic transmission and PAS are recognition that the market as a whole likes these features, not that disabled people need them : but disabled drivers undoubtedly benefit from their greater availability. It is important therefore that we should always be on the look out for technical developments that are probably going to happen anyway and see how they can be used - perhaps with some degree of adaptation - the needs of disabled people. One example may be the introduction of some form of urban private vehicle control through pricing. In spite of sometimes quite major urban road building programmes and more severe parking control/charging there is much evidence to suggest that congestion is reaching unacceptable levels in many large urban areas. A recent survey of London traffic commissioned by the Confederation of British Industries estimated that traffic jams cost business alone some £15 billion a year. Malcolm Buchanan has suggested that a £5 per day licence for any vehicle using inner London roads could be implemented without difficulty and would achieve a 20 per cent cut in traffic, most of which would transfer to bus. The peak period entry licence in Milan has been reported as resulting in a very substantial cut in peak traffic and again with a substantial transfer to public transport. An alternative to direct pricing could be the use of HOV : high occupancy vehicle systems in which certain lanes at specified times can only be used by vehicles with a specified number of occupants. There are examples of this system in the USA, in Washington and California. Were these systems to become widespread it would be possible to treat disabled car drivers as ‘HOVs’ and to give them the advantages conferred by such a system in terms of speedier access into city centres. If some form of rationing by road pricing does happen it would offer the opportunity for exemptions to be made for disabled drivers, thus enhancing their mobility in real terms against that of other private car drivers. Acceptability, rather than technical issues however, may prove more difficult, particularly if a road pricing system using electronic tagging is considered. Another example is the application of the type of electronic tag system which is increasingly used as a security system to prevent goods being stolen from shops or books from libraries. Such a system can be adapted to provide directional or locational guidance (for example in large pedestrianized areas) for blind people or as a means of allowing additional time at pedestrian controlled road crossings. There are further uses for electronic or infra-red devices which could be helpful to many disabled people through remote opening of doors and automatic barriers, triggering synthetic speech messages at public transport information points, providing audible warnings of hazards such as construction work on the sidewalk etc.

CHANGES IN TECHNOLOGY AND TRANSPORTATION

23

Perhaps rather longer term the technical developments fore-shadowed in the European Prometheus research^ will offer a level of automatic control for cars which will mean that more disabled people may be able to drive what will, by the early twenty-first century, be perfectly standard cars. The main objective of Prometheus is to cut road traffic casualties by half by the year 2000, but, like possible developments in road pricing, it may be possible to derive significant spin-off benefits for disabled people. Of course possible - even likely - developments in the next century do not obviate the need for continuing incremental development of existing technology. The benefits of this are clear in both private and public transport. Although the level of modification needed to allow disabled people to drive safely is, in many cases, small, there remain more severely impaired people for whom more complex adaptations are needed. Recent years have seen considerable research and development work on the design of both primary and secondary car control functions. Joy-stick control for acceleration, braking and steering is an obvious example of the former. Infra-red and voice-actuated secondary control systems are examples of the latter. The production of vehicles which can be driven by a person sitting in a wheelchair is another example of the progress being made towards enabling even the most severely disabled people to drive. Again it is possible to envisage the adaptation of the new technology mentioned in the IRIS (Institute for Research in Informatics Applied to Society) research programme by the European Commission, which uses an eye controlled switch system to control a micro-computer : perhaps to control secondary functions on a vehicle. Thus in the future it may be expected that there will be a small (numerically) but important increase in the number of people with severe physical impairment who will be able to drive. Some indication of the effect of both developments in adapted cars and in people’s awareness of what is available can be seen in the increase in the UK of the number of new cars registered that are modified for disabled drivers. In 1980 there were approximately 10,000 modified cars registered : in 1987 the figure was 32,000. It should not be forgotten that there are also technical and design changes which make the use of cars by disabled passengers easier as well. Conventional public transport offers many examples of incremental development. Although there is, and no doubt will remain, an important role for public transport which is intended solely or mainly for disabled people, there is increasing evidence from countries such as Sweden that it makes sense, financially as well as socially, to make ordinary public transport usable by the majority of disabled people. Ergonomic research has shown that relatively minor modifications to ordinary service buses can make a substantial difference to the ease with which ambulant disabled and elderly people can use them. In some cases these modifications make the use of buses possible, when before it was not. Most of the modifications are straightforward. They include such features as lower entrance/exit steps, appropriately designed and located hand holds, improved seat design and spacing, better information displays (route numbers, lit "bus stopping" display, public address system) and other minor

24

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

modifications. They can be achieved as a retro-fit at no more than five to six per cent of the new cost of the (full-size) bus and can be built in ab initio for around one per cent. They have the advantage that they help most bus passengers, not just disabled people. Passengers with heavy shopping, luggage or small children find using buses built to these standards easier to use. Taking this incremental development one stage further a number of countries either already have or are in the process of devising ordinary bus services which will carry wheelchair users. Early developments in the USA were not entirely successful for a mixture of reasons : technical, social and environmental, but examples in Sweden and Germany are showing what can be achieved with careful planning and design and improved technology. The development of wheelchair accessible local bus services in Boras (Sweden) which will no doubt be discussed during the course of this conference, shows what can be achieved by this stratagem. The results of this experiment show significant improvements in the mobility of disabled people, a reduced reliance on special transport services and consequential substantial savings in total costs. Information about local bus services is also receiving attention. There are both "thinking" buses and "articulate" bus stops. Experimental services in Malmo and London which, inter alia, give information on the estimated time of arrival of the next bus at the stop are of obvious value to the travelling public at large, but are particularly helpful to disabled people. Knowledge of when the next bus is due would obviate the need to stand for possibly a quite long time at the stop : something which many disabled people find unpleasant if not impossible. This type of information also reduces the anxiety of passengers, which of itself is an important gain since journeys made by disabled people often subject them to a much higher degree of anxiety than would apply to able-bodied passengers. It has to be said that there are some problems with these systems. They tend to be expensive and there are difficulties of dealing with places with very complex bus routing systems, but like much else in the field of micro-electronics, past experience suggests that continued development could overcome many of these difficulties. Indeed the whole issue of providing information for passengers, whether in advance of making a journey or during it, is receiving more attention. Computer-assisted passenger enquiry offices will, in the future, become much more usual, as will both synthesized voice and visual display (eg dot matrix) of travel information at terminals, interchanges and en-route. The essence of most of these developments is that they provide real-time information : what is actually happening rather than what is scheduled to happen and they can be applied to a variety of different modes of transport. Their application is of particular importance when traffic conditions cause significant delays in services or where, as in post-deregulation Britain, service timetable changes are made more often than formerly. The European Commission’s DRIVE programme, which contains over 50 projects on the application of information technology to road transport, is giving impetus to developments in this area. In the field of more specialized transport there are a number of relevant developments. There are wheelchair-accessible taxis operating in a number of places, including North America and Europe. The London taxi ("black

CHANGES IN TECHNOLOGY AND TRANSPORTATION

25

cab") is now only produced in wheelchair accessible form and a number of taxi licensing authorities in the UK have now specified that they will only give new licences to cabs that are wheelchair accessible. A recent survey work for London Regional Transport showed taxi use is an important element in the mobility of disabled people and is often preferred to the use of Dial-a-Ride. Among Dial-a-Ride users it is common place to find complaints about difficulties of booking services and of lack of availability of buses. The obvious answers may be more vehicles and driving and control staff, but there are also more sophisticated control and scheduling systems that could make significant improvements in system efficiency. In part the difficulty of getting through on the telephone to make a booking is caused by the length of time needed to take down the caller’s requirements and to check whether their request can be met. Computer-aided scheduling cuts this time significantly and, through the development of the ubiquitous micro-computer and appropriate software, is now within the reach of even small Dial-a-Ride systems; unlike early American general Dial-a-Ride systems which, if they were computer aided, had to rely on main frame machines. The general and rapid increase in the capacity of computer systems is obviously a great importance in this area. One result of this is to produce the reverse of the well established economist’s view of economies of scale0. In the early ‘seventies more services could be given for the same cost by operating one large, shared facility. Now, for many types of computer-based activity, it is cheaper to use smaller individual systems : in other words there is a dis-economy of scale. This trend towards distributed, individual systems is likely to continue, but by virtue of the development of networking as well as increased capacity of mini/micro computers themselves, will continue to provide better and speedier computation. Another important consideration is improvement in reliability. As Rubinstein (op cit) has pointed out, ‘in the ‘seventies we didn’t expect our computers to work; we hoped. Today I expect absolute reliability, but I am sometimes disappointed. In the year 2000, computers should always work’. Fully computer-based control systems have been researched and developed as part of the US Urban Mass Transportation Administration demonstration projects and there are now available software packages with extensive arrays of capabilities for automated demand-responsive despatching and control. The ability to produce an efficient demand-responsive system is likely to become more important in the future with the development of systems that combine different types of vehicle - for example taxis and minibuses - and use them to meet the different journey requirements of the same group of people. Transport brokerage schemes which draw together the transport resources of a number of different organizations and agencies also require computer-aided control systems if they are to be effective. As mo;e effective and efficient demand-responsive systems come into being, there will also be scope for the use of data transmission between vehicles and the control centre rather than voice communication. This type of system, which is already in use by some North American taxi companies, speeds up the transmission of a request for service between control and vehicle very significantly and gives much improved utilization of radio channel space.

26

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

Recent experimental use of this type of system by one of the major London black cab operators is reported as improving capacity to process calls for service seven-fold. Reference was made earlier to the increasing impact of urban traffic congestion. One response to this is the development of light rail transit (LRT) systems of which there are over 300 world wide. Some are long established, though with new extensions : others are relatively recent and yet more are at the planning stage. Many are based on conventional technology, some on new technology involving automatic operation of driverless vehicles. However the key issue from our point of view is the increasingly general acceptance that these systems should be fully accessible to disabled people. In other words they will cater for 100 per cent of the population rather than 85 to 90 per cent. In many cases the technology for disabled people to gain access to the system is perfectly conventional. Provided it operates satisfactorily, there is no over-riding reason why innovative new technology should be used except, as in one example in USA, to avoid a lift system for disabled people which is "very slow and embarrassing"'. History is littered with examples of new ideas and new technology which failed to work : "Low" technology can be just as relevant. Passenger lifts are found on many different forms of public transport. They were in origin used for freight not people. They now come in a variety of different forms to meet different needs and design criteria : as part of the vehicle floor; as the vehicle steps, folded away below the floor, remotely controlled, activated by infra red control and so on, yet in essence they remain examples of conventional but extremely useful technology. I had said at the start of this paper that the criteria that I was using as a theme was ‘appropriateness’. One aspect of this is appropriateness of whatever technology is used, to the market for mobility. While there is undoubtedly still a substantial un-met need for mobility among disabled people it would be unwise to consider no more than just numbers of journeys. Among the general population of developed countries there is some evidence to suggest that, per capita, travel is growing at a lesser rate than formerly. Using the UK as an example average mileage travelled per day rose by 23 per cent mid sixties to mid seventies. From mid-seventies to mid-eighties it rose at about two-thirds this rate® with proportionately more of the increase in the first half of that decade. Actual numbers of journeys have risen but at much lower rates ; by about 11 per cent 1965 to 1975 and 6.5 per cent 1975 to 1985. Thus a substantial part of the increase in journey distances is the result of increases in length rather than number of journeys. Within those changes there have been proportionately much greater changes in modal use, with very large increases in car journeys and falls in public transport use, particularly buses. In one sense this represents the choice by people of a mode which offers greater flexibility comfort and control : in other words improved quality of travel. It might be added at this stage that remote working and ‘teleshopping’ systems may reduce the need to travel though the social aspect of such activities is also important and could militate against wide-spread adoption of these systems.

CHANGES IN TECHNOLOGY AND TRANSPORTATION

27

Mobility for disabled people is still at the stage, in general, where quantity of trips - availability of usable transport - is still of major importance, but the issue of quality should not be ignored. When considering how vehicles and systems can be made more accessible the quality issue should not be forgotten. The final aspect of appropriateness that I wish to mention is still concerned primarily with quantity and turns on an accurate assessment of unmet need. From recent research it is possible to place some approximate dimensions on this need. Interviews with a random sample of disabled people in the UK showed that 50-60 per cent of them either were now or would use accessible public transport services. Those who would not were either using private cars or were able to use unadapted conventional public transport. Even assuming all those who expressed a wish to use accessible transport were to do so, in typical suburban residential areas these people would be spread thinly : perhaps only two or three per hectare. Given that to meet that level of density of demand whatever the mode used is, is likely to be expensive this calculation reinforces the argument that wherever feasible a more cost-effective service is likely to be achieved by adapting existing transport services. In considering the role that technology can play this issue should be borne in mind and care taken to ensure that new applications of technology - whether that technology is conventional or innovative - should be carefully targeted to avoid a waste of scarce resources. References 1.

The prevalence of disability among adults, (1988) OPCS surveys of disability in Great Britain, Report 1, HMSO London.

2.

Oxley PR, Disabled People and Cars : An Overview (1988) ECMT Seminar Report, ECMT Paris.

3.

Oxley PR, Cornwell M and Sims B, Analysis of Modifications to Cars in Relation to Types of Disability, (1989) CTS Cranfield.

4.

Prometheus : Programme for European Efficiency and Unprecedented Safety.

5.

Rubinstein R, The Human Factor Designing Computer Systems for People, (1989) DECUS Conference, The Human Factor, University of Exeter.

6.

Light Rail Transit, Passenger Transport Executive Group (1988) (p.84), Strathclyde Passenger Transport Executive Glasgow.

7.

Based on data from National Travel Surveys (UK) 1965, 1972/3, 1975/6, 1978/9 and 1985/6.

Traffic

with

Highest

PLENARY SESSION II: APPROACHES - A STATE OF THE ART

TOWARDS MOBILITY AS A HUMAN RIGHT: SWEDEN'S POLICY ON MOBILITY FOR THE DISABLED Presentation at the 5th International Conference on Mobility and Transport for Elderly and Disabled Persons Claes-Eric Norrbom, Director-General, Swedish Board of Transport Demand for Personal Transportation

Swedish society is becoming increasingly dependent

on efficient transportation and telecommunications.

Several structural changes contribute to the increased demand for transportation. Industry and trade

development especially have created a strong demand for efficient personal transportation. Regional

development will also influence the future demand for transportation.

These combined developmental changes create new

demands for example to make work-related service or

business trips. The structure of society depends increasingly upon transportation.

Currently, there is a great need to increase the

mobility of persons with various restrictions on

their mobility. This need arises not only from a

desire to be more active in general or the view that

mobility is a social and human right. It is also

created by structural changes in society. The desire to integrate disabled people into society increases

their need for service-oriented and recreational

transportation as well as transportation to and from

work. Thus, increased mobility refers to increasingly large social groups, including those whose mobi-

lity is limited by .a disability. 28

SWEDEN’S POLICY ON MOBILITY

29

Automobiles currently account for 75 percent of the total transportation use in Sweden. The Swedish

Board of Transport predicts that total transporta-

tion use of all modes of transport will increase by about 50 percent during 1985— 2020. It is expected

to be greatest in the first stages of the period,

however. In all Board of Transport scenarios, auto-

mobile use will increase, while public transportation use will depend greatly on social measures to support public transportation and limit automobile

use for such reasons as protection of the environ-

ment. This applies especially to local and regional public transportation.

Goals of Sweden's Policy on disabled Persons

Swedish policies aim to normalize the situation of disabled people and integrate them into society.

Thus, efforts concerning disabled persons form a

very important part of the further development of

Swedish welfare. People with disabilities shall thus

be given the same opportunities as other people to obtain advanced education, participate in working

life, have access to improved living conditions, or

participate in leisure and cultural activities other words, live an active life.

- in

Politically, this is reflected in the Swedish traffic policy on a satisfactory supply of transporta-

tion to all sections of the country. An important

political goal is that elderly and disabled persons

shall be offered equal and satisfactory transporta-

tion, and that society's transportation systems be accessible to everyone. Thus, to a great extent,

this is a matter of quality of life, social equali-

ty, and the social right to be able to move about at

will in society. This goal demands that the

30

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

transportation system and its environment be updated to serve the needs of a variety of groups.

The measures taken to achieve the social-welfare

goal of assisting disabled persons in the transpor-

tation sector can be summed up as having the follo-

wing direction, based on a resolution by Parliament of 1979. Public transportaiton shall gradually be

made accessible to disabled persons; this has in-

cluded a number of legally mandated updates increasing disabled persons* accessibility. These adapta-

tion measures also apply to terminals and their

immediate environment. It should be mentioned that

voluntary adaptation of public transportation was

not viewed as realistic at the end of the 1970s, so Parliament chose to pass laws requiring it.

A 1979 act of parliament also established a National Transport Service especially for people with severe

disabilities; it was initially an experiment but was

later made permanent. The National Transport Service

has become a complement to the Local Transport Ser-

vice, which has a much broader target group. Dis-

abled persons and their families are also entitled

to automobile subsidies from the government.

A basic goal of these improvements is to avoid ma-

king special solutions permanent. In the long term,

the extent of these special solutions in the forms

of local or national transportations services can be limited if more disabled and elderly persons are

given the opportunity to travel by regular public

transportation. Some people may thereby be able to

postpone their use of the special transport system.

SWEDEN’S POLICY ON MOBILITY

31

A basis for discussions is the necessary overall

veiw of the various government measures increasing the mobility of disabled persons and their travel choices. Regarding journeys in their entirety is another prominent base for discussions about the

development of public transportation and for disabled persons' travel opportunities. This issue,

thus, is important for the future competitiveness of public transportation.

Parliament's transportation policy of 1988 estab-

lished a special time-limited government subsidy to

stimulate the adaption of local and regional public

transportation to disabled persons. Clearly, however, financial responsibility for the necessary

adaptions rests with the parties indicated in the regulations.

The Swedish Board of Transport has the overall and

coordinating responsibility for making public trans-

portation accessible to disabled persons. The Board of Transport initiates, plans, issues directives on and is responsible for following up adaptions made

to vehicles. Furthermore, the Board of Transport is

responsible for providing subsidies for accessibili-

ty measures in vehicles and terminals under the new

governmental subsidy program. The Board of Transport is also responsible for the National Special Trans-

portation Service.

Summary of Current Laws on Making Public Transporta-

tion Accessible to Disabled Persons

By law, the supervisory authority for public trans-

portation and the transport companies shall make public transportation accessible to people with

disabilities. When public transportation is planned

32

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

and put into effect, the special needs of disabled

persons shall be tken into account to the extent possible.

We have chosen to give priority to measures that

assist the largest disability groups. On the other

hand, the expensive measures that would have assisted a smaller group of persons have been delayed,

measures such as legally requiring wheelchair lifts on buses.

Part of the reason for this approach is that res-

tricted mobility is not an isolated phenomenon but rather a general problem for a large part of the

population in specific travel situations. These

problems arise not only as a direct result of being disabled, but also, for example, when travelling

with a baby carriage, when carrying luggage and when small children are travelling. These difficulties

sometimes may affect a fourth of the total Swedish

population and of them over one million view them-

selves as having restricted mobility (permanently).

Emphasis was initially placed on technical solutions that were familiar, such as correctly formed and

suitably placed support rails, minimum door widths

and step heights, contrasting level differentiation,

good lighting, clear signs, etc. These measures

didn't require any further development. The directives were designed to give the manufacturers and the transportation companies reasonable time to

adapt the vehicle. Furthermore, a difference is made

between new and old vehicles.

The adaptive measures for the most severely disabled

persons that were not possible at the end of the

SWEDEN’S POLICY ON MOBILITY

33

1970s, primarily for technical reasons, were sup-

posed to undergo intensified research and develop-

ment. It can be said that important advances have been made in the developmemt, for example, of a

special transportation seat, a lifting device for

wheelchairs and wheelchair clamps.

Directives have been issued governing adaptive measures for buses, minibuses (often called special

vehicles or transportation-service vehicles), railroad carriages, tramcars, underground railway carriages, light-rail carriages, ships and airplanes.

Thus, directives have been issued on the majority of

vehicles; taxis remain.

Successive adaptation is planned for terminals - an

important part of transportation. These measures are

also part of the programme for adaptation to the

disabled initiated by Parliament in 1979. The directives are worked into recent construction laws.

The Results of Accessibility Adaptations

The Swedish Board of Transport is now evaluating

accessibility measures taken to date on vehicles.

Evaluation results are vital to maintain a satisfactory basis for judgments on how far future accessibility measures should reach and by what means.

In short, the directives are well observed to date for buses in service. Large buses in contractual

service were not subjected to the directives until 1989, but the poll showed that over half of these

buses had been made accessible voluntarily. Mini-

buses and special vehicles for transporting wheelchairs were almost completely updated. Glancing

34

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

summarily at the remaining modes of transportation

indicated satisfactory observance of the directives.

The travellers* viewpoint can be summed up as observing a general improvement in accessibility to

modes of transportation. The improvements made vary according to the disability in question. Nonethe-

less, difficulties remain for persons with severely

restricted mobility. If the technical improvements are to have their intended effect, they must be

complemented with information for the service personnel working in the transportation sector about

the situation of persons with severely restrictive disabilities.

The reason why the situation for people with the

most severe restrictions on mobility cannot show any large improvements, is due to the fact that public

transportation systems have not been made completely accessible, largely through long-term adaptation to

varying access levels. This means level steps,

lifts, or ramps to all modes of transportation,

stops and terminals. Many technical problems have

since been overcome, but there are still problems to solve to attain complete accessibility. Even if

transportation and terminals are made completely

accessible for all disabled persons, there are many

problems in the surrounding environment, such as on

the road between the home and the railroad station, bus stop etc. The extra costs of making vehicles more accessible

has varied considerably between companies. On the

average, the extra costs seem to be 2-3 percent of

total investment costs.

SWEDEN’S POLICY ON MOBILITY

35

It is difficult to determine how many more disabled

persons travel as a result of increased accessibility. The transportation companies judge that the

measures have only moderately influenced the number of disabled persons who travel. However, many com-

panies believe that older persons travel more by

public transportation as a result of the adjustments

made.

It would be interesting to see how making public

transportation more accessible has effected travel

by the Local and National Transport Services. How-

ever, this is now impossible, even when accessibili-

ty measures have been quite extensive. Other factors

may influence travel by Transport Service more than

access to public transportation. Some disabled persons will always need the Special Transportation

Service. It is also important to allow them freedom of choice among modes of transportation. Research and Development

A continued increase in accessibility measures requires an increase in the costs of the measures

which would benefit smaller groups of people. This

can also become an issue for other groups. Mandatory

wheelchair lifts in buses on municipal routes would imply increased costs and take extra time at stops.

Level-adaptive measures, of which the installation

of wheelchair lifts is an important part are, how-

ever, an area that must be given continued attention in terms of the opportunities for people with dis-

abilities to move about. This applies to the direc-

tives and to the development of technical solutions for the various modes of transportation.

3

36

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

An example of interesting developmental projects is a safe wheelchair clamp for use in motor vehicles

that can be used on all wheelchairs and in all ve-

hicles. Other projects include buses with a smoothly functioning lift and more accessible taxis.

We must also develop and test different transportation solutions. The future public transportation

system must be allowed to contain several alterna-

tives. This is proven not least by the experiments

with service routes mentioned previously. Service

routes are bus routes that are open to everyone. The

difference from other public transportation is that service routes are routed primarily to serve the

needs of travelers who are elderly or have disabili-

ties. There should be additional developmental op-

portunities for making transportation suitable for elderly and disabled travelers. An area that we believe is in need of increased

study is the formation of the environment surroun-

ding transportation, how it can be improved, and how

much it determines the likelihood of disabled and

elderly people traveling by public transportation.

If the technical adaptations made to date are to be

used correctly, it is important that knowledge of

people with motor disabilities and about the adap-

tive measures that have been taken reach the necessary ears.

The appropriate standard of accessibility is also a

question of attitudes toward what is generally reasonable to expect of accessibility measures. Some

measures for both vehicles and terminals can probably be hastened by means of financial assistance,

such as the government subsidy that has been introduced in Sweden.

THE SITUATION IN EUROPE Ann Frye, Head of Disability Unit Department of Transport, UK

and Chairman, Working Group on Transport and Disability European Conference of Ministers of Transport

Europe - a diversity of cultures and traditions The

nations

that

make

up

Europe,

definition of the European Community, ical sense,

whether

within

the

or in the wider geograph-

represent a multitude of different social,

and political traditions.

formal

economic

To talk about Europe is to talk about

variations between different parts of the same country often as

wide if not wider than those between different countries.

From

the Mediterranean countries of the south of Europe to the Baltic states

of

the

north,

perceptions

and

different as the climate and the landscape.

attitudes

can

be

as

Developments in the field of transport for people with disabilities

are

totally

dependent

attitudes and priorities,

on

economic,

social

and

political

and so the rate of progress and indeed

the direction of progress is again widely diverse.

There remain

those countries in Europe in which disabled people are not seen in public,

they are not regarded as part of the community,

are kept and cared for within the family.

but

At the other end of

the spectrum are those countries which regard disabled people as a totally integrated part of the community and where attitudes and

infrastructures

possible, together

in

and

spite

to

have

of

identify

been

this

developed

diversity,

a movement

particular over the last 5 years, a common purpose in mind.

37

that

accordingly.

to

draw

has

It

is

place,

in

the

taken

threads

in a common direction and with

38

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

Moving towards a common focus When the European Conference of Ministers of Transport first set

up a working group on the subject of transport and disability in 1984,

Italy,

countries as different in their traditions as Sweden and Spain and Switzerland,

came together for the

with very little to show in terms of hardware between them,

first time

that was common

but with a clear political understanding that the

transport needs of people with disabilities had to be recognised and

provided

sustainable.

for

in

a

way

that

was

both

practical

and

The ECMT Working Group started first by drawing together data on

what was happening in each of the 14 countries that were taking part in the Group.

It soon became apparent that no two countries

even described or classified disability

in the

same

way,

that

there was little common ground in the organisation and financing

of transport services large differences

for disabled people,

in structures

and

social support available.

and that there were

in levels

of

economic

and

From this starting point, the Group concentrated on finding those areas in which all countries,

at whatever stage of development,

could find a common focus for change.

The obvious place to start

was with the most local form of transport giving people the means to move about outside their own front doors. level of local mobility,

Without

a basic

longer distance journeys cannot even be

contemplated.

From that early work and from the recommendations

now

in

adopted by Transport Ministers be

seen

improving

in 1986,

the

design

accessible local transport services.

countries,

clear developments can and

availability

of

In many cases and in many

these still stop short of providing wheelchair access

but they do at least recognise and increasingly provide for the

needs of that much larger group of frail, disabled people.

elderly and ambulant

THE SITUATION IN EUROPE

39

There has been considerable progress too in the setting up and funding

of

door

to door

transport

services.

There

are

still

Europe

works

major variations but the concept of providing transport on this basis

is

widely

recognised.

The

diversity

of

strongly to the advantage of the Group as a whole in areas such

as this. field,

and

Those countries which have been the pioneers in this in

this

Sweden

is

of

the work

outstanding,

have

been

able

provide a model and a pattern for those coming later to follow. The

next

focus

of

the

ECMT

Group

was

to

to

provide

people with disabilities with the opportunities for travel, both at national and international level.

physical

possible,

means a

for

journeys

continuity

of

to

be

systems

This involves providing the

made

confusion and anxiety are minimised.

and

and

providing,

procedures

so

where

that

There is still a long way

to go before severely disabled people in particular can travel

across Europe, confident that they will find the facilities they

need

wherever

they

beginning

to have

is

accessible

go.

It

the basic

is

true,

infrastructure

that national and international transport, fully

understanding

of

the

and

that

where

shortcomings

means to overcome them.

however,

and

gaps

that

in place

we

are

to ensure

particularly by rail, exist

a readiness

there to

is

find

an

the

Recent developments It is not possible here to catalogue all the developments that

are taking place in this field across Europe - a statement which is in itself encouraging.

A few years ago it would have been

quite possible to summarise progress on one side of paper!

A brief review of what is happening currently in different fields in some of the countries of Europe will

indicate the range and

extent of the progress that is now being made.

40

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

Information

It has long been recognised that a lack of information is often

the biggest handicap with which a disabled person has to contend.

In many countries now it is not so much the lack of provision but

the

lack of knowledge

people

with

regularly.

problem

about that

disabilities Many

as

from

countries

a major

priority,

of

provision

travelling Europe

both

on

that

has

now

tackling

more

are

an

inhibited

widely

individual

and

more

this

basis

through organisations like the ECMT and the EC.

and

Comprehensive guides on transport facilities for disabled people have recently been published in France and the UK and are under

preparation in the Federal Republic of Germany.

In Finland,

a

major planning exercise is under way to establish an information network

for

people

with

system in France.

disabilities

similar

to

the

Minitel

Information needs to be directed, not only at disabled people as

consumers,

but

transport.

understanding

A

also

lack

all

at

those

of

who

information

too

often

plan,

design

combined

result still

with

in

and

provide

a

lack

systems

of

and

facilities in which the needs of people with disabilities have

been overlooked. Denmark, looking

traffic.

for

at

committee

the problems

In

to

disabilities. all

the

This

example,

Ireland,

look

at

a

problem

report

too

is

has

that disabled

the

the

Transport

now being

recently people

have

Minister

transport needs

been

of

has

tackled.In

published

coping set

people

up

That Committee has regular weekly meetings

national

transport

agencies.

This

process

with

a

with

with

of

regular

Swiss

Federal

consultation between disabled people and transport providers is particularly

important.

On

similar

lines

the

Railways has set up a coordinating body to provide a forum for

discussion between

for disabled people. In Norway,

transport

operators

and

associations

of

and

there is particular emphasis on publishing guides to

show transport providers what can be done and in particular to illustrate the cost-effectiveness

of providing

for people with

THE SITUATION IN EUROPE In addition

disabilities.

already published,

to a guide

41

"Roads

for more

People"

a new one has now been prepared covering all

modes of transport from wheelchairs and walking aids to sea, air and land transport.

In the United Kingdom,

the Disabled

Persons

Transport Advisory

Committee has produced a specification for buses which are more accessible to elderly and ambulant disabled people.

of

adopting

this

are

illustrated

by

demonstration

The benefits vehicles

on

tour throughout the country and by demonstration days organised

by the Department of Transport for transport operators and local authorities.

Public transport Although on a day by day basis, progress can still seem very slow

and very limited, a review of recent developments in a number of European countries demonstrates that there are not just and

isolated

developments

but

that

underlying

random

individual

initiatives there is a determination to establish the transport

needs of disabled people within the public transport scene.

To take just a few recent examples, in Denmark coaches travelling

over 100 kilometers must now be equipped with lifts and have at least 2 positions for wheelchair users, while Danish railways are

testing

trains.

prototype

In France,

announced,

lifts

at 30

stations

used

by

short

distance

a major package of new initiatives has recently been including

substantial

improvements

to

access

at

access

to

stations to provide facilities for wheelchair users, blind people

and

others,

increasing

availability

of

wheelchair

express train services including the TGV, a range of new services

on the suburban rail network and an extensive programme of staff training in disability awareness.

In France too, a commitment has now been made by Government that

by the end of 1989 all buses and coaches must have an option to provide wheelchair access and that within 5 years all buses and

42

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

coaches

should be totally accessible.

Government

funding will

support the purchase and development of vehicles with good access features.

In Finland,

a working group representing the Transport Ministry

working

the

and

representatives

public

on

transport

regulated

of

all

the

development

through

which, the

public

of

although

minimum

issuing of

government subsidies.

not

transport service

legally

licences

and

operators

standards

binding, the

will

granting

is

for be of

Helsinki City Transport has also started

planning a new tram service that will be "user-friendly” similar to

the

systems

that

elsewhere.

already

exist

in

Grenoble

in

France

and

In Germany, funding has been approved to retro fit lifts to trams

in Munich and funding is also being made available for platform lifts

to provide

access

to

Intercity

trains.

In Ireland

too,

there has been major progress on the railways with all main line stations now providing

full access

and with

and portable ramps on all platforms. being built dictating

for suburban railways

higher

station works.

standards

of

accessible

toilets

Accessible carriages are

and new building

access

will

apply

regulations to

railway

Italian railways too have just adapted 80 carriages for disabled

people

in wheelchairs

to be

introduced on main

lines over the

coming year and some work is also in progress to adapt stations to remove barriers and improve access. also

experimenting

providing

an

with

integrated

wheelchair users.

buses

in

system,

Some Italian towns are

standard

including

public

service

provision

The Netherlands is also looking at improving access to trains.

for

A

lift is being developed for use on short distance trains and if

trials prove successful it will be installed on all newly-built rolling-stock.

A low-floor tram has also been designed and is to

be introduced shortly into Amsterdam.

THE SITUATION IN EUROPE In Norway,

43

an interesting recent initiative has come from taxi

operators and bus companies who are working together to set up transport centres where services can be better coordinated

for

In Spain,

and

disabled people.

there

is emphasis on

stations and on staff training.

improving

access

to trains

Swiss Federal Railways have also

been in consultation with disabled people to design a new family

compartment for trains which will have a play space for children and 3 places for wheelchair users. In the UK,

recent

matter

course

legislation now means

that all new taxis

in

London and other major cities must be wheelchair accessible as a of

and

that

from

the

1

January

2000,

wheelchair-accessible taxis will continue to be licensed.

only This

will mean that eventually a pool of 15,000 wheelchair-accessible vehicles providing a door-to-door alone.

service will exist

in London

The British Rail network now provides wheelchair access to most Intercity

routes.

The

British

tradition

of

high

station

platforms makes boarding and alighting by means of portable ramps

much easier for wheelchair users than in many other countries of Europe.

British Rail have also developed and are introducing a

wheelchair

accessible

toilet

compartment

on

Intercity

trains.

Interestingly this new development has been warmly welcomed by

those travelling with small children who also find conventional train toilets very restricted. Also

in

the

UK,

many

bus

operators

and

local

authorities

are

adopting the features recommended by the Department of Transport

and the Disabled Persons Transport Advisory Committee for lower steps, these

better handrails,

are

designed between

both

into

being

new

Heathrow

better colour contrasts

retro

vehicles.

Airport

fitted

and

The

to

main

Central

existing

and so on and

scheduled London,

vehicles bus

now

and

service

provides

wheelchair access on all vehicles and an experimental service has

44

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

been started providing wheelchair access on an route.

Intercity coach

Light rapid transit systems at planning and development

stages, now incorporate full access as a matter of course.

Special services In most countries

away from special

in Europe now the

services

focus

mainstream public transport outlined above, urgent

and

growing

need

is generally moving

towards the kind of developments in

for

door

to

door

but

there

provision

is still

and

many

countries continue to research and develop more effective means of providing for it. In Finland, 1991

for example,

to set up special

municipalities

services

and

have until

are obliged

to

the

end

provide

of

a

minimum of 18 single journeys a month, together with all work and study trips regardless of the disabled person's financial status. In Italy,

specially adapted minibuses are now providing special

services in some towns.

In some cases these run on scheduled

routes while in others they are provided on demand.

So far they

are on an experimental basis only but have been introduced with the aim of making some contribution towards meeting the demands

of basic mobility at the same fares as normal public transport. Personal mobility In

some

countries

the

provision

of

cars

is

regarded

as

the

highest priority on the basis that it gives the greatest level of independent

mobility,

in

others

cars

and

driving

second place to developments in public transport.

however,

there

is recognition

that

technical

have

taken

Increasingly

developments

that

allow more and more disabled people to drive, must be accompanied

by the provision of

advice

and

information

adaptation

and control

to enable

disabled

people to make the right choices to enhance their mobility. number of

specialist

manufacturers

A

from

across Europe have recently come together in an association to

promote

the

essentially

development

of

non-commercial

highly

equipment

specialised for

the

and

most

therefore

severely

THE SITUATION IN EUROPE disabled people. basis

there

is

products.

In Belgium,

a

45

By approaching the problems on a Europe-wide stronger

possibility

of

producing

viable

the concept of providing advice and assessment

disabled drivers has been long established.

for

The United Kingdom

which based its system on the Belgian example, now has more than a

dozen

assessment

and

advice

centres

across

the

shows

for

including one run by the Department of Transport.

the

Department

people.

The

organises

Mobility

biennial

Roadshow

to

motor

be

held

country,

In addition,

in

disabled

June

1989,

is

expected to attract over 20,000 disabled people in the course of 3 days to look at and test drive a wide range of vehicles and

equipment. This is some indication of the size of the market and of the range of products now appearing to meet it.

There are also moves following a recent ECMT seminar on cars and driving

for

licensing

nor

people

with

technical

disabilities

safety

to

ensure

requirements

that

impose

neither

unnecessary

limitations on disabled people's ability to hold a licence and

adapt a car to meet their needs. Pedestrian facilities

Creating a barrier-free pedestrian environment has generally been one of the most neglected areas.

many

countries

is

that

the

One difficulty which exists in

department

at

national

or

local

government levels responsible for transport developments is very often

not

the

department

with

responsibility

for

pedestrian

facilities or the built environment.

And yet it is fundamental

any part of it is to be manageable.

Streets and shopping areas

to progress that every part of the journey must be accessible if cluttered with steps, kerbs and other obstacles, big

an

impediment

inaccessible trains.

to

mobility

as

high

will provide as

floor

buses

and

Creating a more accessible pedestrian environment has been one of the

priorities

while

almost

of

recent

every

ECMT work.

country

has

Research

standards

has

and

shown

that

regulations

46

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

governing access to buildings, almost none have similar standards for the pedestrian environment.

considered

by

Ministers,

ECMT resolutions shortly to be

recommend

that

such

developed and that stronger links are established,

standards

be

both between

those who provide and design public transport and the pedestrian

environment

and

those

responsible

for

buildings.

Among

other

initiatives the ECMT Working Group is soon to publish a simple

leaflet aimed at promoting the basic messages of good planning

and design among highway authorities and engineers.

There are examples of good practice and of interesting develop-

ments in a number of countries. have

produced

very

valuable

pedestrian environment, Transportation

published

the

The Netherlands,

guidelines

on

for example,

designing

the

Both Belgium and Germany have

also

as have the Institution of Highways and

in the UK. results

of

studies

aimed

at

promoting

the

integration of disabled people into the urban environment. Norway

too

has

example, design

guidelines gradients

and

that

and

positioning

are

generally

acceptable

of

street

accepted

distances,

furniture,

people with both sensory and mobility handicaps.

as

to

covering, well

be

as

usable

for

the by

The next decade - influences and priorities For

those

countries

currently

outside

the

European

Community

framework as well as for those within it, the coming of 1992 and

the single European market, recognition

national goal

now

that

the

is having a marked effect.

time

traditions must be

is

soon

subsumed

of a Europe without barriers,

coming

There is

when

different

if we are to achieve

and that means barriers

mobility just as much as barriers to trade.

the

to

Perhaps the most striking evidence of this development has been in

recent

French,

German

and

British

standards of access for buses and coaches.

moves

towards

setting

In most countries of

Europe, there has been great hesitation over many years in moving towards wheelchair access to mainstream bus services.

been

isolated

examples

but

generally

speaking

There have

wheelchair

provision has been restricted to specialised on demand services

47

THE SITUATION IN EUROPE and to personal mobility.

Now both Germany and France have shown

a clear determination to develop a workable system of integrating

wheelchair

vehicle

users

onto

manufacturers

mainstream

are

bus

common

to

services.

Europe

as

Since

a

whole,

most

the

repercussions of these moves, together with British moves to set standards for elderly and ambulant disabled people,

are already

beginning to be seen across national boundaries.

The next decade will undoubtedly see a continuation of this trend

towards the breaking down of barriers and the establishment of

common

approaches

towards

the

provision

of

mobility.

The

differences in levels of provision and approach will be much less

noticeable between South and North as well as between East and

West

and

it

Eastern-European

mobility

as

a

is

interesting

countries

priority.

are

The

to

now

speed

note also at

that

a

beginning

which

number

those

to

of

regard

countries

starting last in this field can progress is greatly enhanced by

the benefit of experience from those who started first.

There is no doubt that Europe is now united in the common cause

of establishing people with disabilities within the community. the

barriers

handicaps

is

and a

integrated society.

© Crown Copyright

removing

first

in their proper place

Nor is there any doubt that breaking down and

the

obstacles

vital

step

that

create

towards

mobility

creating

an

48

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS References

1

Transport for Disabled People - International Comparisons of Practice and Policy with Recommendations for Change (ECMT 1986)

2

Transport

for

Disabled

People

-

International

Co-ordination and Standardisation of Measures and Policies to Promote Mobility (ECMT 1987)

3

Transport

for

Disabled

People

-

Developing

Accessible

Transport: the role of demand responsive services (ECMT 1987)

4

Transport for Disabled People - Disabled People and Cars (ECMT 1989)

The U.S. Approach to the Needs of the Elderly and Disabled Dr. Sandra Rosenbloom, Professor of Planning INTRODUCTION

Transportation policy for the elderly and disabled is made in multiple arenas and by multiple actors in the United States: the Courts, Congress and fifty state legislatures, influential even if small advocacy groups, and hundreds of transit operators and thousands of social service transportation systems. Given this background it is not surprising that U.S. transportation policies and programs for the elderly and disabled are often piece-meal, disconnected, disorganized, and difficult to describe. Even where there is an "official" Federal policy it is difficult to determine if states and local communities are actually following that policy. At the same time, a national consensus has been growing on a number of issues, and Federal Court decisions are incumbent on all states and cities. So this paper attempts to describe the current state of U.S. transport policy with regard to how services are delivered to the elderly and handicapped, how conflicts between policies and programs are being resolved, and how well these current policies meet the needs of the elderly and disabled. The paper closes with a discussion of additional government responses that might be more appropriate for meeting the needs of the disabled and elderly. TRANSPORTATION PROGRAMS AND POLICIES

National and state policies on transportation for the elderly and disabled have focused on two specific issues: first, changes in traditional transit services, and, second, the provision of special transportation services operated separately, and often independently, from those provided by traditional transit operators. Our policies and programs have been developed in four major arenas. First, some components of our E & H policy result from our Federalist system which gives the 50 individual states very strong powers to individually pass legislation in this area; states, in turn, often allow specific cities to independently establish transportation programs and policies. Second, some policy components result from our political system which values debates between advocates of various positions and which can give relatively small advocacy groups the power to significantly impact programs and policies. Third, some transport policy for the E & H results from the ability of our judiciary to make service and operational decisions—if civil or human rights issues are involved--even if these decisions are generally the domain of legislative bodies or administrative agencies. And fourth, some components of our transportation policy for the elderly and handicapped develop because different kinds of Federal, state, and local administrative agencies differently interpret the Federal and state laws and court rulings that do exist. In this respect transport may be very similar to the implementation of other policies in the United States. 49

50

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

CHANGING TRADITIONAL TRANSIT SERVICES

The U.S. Department of Transportation has been the major Federal agency acting to change the nature of transit services to the elderly and disabled. In the last 15 years, in response to both legislative acts and its own policy positions, the DOT has required local transit operators to which it gives financial assistance to 1) provide half-fares in the off-peak to elderly and disabled people, 2) involve elderly and disabled people in planning efforts, and 3) give special attention to the needs of handicapped persons for special fare vending and collection systems, signing, etc. A fourth policy position which is extremely controversial involves equipping traditional transit vehicles and systems with accessibility features--usually wheelchair lifts on buses and elevators in subways. In May of 1979 the DOT required transit operators to ensure that their systems were accessible to all handicapped persons; this policy invoked immediate and hostile opposition. A number of transit operators sued the DOT and ultimately won when a Federal Appellate Court ruled that DOT had exceeded its statutory authority in promulgating this policy. In July of 1981 the new Reagan Administration approvingly removed the accessibility restriction. From 1981 until recently, transit operators were allowed but not required to equip their buses with wheelchair lifts. They were required to spend an amount equivalent to 3.0 percent of their Federal operating assistance for either accessible transit or special transit services (as discussed below). Several States however, including Michigan and California, still required operators in their states to purchase lift equipped buses. The nation’s most successful accessible bus system, Seattle, continued to operate buses with wheelchair lifts. In February of 1989 another Federal Appellate Court overturned both the 3.0 spending obligation and the optional accessibility requirement, ruling that both were arbitrary. In essence the Court ruled that lift equipped fixed route buses were required by DOT’S legislative mandates, and that transit systems might be expected to spend more than 3 percent for services for the elderly and disabled. The DOT has not decided if it will appeal the ruling to the U.S. Supreme Court. Obviously policies on the accessibility of traditional transit services are in turmoil. SPECIAL TRANSIT SERVICES

Introduction A number of Federal agencies are involved in funding special transit services for the elderly and handicapped, so it is hard to identify all their approaches and underlying policies. Special services, often in small vehicles, often doorto-door, and often demand-responsive, are being provided by traditional transit operators, by social service agencies, and by private transportation providers (like taxis) under contract to either transit or social service systems. Ironically, the U.S. DOT probably spends far less on special transportation for

THE US APPROACH

51

the elderly and handicapped than do the Federal Departments of Housing and Urban Development, Health and Human Services, and Labor. A 1977 study by the U.S. Government Accounting Office estimated that 114 Federal programs expended money on transport services to disadvantaged and vulnerable client groups; the Department of Health and Human Services was responsible for one-half of these programs while the U.S. DOT was responsible for only three! Table 1 shows the major Federal programs funding transportation services to the elderly or disabled; clearly many smaller programs are not shown. Not all of the transportation funds are spent on special services; some are spent for bus tickets or to reimburse social workers or family members for driving a client. However most funds probably are spent on special transit services. The uncertainty over total national expenditures on transportation by nonDOT agencies is created because these agencies, and their state and local counterparts, simply do not separate transportation costs from the major program costs with which they are associated (je nutrition services for the elderly, sheltered workshops for the disabled, etc.) Almost all of the special transportation services provided in the United States, and discussed below, have severe limitations on who may travel, where they may go, when they may travel (both time of day and day of the week), with whom they may travel, and how far in advance they must call for reservations. DOTs Policies and Programs The U.S. DOT has long had a role in the development of special services provided or paid for by transit operators. In 1970 Congress mandated that federally aided transit systems must make "special efforts" for the elderly and the handicapped. In response to the "special efforts" requirement, transit systems began to provide a spectrum of special services ranging from those operated by transit employees in publicly owned vehicles to those operated by taxi operators or even social service agency transportation systems under contract to the transit operator. After accessibility requirements were rescinded in 1981, most transit operators chose to provide or pay for special transit services as their way of responding to the needs of the elderly and handicapped (in many cases simply continuing services begun in the early 1970’s in response to the special efforts requirement). Today there are a myriad of service models but a 1987 study by Teal et. al found that over two-thirds of all cities directly provided special transit services in their own system vehicles using their own drivers. However the 10-15 biggest cities in the country developed large contract systems, obtaining services from private providers and occasionally from social service systems, generally based on competitive bids. Houston and Pittsburgh began "brokerages" which coordinated the activities of a number of local special transit operators, contracting for services from the most

52

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

appropriate provider and selling services to other social service agencies for their clients. Some cities, including Milwaukee and Dallas, began fairly large scale user-side subsidy programs. A more important distinction between cities lies in who is eligible to use special services provided and paid for by the transit system. Many communities maintain that their legal obligation is to provide special services for only those people who have physical or mental difficulties in using traditional fixed route transit. Able bodied elderly are often not eligible for special transit services simply because they are poor, or have inadequate transit, or cannot drive. Thus DOT funded services have come to be focused more clearly on the disabled than on the elderly, although individual cities have responded differently. While data are difficult to obtain, most transit systems are providing services to less than 5% of the population whom they believe eligible for those services. Most systems provide over 70% of all trips to less than 10% of their riders, most riders using the system infrequently. Given trip restrictions and reservation requirements, these results are not surprising. Many services are so inflexible and inconvenient that most elderly and disabled people cannot or will not use them. Social Service Agency Special Systems The Department of Health and Human Services is probably the largest provider of non-transit special transportation services. In 1985 an HHS Administrator estimated that the Department spent $800 million for transport services for the elderly, disabled, and poor. However this estimate may be low, because a 1980 study for the Administration on Aging, one of many offices located in the Department of HHS, estimated that agencies funded by Title III of the Older Americans Act alone spent between $500-800 million annually for transportation services. These special transportation services are provided to a myriad of clients under a myriad of programs funded by HHS agencies and others. Generally the elderly and handicapped may only use such services if they are clients of the agency providing the service and if they are travelling to agency sponsored activities. Most local programs severely restrict both eligible users and the places to which they can travel. Not surprisingly, a National Health Survey found that in 1983 less than 18% of elderly people had ever used either special transit or agency special services, regardless of their disability or household status. These findings are illustrated in Table 2 which shows that elderly women under 75 are the most likely to use special transit services, elderly men over 75 the least likely. Other studies have found that among those few elderly who have used special services, most use it for less than 10% of all their trips. Another result of this fragmentation of riders and programs is that any community may have an array of uncoordinated service providers, the total somehow being less than the sum of the parts. In 1982, after conducting a

THE US APPROACH

53

national survey and reviewing the literature I wrote, There is strong evidence that these systems operate not only expensively but inefficiently. Vehicles can be underutilized and there is often redundancy and waste in this fragmented "system" of delivery transportation to the elderly and handicapped. Even when there is no redundancy, ...there [are] may missed opportunities for greater efficiency through joint purchases of vehicles, maintenance, or repair services. While there have been many improvements since then (discussed in the next sub-section), this description is still accurate, largely because I originally underestimated both the extent of fragmentation and the number of individual programs funding special transportation services to the elderly and disabled. The Relationship of Transit and Non-Transit Special Services Because both DOT and HHS sponsor so many special transportation services for elderly and handicapped travellers, and because there has been so much redundancy in social service agency transportation programs, there have been attempts to coordinate among HHS programs and between HHS and DOT programs--at both the national and local level. In 1978 Congress mandated that all services delivered to the elderly under the Older Americans Act, including transportation, be provided in a coordinated and comprehensive manner. Also in the late 1970’s, DOT began stressing the "brokerage" concept as a mechanism to coordinate the multiplicity of local social agency providers with the special services provided by the transit operator. In October of 1986 the Secretaries of DOT and HHS signed a joint agreement on the coordination of transportation services funded by the two Federal level agencies. Among other activities, this Agreement established a coordinating council at the Federal level to conduct research and monitor coordination activity at the local level. Indeed, at the local level, HHS funded agencies have increasingly worked with one another and with the local transit operator. Many large transportation systems which are run by agencies funded by the Older Americans Act currently contract with other social service agencies to carry their clients, or they are active participants in coordinated transportation services organized by local transit authorities; Houston and Pittsburgh are examples. In other communities, smaller social agencies (without their own vehicles) routinely contract for transportation services for their clients from either the transit agency’s special transit system or from other social service agency transportation providers. Several dozen (and more) social and human service agencies buy transportation services for either individual or group trips from the public transit operator’s special system in Portland (OR), Lancaster (PA), San Francisco, Seattle, and Sacramento, for example.

54

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

In spite of these success stories, it is often difficult to get many local agencies to coordinate their services. Federal level pronouncements, without active sanctions, do little to address the natural resistance of most agencies to change or to giving up the prerogatives that come with running their own system. Even mandatory coordination or competitive bidding requirements can be inadequate because so much competitive contracting in the social service network is artificial for two reasons. First, since so few social providers keep separate (or accurate) transportation cost data the process does not evaluate the real costs of transportation delivery which makes competition meaningless. Second, the process is often set up to ensure that other social service agencies, or even a subsidiary of the contracting agency, win the contract. Several state governments have also taken an active role in encouraging coordination of special transportation services at the local level, and their efforts seem more promising. Florida, Iowa, Maine, and North Carolina have each established mandatory coordination requirements under which a designated regional provider becomes the only eligible recipient for DOT and most HHS transportation funds. All local agencies in those states must either purchase transportation services for their clients from the designated provider, or they must prove that they can do it cheaper. HOW WELL ARE WE DOING?

Table 3 suggests why transit and special transit systems are not carrying more elderly and handicapped people; most people, regardless of age or disability, take the majority of their trips in the private car. In fact, Table 3 shows that from just 1977 to 1983 the car became increasingly important to the elderly in urban areas. National Health Interview Survey data from a special 1977 survey of the handicapped also show these patterns; over 50% of those under 65 who were seriously handicapped (defined as unable to conduct one or more major life activities) drove their own cars. The NHIS data also showed that less than 1/4 of the elderly under 80 reported not using transit because they needed help to do so; as many as 20% of those who reported not using transit because they needed help drove their own cars! The eligibility barriers, travel restrictions, and advance reservation requirements that characterize most of the special transportation services available today make them unresponsive to a nation dependent on the convenience and flexibility of the car. The sheer number of systems and the confusion that arises over which elderly or disabled people are eligible for which services also deters ridership. It is not surprising, therefore, how low current ridership is (low given the number of elderly and handicapped people in urban areas). Moreover, special transit doesn’t seem a feasible alternative to driving for the elderly, even if eligibility and other barriers were dropped, given the current costs--$7-35 a one-wav trip in urban areas--and the large number of people who would require some service. Table 4 shows the staggering

THE US APPROACH

55

number of trips society must provide for the elderly alone, if it made up some percentage of the travel gap between otherwise comparable people who did and did not drive. Special transit services would have to offer over 6.6 trillion trips per year across the country if they only served 10% of the trips of the most severely handicapped among the suburban elderly! POTENTIAL SOCIETAL STRATEGIES

There are no easy responses to the mobility problems facing elderly and disabled people. Resolution of their transportation problems will require a package of solutions which are responsive to both their individual needs and the unique geographic and economic conditions of the community in which they reside. Potential solutions fall into four categories: keeping competent drivers in their cars as long as possible, better utilizing the private transportation resources of friends and family to serve the elderly and disabled, providing traditional transit services in ways more appropriate for the handicapped and elderly, and providing car-type transportation without expensive formalized special systems. Special transit services should be reserved for those unable to drive themselves, receive rides, or use specially designed fixed route transit services. First, since some of the difficulty in driving is financial, the government could offer insurance and gas subsidies to the disabled or elderly who could periodically demonstrate competent driving skills. These subsidies could, of course, be made contingent on demonstrating financial need. Second, to use existing private resources to support the elderly and disabled, the government could develop fairly large scale programs which reimburse drivers (with adequate insurance and competent driving skills) for the costs incurred in transporting these people. This approach has two implications; first, since some of the recipients will themselves be elderly, this approach keeps some elderly drivers driving longer (through the minor financial supplements). Second, this approach will allow the elderly person driving others to be useful; Frances Carp has noted that one of the reasons the elderly fear losing their licenses is that they like giving rides to other people because it makes them feel needed. Since the elderly and disabled without licenses take most of their trips in cars, they obviously know people who drive. Those needing rides may be more willing or able to ask for help if they can offer the driver a financial incentive. Third, several options would make traditional transit more responsive to the needs of the disabled. Traditional fixed route transit services could be reoriented to serve the suburban origins and destinations of elderly people and particularly elderly women. Specially targeted fixed route services have been successful in some American cities; in a large Swedish city, re-organizing traditional buses to serve concentrations of elderly people reduced the demand on the special transit system by over 50%. Smaller buses, with lower entry steps, might make it easier for those with moderate difficulties to travel.

56

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

Another option involves community-based services, generally in smaller more accessible vehicles. Such services are being provided in limited suburban areas in a number of communities, offering either demand-responsive or fixed route transit or some mixture of both. For example, Memphis, San Diego, and Tucson have each contracted with private operators to provide community-based services in low density areas. In all cases the cities have reduced the actual or expected subsidy required by traditional services, with the majority of riders being elderly travellers. Fourth, in order to provide the flexibility of the car without organizing a formal system, the government could make better use of existing community providers like taxis. The transit authority or other public agency in each community could negotiate lowered taxi rates for all elderly and disabled citizens. Most local taxi operators would be very willing to cut regular meter fares by 10-20% if they were guaranteed some volume of business. The guarantee would require little public subsidy in the long run. For the elderly or disabled unable to pay the reduced taxi rates, public agencies could offer user-side subsidies, subsidizing some or all of the fare. Many communities have found this to be a cost-effective option. Several U.S. cities have instituted user-side subsidies and their costs have been, in general, substantially lower than organizing a public system to deliver special services, even if the public agency contracted with a taxi operator to provide that service! Last, special transit systems should be operated for those who can find no one to drive them, who cannot use traditional transit no matter how it is routed, and who cannot use reduced or subsidized-fare taxis. Such services are very expensive and are only cost-effective for those who cannot be served in any other way. In general this would encompass very handicapped individuals and those who need escorts or supervision during travel. Obviously, these alternatives may be not be possible or available in all communities. The transit options are not very appropriate for rural communities; there the elderly and disabled must rely on other drivers. Not all communities have taxi operators, although many more have taxis than have transit operators. But these prototypes suggest important ways to augment special services and transit services in order to meet the mobility needs of the elderly and handicapped now and in the future.

THE US APPROACH

57

Table 1

D IR E C T L Y

OR

E IG H T M A JO R D O T /H H S P R O G R A M S TH A T IN D IR E C T L Y F U N D T R A N S P O R T A T IO N S E R V IC E S

Total Program Federal Programs/Administrative Agency Estimated 1987 ___________________________________________Appropriation DOT Programs

Beneficiaries

‘ Section 9 * Urban Mass Transportation $ 2 ,2 2 4 ,9 8 9 ,0 0 0 Capital and Operating Assistance Formula Grants Formula Grants Urban Mass Transportation Administration

Individuals residing in urbanized areas benefit from these grants to public and private operators of mass transportation services. (Some diversion to rural areas is possible.)

•Section 16(b)(2) * Urban Mass Transportation Capital Improvement

$ 3 5 ,0 0 0 ,0 0 0 Project Grants

Elderly and handicapped individuals can receive transportation services through funded nonprofit organizations or private operators contracting with the nonprofit organizations.

‘ Section 18 - Public Transportation for

$ 7 5 ,0 1 1 ,0 0 0

Nonurbanized Areas Urban Mass Transportation Administration

Formula Grants

Individuals residing in rural or small urban areas can receive transportation services from public transportation providers funded with these grants or private operators contracting with the public providers.

Grants Urban Mass Transportation Administration

HHS Programs Individuals meeting income and resource requirements and requiring medical services can receive transportation services to medical

•Medical Assistance Program - Medicaid, Tile XIX Health Care Financing Administration

$ 2 6 ,7 0 0 ,0 0 0 ,0 0 0 Formula Grants

•Special Programs for the Aging • Title III, Parts A & B-Grants for Supportive Services and Senior Centers Administration on Aging, Office of Human Development Services

$ 2 7 0 ,0 0 0 ,0 0 0 Formula Grants

Older persons aged 60 and over, especially those with the greatest social and economic needs, can receive transportation services to and from senior multi-purpose centers, medical services, shopping, and other locations.

•Special Programs for the Aging - Title III, Part C-Congregate Nutrition Services Administration on Aging. Office of Human Development Services

$ 3 4 8 ,0 0 0 ,0 0 0 Formula Grants

Older persons aged 60 and over and their spouses, especially those with the greatest social and economic needs, can receive transportation services to and from nutrition sites.

‘Social Services Block Grant Office of Human Development Services

facilities.

$ 2 ,7 0 0 ,0 0 0 ,0 0 0 Formula Grants

Depending on the services provided by the grant, individuals defined as eligible by the program can receive transportation services to support program services.

Source: Derived from the 1987 Catalog of Federal Domestic Assistance. Executive Office of the President. Office of Management and Budget and U.S. General Services Administration, Washington, D.C. (June)

58

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

Table 2 Percentage of Elderly Using Special Transportation Services, 1983, by Age and Sex

20

-

All

HO Ma,e I

65-74

I Female

75+

Source: Calculated from unpublished data from the 1983 National Personal Transportation Study

16--6Q

90.0

81.3

URBAN

1 9 77

1983

85.0

1983 91.6

93.5

87.1

85.2

89.7

91.4

82.2

79.4

6 6 -7 0

87.5

86.3

83.3

80.1

71 -75

88.7

83.1

81.8

70.8

7 6 -8 0

Private Vehicles = Autos, trucks, passenger & other vans, station wagons, and R.V.s

Source: Calculated from unpublished data from the 1977 and 1983 National Personal Transportation Study

87.7

1977

RURAL

3

Percentage of All Trips Taken In Private Vehicles in 1977 and 1983 in Urban and Rural Areas by Age Group

Table

82.2

84.8

75.7

63.7

81 -85

80.2

94.2

74.6

67.4

85 +

60

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

Table 4 L a te n t D e m a n d fo r T ra n s p o rta tio n S e rv ices of the P o p u latio n 65 and O ver In 2000 (B a s e d on H ig h P o p u la tio n P ro je c tio n s fo r 200 0)

Number Who Trips/Capita/Year* Total Annual Trips Do Not Drive Not Made 1 7 3 4 .4

Urban Actvity Limitation_______________ Unable to Conduct Major Activity Limited in Major Activity Limited but Not in Major Activity Unlimited

1 ,4 2 5 ,2 0 8 ,5 8 2 1 ,7 1 1 ,1 4 5 ,3 8 8 5 1 5 ,3 1 7 ,4 1 7 3 .0 4 0 ,9 8 4 ,0 7 3

8 2 1 ,7 3 0 9 8 6 ,5 9 2 2 9 7 ,1 1 6 1 ,7 5 3 ,3 3 5 1 7 3 4 .4

Suburban Actvity Limitation_______________ Unable to Conduct Major Activity Limited in Major Activity Limited but Not in Major Activity Unlimited

2 ,1 0 1 ,5 7 8 ,7 5 6 2 ,5 2 3 ,2 1 4 ,3 1 2 7 5 9 ,8 7 4 ,8 3 5 4 ,4 8 4 ,1 6 2 ,9 5 6

1 ,2 1 1 ,7 0 4 1 ,4 5 4 ,8 0 5 4 3 8 ,1 2 0 2 ,5 8 5 ,4 2 6 1 6 7 9 .3

Rural Actvity Limitation_______________ Unable to Conduct Major Activity Limited in Major Activity Limited but Not in Major Activity Unlimited

1 ,0 5 8 ,5 0 0 1 ,2 7 0 ,8 6 4 3 8 2 ,7 2 5 2 ,2 5 8 ,5 3 3

T o ta l N u m b e r o f T rip s N ot T a k e n D u e to L a c k of T ra n s p o rta tio n

1 ,7 7 7 ,5 3 8 ,5 6 8 2 ,1 3 4 ,1 6 2 ,5 8 7 6 4 2 ,7 1 0 ,5 4 4 3 ,7 9 2 ,7 5 4 ,6 4 9

2 4 ,9 0 8 ,6 5 2 ,6 1 6

Sources: Calculated from the Driving Loss Model, derived from cohort-specific activity limitation rates and non-age specific HIS data Published in Lewis and Smith, 1985 and Developments in Aging, 1983: and mid-series population estimates published in U.S. Department of Commerce. Bureau of the Census. 1980 Current Population Reports, Population Estimates and Projection, Series P-25, No. 952. Also based on unpublished 1983 National Personal Transportation Study data.

Difference in trip rate between comparable people who have and do not have drivers licenses.

TOWARDS A DOCTRINE OF MOBILITY AS A HUMAN RIGHT

by: David L. Lewis, Ph.D. James F. Hickling Management Consultants Ltd. Toronto, Ottawa, Washington D.C.

Ling Suen, M.A., C.I.P. Transportation Development Centre Montreal

61

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

62

I. INTRODUCTION

Since the early 1970s, nations have taken steps to help disabled persons free themselves from the traditional bonds of debility— isolation, loneliness, unemployment, poverty, and discrimination. One of the most visible symbols of this concern was passage in the United States of Section 504 of the Rehabilitation Act. Enacted in 1973, Section 504 applied the same principle to disability as that applied nine years earlier when the Civil Rights Act of 1964 prohibited the denial of human rights on the basis of race, sex and religion. By simply replacing the words "race, sex and religion" with the term "handicap", Section 504 became the disabled population’s basis for seeking mobility and access to virtually all American institutions; Section 504 states that; no otherwise qualified handicapped individual in the United States shall, solely by reason of his handicap, be excluded from the participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving federal financial assistance.1 While the United States tackled the problem of integrating disabled people into mainstream society from the standpoint of human rights, Canada and the nations of Europe viewed transport for disabled persons as a "merit good", a minimum level of which is to be supplied to all, regardless of their ability to pay. A merit good is a commodity or a service that is consumed in an amount smaller than the minimum considered to be necessary in order to achieve a social optimum. Once a merit good is identified, governments will induce more consumption through subsidies and other means. In other words, many nations tended to view poor mobility among disabled people as a transportation problem rather than a denial of human rights. The war in Vietnam, which produced large numbers of disabled Americans in the late 1960s and early 70s, coincided with a decade characterized by the most intense scrutiny of civil and human rights in U.S. history. This convergence of events goes far to explain the rights oriented approach to disability taken in the United States as distinct from the more technical focus adopted in other nations. Over the years, however, the U.S. disabled-rights movement steadily spilled across national borders. Encouraged further by events such as the United Nation’s International Year of the Disabled and the spread of organized disability groups, human rights is steadily — perhaps inevitably — emerging as a mobility issue in Canada, Europe, Africa, South America, Australia and the Middle East. Though still wrestling with its transport implications, Canada’s transport policy has been newly grounded in a Charter of Rights and Freedoms (1982) and the Canadian Human Rights Act (first enacted in 1976 but amended to cover disability in the 1980s). The Charter of Rights and Freedoms states that;

l

Public Law 93—112, 93d Congress, H. R. 8070, September 26, 1973.

A DOCTRINE OF MOBILITY

63

Every individual is equal before and under the law, without discrimination based on race, national or ethnic origin, colour, religion, sex, age or mental and physical disability (Section 15). And here in Sweden, the Fifth International Conference on Transport for Disabled and Elderly Persons (May 1989) is titled Towards Mobility as a Human Right and reflects Europe’s recognition of the need to struggle with the implications of this newly emerging issue. The U.S. experience indicates in fact that such implications could be very major indeed. In no area has the application of Section 504 been as confounded by litigation, controversy, and polemics as in transportation. Key problems are the lack of any clear social or legal doctrine for determining what constitutes discrimination in the provision of transport services and the absence of consistently sound policy analysis as a basis for making administrative and judicial decisions. To help nations plan the way in which they integrate the human rights focus into transportation policy and planning for the disabled, this paper presents an in—depth review and analysis of experience in the Western world. Section II looks closely at the United States and Canada. More so than any other nation, the U.S. has run the gamut from a pure transportation policy focus to one geared entirely to human rights. Canada has followed a more steady course, although recent developments are suggestive of change. Section II looks carefully at the evolution of policy in North America, analyzing key administrative and Court rulings from 1973 to the present. Section III then presents a comparative analysis of North America, Europe and the developing world over the same period of time. Guided by the findings of Sections II and III, the fourth section examines the need for a firmer foundation, or doctrine of human rights to guide transportation policy in the coming decades. The section develops principles upon which such a doctrine might be established. Conclusions are offered in Section V. To aid in the development of a stable doctrine of human rights, the Appendix investigates the relevant judicial principles, using key Court cases as the basis for analysis. Although many more cases have been heard in United States than elsewhere, some significant Court rulings have been delivered in other nations as well.

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

64

II. NORTH AMERICA

Though similar in geography and urban culture, the United States and Canada have taken very different approaches to transportation in the context of human rights. This Chapter looks at both nations, beginning with the United States. THE UNITED STATES Interest in the travel problems of disabled people emerged in the late 1960s and by 1975 the federal government had developed regulations requiring that urban transportation make "special efforts" to serve their needs. Over the same period, interest in "paratransit" technology and transit delivery systems was growing rapidly. Legitimized by the Urban Institute and the Massachusetts Institute of Technology Encouraged and encouraged by research and demonstration projects financed by the Urban Mass Transportation Administration, paratransit in the form of dial-a-ride and related door-to-door transit systems quickly became the most popular "special effort" at the local level. Although Section 504 was enacted in 1973, it remained obscure and un—noticed until, in 1977, the American Coalition of Citizens with Disabilities (ACCD) and the Paralyzed Veterans of America (PVA) brought Section 504 into national focus by objecting to paratransit on the grounds that it represents a form of de facto discrimination and thus inconsistent with the protections offered under Section 504. They also showed, correctly, that the federal government was required to establish regulations to implement Section 504 and that no action had been initiated by the federal government. To bring federal programs into compliance with Section 504, President Ford issued Executive Order 11914 directing the Department of Health, Education and Welfare (HEW) to establish specific guidelines for determining what practices constitute discrimination within the meaning of Section 504. In January 1978, HEW issued final guidelines and a timetable for the publication of regulations by the federal agencies. The key feature of the guidelines is the requirement that existing facilities be accessible to handicapped persons: A recipient of federal funds shall operate each program or activity so that the program or activity, when reviewed in its entirety, is readily accessible to and usable by handicapped persons. This paragraph does not necessarily require a recipient to make each of its existing facilities or every part of an existing facility accessible to and usable by handicapped persons.2 The Department of Transportation (DOT) has the responsibility to administer federal guidelines in regulating programs for financial assistance to local transportation 2

Department of Health, Education, and Welfare, Implementation of Executive Order 11914. Federal REgister, January 13, 1978, Part V.

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operations. Working closely with the ACCD and the PVA, it published rules for that purpose in January 1979.3 They required that: All buses purchased after July 2, 1979, must be equipped with features that enable wheelchair users to ride them; All buses must adhere to the Transbus design (Transbus is the name for a bus with a very low floor and one less step inside than present buses) as soon as it is manufactured.4 Key stations, defined according to criteria in the regulations on subway and commuter rail systems, must be equipped with elevators within 30 years; key stations on light rail systems must be equipped with elevators within 20 years; At least one car per train on subway and commuter rail systems must be adapted to allow wheelchair users to board. Half the fleet of streetcars must be accessible within 20 years; and Where all changes are not completed within three years, each city must make available some form of temporary service (like fitting lifts to old buses, or supplying some form of temporary taxi service). Public Reaction A wide range of possibilities exist for diminishing the travel problems of handicapped persons, including cash subsidies, adaptations to existing regular route bus and rail services, door-to-door vans and taxis (so-called "dial-a-ride") and specially adapted automobiles. To one extent or another, most nations have devised plans based on a combination of approaches, each tailored to the different requirements of persons with different disabilities and income levels. In the United States, the question of human rights led the question of alternatives to become a source of great controversy. Those speaking on behalf of advocacy groups of handicapped persons maintain that special door-to-door services are discriminatory and that Section 504 protects them against such discrimination by guaranteeing their right to use the same federally financed public services available to everyone else. Other handicapped persons argue that separate services are permissible, but only it they offer a standard of convenience "equal" to that of transit. The argument has been advanced by many transit authorities that services which take passengers from door-to-door help a far greater number of severely disabled Federal Register, Vol.44, No. 106, July 31, 1979. In late 1979, transit bus manufacturers refused to bid for Transbus production contracts, claiming that a low-floor bus represents too large a financial risk and is technologically impossible to build. To investigate that charge, DOT commissioned a study by a technical panel of the National Academy of Sciences. That panel, in September 1979, agreed that Transbus represents considerable financial risk, and that its key components are unproven.

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MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

persons than would the adaptations to buses and trains called for by DOT. Although so-called "user-side" subsidies—coupons that are tradeable for reduced-fare taxi rides— represent a popular form of such door-to-door service, the use of direct cash subsidies (such as the British Mobility Allowance) has yet to emerge as a serious option in the debate surrounding Section 504. Much controversy has also arisen over costs. Those who favour door-to-door services often argue that they cost less to provide. Others who favour transit adaptations argue either the reverse, or that cost is not an issue where civil liberties and integration are concerned. There is no question, however, that either approach is costly, and that pursuing one would reduce the financial means available to pursue the other.5 Judicial Review Numerous cases have been brought under Section 504 to address these questions. Cases fall into three main categories: those which discuss whether Section 504 creates a private right of action;6 those which discuss whether Section 504 creates an affirmative duty;7 and those which discuss the requirements of Section 504 with regard to the specific public services, such as education and transportation.8 In Southeast Community College v. Davis9 the U.S. Supreme Court for the first time interpreted Section 504 of the Rehabilitation Act. Although the case dealt with educational opportunities for handicapped persons, it has important implications for transportation. In its decision of June 11, 1979, the Supreme Court found that Section 504 would not preclude a public college from denying an individual admission to a nursing program because of a hearing impairment, where the impairment itself might interfere with the ability to perform duties safely. The Court found that Section 504 imposed no affirmative duty to modify educational programs in this situation, observing that technological advances could be expected to enhance opportunities for handicapped persons to participate in programs, but Op. Cit. Congressional Budget Office. The leading case of the question of a private right of action is Lloyd v. Regional Transportation Authority. 548 F.2d 1977 (7th Cir. 1977). See also, Lau v. Nichols, 414 U.S. 563 (1973), and Cort v. Ash. 422 U.S. 66 (1975). Ibid, Lloyd v. Regional Transportation Authority, see also, Handicapped Federation v. Andre. 588 F.2d 413 (8th Cir. 1977).

United

Paralyzed Veterans of America v, Colman. 451 F. Supp.7 (E.D. Mich. 1977); Leary V. University of North Carolina. 440 F.Supp. 226 (E.D. Wics. 1977); Snowden v. Birmingham-Jefferson Countv Transit Authority. 407 F.Supp! 636 (N.D. Ohio 1977); Atlantis Community v. Adams. 453 F.Supp. 825 (D. Colo. 1978); Leary V. Crapsve. 566 F.2d 863 (2d Cir. 1977). Southeast Community College v. Davis, 47 U.S.L.W. 4689 (June 11, 1979).

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"without imposing undue financial and administrative burdens upon a state."10 Further on the question of affirmative effort the Court state that; Section 504 does not refer at all to affirmative action, and except as it applies to federal employers, it does not provide to for implementation by administrative action ... here neither the language, purpose, nor history of Section 504 reveals an intent to impose an affirmative action obligation on all recipients of federal funds. Accordingly, we hold that even if HEW has attempted to create such an obligation itself, (through its regulations of January 1978, see page 16 above ... author’s note) it lacks the authority to do so.11 The Court reserved judgment on whether Section 504 gives rise to a private right of action. The Davis decision has already had a far reaching impact on the application of Section 504 to transportation programs. In APTA v. Andrew Lewis the U.S. Court of Appeals for District of Columbia struck down the validity of the DOT regulations under Section 504, remanding them to the Secretary of Transportation for his reconsideration.12 Applying the Davis standards, the APTA Court noted that at some point a transit system’s refusal to take modest, affirmative steps to accommodate handicapped persons might violate Section 504. Nevertheless, the Court found that: DOT’S rules do not mandate only ... modest expenditures. The regulations require extensive modifications of existing systems and impose extremely heavy financial burdens on local transit authorities ... These are the kind of burdensome modifications that the Davis Court held to be beyond the scope of section 504.13 Congressional Review While the Appeals Court was engaged in its deliberations, two other events transpired that would secure the demise of the DOT regulations. In the House Public Works Committee in June 1979, Representative James Cleveland offered an 10

Ibid, at 4693.

11

Op. Cit. at 4692.

12

American Public Transit Association et. al v. Brock Adams et. al. 80—1497 (U.S. Court of Appeals for the District Court, 1979). The American Public Transit Association is a voluntary trade organization for public transit operators in the United States and Canada, which brought suit in federal District Court to enjoin the U.S. DOT regulations. The District Court had entered a judgment affirming the validity of the regulations, see American Public Transit Association et. al. v. Brock Adams et. al. 791697 (U.S. District Court for D.C. 1979).

13

Ibid. APTA v. Adams, at 12-13.

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amendment to the Surface Transportation Amendments Act that would devolve most decisions on public transport for the handicapped to states and localities. It did, however, attempt to define minimum standards of service, such as a reasonable advance reservation period for dial-a-ride services, (some services today require a day or more of advance notice—see below). Passed on the floor of the House, the Surface Transportation Act was killed by a filibuster in the lame-duck Senate of December 1980, (for reasons unrelated to Section 504). Still, politically untouchable up to that point, Section 504 was now fair game in both Chambers of the Congress. Second, the November 1980 Presidential elections brought to power an Administration dedicated to a reduction in federal regulation. Within six weeks of taking the Oath of Office, President Ronald W. Reagan placed the DOT rules on a list of regulations scheduled for an Executive review of cost-effectiveness in federal rulemaking. Six weeks after that, however, the Administration proposed new legislation to devolve virtually all decisions on transportation for disabled persons to states and localities. The Administrations’s preference for new legislation rather than new regulations probably stemmed from a number of factors. For one thing, DOT under President Carter had vigorously defended its regulations against analytical studies that demonstrated the high cost and low effectiveness of adapting regular transit vehicles for wheelchairs. DOT had published its own estimates which indicated superior benefits and lower costs for adapted transit as compared to other alternatives, such as door to door dial-a-ride service. A regulatory change would thus place DOT civil servants on the spot; they would have to suggest that those estimates were in error, or enact new regulations with a seemingly inferior costbenefit profile. Also, new legislation could provide the sound legal basis that administrative action had lacked to date. Despite all this, the Appeals Court decision in June 1981 put delay in the hope of new legislation out of reach of the President. The problem was no longer one of influencing Congressional decisions. The Reagan administration was required to issue new rules, consistent where possible with its predilection toward states rights, and in line with the Appeals Court decision which had noted that the "...line between a lawful refusal to extend affirmative action and illegal discrimination against handicapped persons will not always be clear,"14 and that "situations may arise where refusal to modify an existing program might become unreasonable and discriminatory."15 So-called "interim" regulations (temporary guidelines to steer localities prior to the issuance of revised final rules) for that purpose took effect in July 1981, four weeks after the APTA Court ruling.16 Predictably, transportation planning for the disabled was devolved to the states and localities. Efforts to define minimum service quality standards were absent. Instead, general examples of acceptable approaches were supplied, such as lift-equipped fixed-route buses, door-to-door public transportation, and user-side subsidies. Localities were encouraged to spend a minimum of 5 percent of their federal financial assistance on service for disabled 14

Op. Cit. at 12.

15

Op. Cit. at 12.

16

Federal Register, July 20, 1981.

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persons (a figure based simply on the estimated proportion of the general public who have transportation-related handicaps). Section 504 gained renewed Congressional interest a year later. As of July 1982, when the Congress was preparing to debate major new highway and transit bills, DOT had yet to propose a final regulation under Section 504. Democratic Senators Cranston and Riegle—both long-standing proponents of "handicapped rights"— expressed concern over DOT’S sluggishness and over the fact that the interim regulations failed to ensure adequate service quality for disabled persons. In particular, Senator Cranston pointed to wide-spread deficiencies in existing door-todoor services such as long advance booking requirements, trip purpose restrictions, restricted geographic service areas, and other limitations designed to ration limited door-to-door vehicle fleets. He argued that DOT’S regulation should seek to prohibit such deficiencies in localities that elect to provide door-to-door service in lieu of lift-equipped fixed-route service. To address these concerns, the Congress Transportation Act of 1982 requiring that:

included language

in the Surface

"... the Secretary (of Transportation) shall, not later than 90 days after the date of enactment of this subsection, publish ... for public comment, proposed final regulations to implement Section 504 and, not later than 180 days after the date of such enactment, promulgate final regulations, establishing ... minimum service quality criteria for the provision of transportation services to handicapped and elderly individuals ...ll17 Revised Administrative Decisions Though wide of the mark in terms of the deadline, on September 8, 1983, the Department of Transportation responded to Section 317(c) and published regulations1718 to guide local transit operators in complying with the requirements of Section 504. The final regulations specify transportation options that would meet the requirements of Section 504; they specify minimum criteria governing the level and quality of service; and they propose the concept of a cost cap to limit operators’ financial liability in complying with the minimum criteria. Options. The regulations allow localities to select their own approach serving the transportation needs of disabled persons from a range of permissable options. These are: Equip 50 percent of the fixed route bus fleet with wheelchair lifts. In pursuing this approach, the transit authority would have to ensure that at least half of the buses it operates during peak and off-peak periods are lift-equipped for wheelchair users.

17

Section 317(c): Surface Transportation Assistance Act of 1984.

18

Federal Register 48 FR 40684.

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MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS According to the proposed Offer Specialized paratransit service. regulations, such a system would provide demand-responsive service by means of lift-equipped vans operated by the transit authority or subsidized user-side taxi vouchers. A mix of fixed route and paratransit service. This option allows a variety of approaches. For example, the transit operator might adapt fewer than half the buses with wheelchair lifts (say, 15 percent or 25 percent) while using paratransit service to cover parts of the city not serviced by lift-equipped buses.

Transit operators that opt to provide specialized demand responsive transportation would need to establish eligibility criteria such that all persons who are physically unable to use the recipient’s regular inaccessible service are permitted to use the specialized service. Service Quality Criteria. Transit operators opting for specialized door-to-door service are by the regulations to meet six minimum service criteria, although only if doing so would not cost more than the specified cost cap. The criteria are outlined as follows: Under the first criterion, service shall be available to handicapped persons throughout the same general service area as the operator’s service for the general public; Under the second criterion service shall be available on the same days and during the same hours as the recipient’s service for the general public; Under the third criterion the fare for a handicapped person using the specialized service shall be comparable to the fare for a member of the general public using the operator’s regular service; The fourth criterion prohibits the establishment of trip purpose priorities or restrictions that do not apply to the general public’s use of the operator’s regular service; The fifth criterion addresses the long period of time that elapses under many existing systems between a request for service and the arrival of a vehicle. The DOT notes that this waiting period can be 48 or 72 hours in some cases and is far longer than a member of the general public must wait for public transportation. This criterion would limit the waiting period to a "reasonable time" to be determined by the operator, after obtaining the views of handicapped persons and their organizations through the public participation process; The sixth criterion prohibits the use of waiting lists; this criterion would require the door-to-door service system to have sufficient capacity to serve all eligible users. Cost Cap. As noted above, the regulations provided a cost cap to determine the maximum amount a transit operator needs to spend in providing service for disabled

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persons. This means that if a locality cannot meet all six criteria within the cost cap, it can, if it chooses, make trade-offs among all six service criteria until costs fall to that level. (A transit operator can, if it so elects, spend more than the upper limit.) It is noteworthy, however, that tradeoffs in minimum eligibility standards would not be allowed (such a limiting service to wheelchair users while maintaining a high level of service). The cost cap was defined as 3.0 percent of the average annual transit authority operating expenses over the current and previous two fiscal years. Underlying Basis of the Proposed Regulation: conflicting Legislative and Judicial Requirements. The legislative and judicial requirements to be met by the Department’s regulation serve different and sharply conflicting objectives. The minimum service criteria represent the Department’s response to legislative policy established in Section 317(c) of the Surface Transportation Assistance Act of 1982; the cost cap, on the other hand represents the Department’s response to judicial constraints articulated in two court decisions of 1979—Southeast Community College versus Davis and APTA versus Andrew Lewis. Section 317(c) of the Surface Transportation Assistance Act of 1982 requires the Department to establish minimum criteria to ensure an adequate level of transportation service for handicapped persons. As noted above, Senator Cranstron, a co-sponsor of the legislation, pointed to "wide-spread deficiencies" in paratransit service for handicapped persons (such as long advance notice requirements and priorities based on trip purpose) and the legislation seeks to change that situation. The judicial requirements do not pertain to service quality, however. Rather, the case law addresses the level of financial responsibility that the government can impose upon a state or public agency in regulating its activities. Applying the standards developed in the Davis case, the APTA court noted that at some point a transit system’s refusal to make modest, affirmative steps to accommodate handicapped persons might violate Section 504. However, with regard to the Department’s Section 504 of 1979 the Court determined that; DOT’S rules do not mandate only modest expenditures. The regulations require extensive modifications of existing systems and impose extremely heavy financial burdens on local authorities ... These are the kind of burdensome modifications that the Davis Court held to be beyond the scope of Section 504.19 To be sure, the concept of "burdensome modification" or "undue hardship" is not well developed in the case law (nor in the comments to the proposed regulation of September 1983); the cost cap developed in the proposed regulation is, in effect, a surrogate for the approximated level above which expenditures by a recipient of federal transit subsidy would create an undue financial burden. Although lift-equipped fixed route buses and specialized paratransit systems are in operation in various cities around the nation, five critical questions needed to be addressed regarding the proposed regulation: 19

Ibid APTA v. Lewis, at 12-13.

72

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS Are the six minimum service criteria consistent with notions of equity and equal benefit under Section 504?; What represents a "reasonable" advance response time— how can planners actually define reasonableness in designing transportation systems under the DOT specifications?; To what extent can paratransit that meets the six minimum service criteria be provided within the either one of the two proposed cost caps?; If paratransit that meets the six minimum service criteria cannot be provided within the cost cap, what kind of reductions in service quality would be needed to bring costs into line; or what kind of increases in the cost cap would be required to assure that the criteria are met?; and How would the costs of adapting fixed-route buses for wheelchairs compare with the costs of providing specialized paratransit service and with the cost cap? .Back to Court

Although disability groups were satisfied with the six minimum service criteria in the new regulation, they were affronted by the notion of a cost cap. The DOTs own analysis had shown that smaller cities might have difficulty meeting the six criteria within the cost cap and disability groups argued that the regulation thus permitted a violation of their human rights. In 1985 the Eastern Paralyzed Veterans of America once again took the federal government to court and obtained a ruling that the cost cap concept in the regulations "eviscerates" the human rights of disabled people and thereby appeared to reject the Supreme Court’s concept of undue financial burden. Although the federal government appealed that ruling, an early 1989 decision upheld the lower court’s decision and also found that the 1985 regulatory action permitting the use of paratransit in lieu of lift-equipped buses was itself ultra viries. As things stand now, therefore, cities in receipt of federal transit funds are once again required to include lift-equipped fixed-route bus service in their development plans. ... and Back to Congress At the same time, however, Congress is once again considering new legislative steps. Through the proposed Americans with Disabilities Act of 1988 Congress would require that half of the peak—hour fleets of transit vehicles be lift—equipped within seven years and that paratransit and other specialized services must be treated as "supplementary" to accessible fixed-route public transport. CANADA Early initiatives in Canada mirrored the "special efforts" philosophy of the United States and, as in the U.S., pre—dated the establishment of special legal protections regarding the civil and human rights of disabled people. Transport policies reflected the belief that many disabled people had severe mobility limitations and policy

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makers sought the most effective and efficient means of diminishing the problem. After considerable study by the policy community, mainly at the provincial and municipal level, a consensus emerged in favour of paratransit and by 1980 virtually every Canadian city offered a specialized door-to-door service. Major new urban rail systems are constructed to accommodate wheelchairs but beyond this (two systems) there is no local fixed-route accessible service. Constitutional and Legislative Origins of Transport Policy Promulgated in the early 1980s, the Canadian Charter of Human Rights and Freedoms was enacted on behalf of all Canadians and singled out a wide range of minorities, including the mentally and physically disabled, in declaring that all are equal before the law. In addition, amendments to the Canadian Human Rights Act empower the federal government to make regulations "prescribing standards of accessibility to services, facilities or premises, for the benefit of persons having any disability". In addition, a Federal Human Rights Commission was established to hear complaints against transport providers under the terms and conditions of the Charter. Although there is no requirement for carriers regulations made under the Human Rights Act, complaints before the Canadian Human Rights be consistent with the regulations would discriminatory practice.

to comply with federal standards or sanctions can flow from the filing of Commission. Any practice found to be deemed to constitute a non-

Judicial Origins of Policy As in the United States, policy in Canada has its origins in Constitutional, legislative and judicial activity. In July of 1980, the Canadian Transport Commission (CTC — a quasi-judicial regulatory authority and independent court of record— now replaced by the National Transportation Agency) issued a key decision in the case of Clariss Kelly, a law student in a wheelchair who sought to travel from her home to school and back by train. The railway had refused to assist her to board its trains and required that she be accompanied at all times by an attendant, who would be charged an additional fare.20 Acting under the general authority of the National Transportation Act of 1968, the Committee granted disabled people access to rail transportation, arguing that; "Miss Kelly in our view has much to contribute to society and we will lose in the long run by allowing barriers, either financial or otherwise, to be placed in her way when she travels"21

20.

David Baker, Air Accessibility Standards: The Canadian Model, Third International Conference on Mobility and Transport for Elderly and Disabled Persons, October 1984, page 4-1

21

Clariss Kelly v. VIA Rail Canada (1980) 1 CHRR D/97 at 107/8.

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The CTC established four principles as part of the Kelly decision, as follows; o

Lifting devices were required at all major intercity rail stations to enable boarding by wheelchair users (manual devices were to be installed immediately and a plan presented by the rail authority was accepted as a basis for longer term development);

o

Disabled people were granted the right to decide whether or not they require an attendant on a public conveyance under federal jurisdiction;

o

Attendants were required to be considered "an extension of the disabled traveller" and thus not charged a separate fare; and

o

The rail authority was denied the right to deny carriage to a disabled person or to require waivers of liability on the grounds of safety .

Technological Response and Innovation Although the Kelly decision preceded enactment of the Charter and Rights and Freedoms, it nevertheless stimulated a concerted effort to find means of making intercity modes of transportation physically accessible people in wheelchairs and others with severe debility. In 1982, for example, federal Department of Transport funded a demonstration project for the development and acquisition of a wheelchair accessible bus to be operated in regular intercity service for a period of three years. Success with the experiment led Transport Canada to establish the objective of an accessible bus in every major intercity bus route within a period of two years.22 More recently, the federal government has initiated a range of other initiatives that reflect a priority on access to intercity modes of transport, as follows; o

Development of a suitable aircraft boarding device for transferring wheelchair users from the terminal to the aircraft;

o

A plan on how to provide accessible transportation services at airports;

o

Financial assistance to intercity bus operators for the installation of of wheelchair lifts.

22.

The objective was reported in 1986 (see, F.M. Kennedy et. al., A Program to Provide Intercity Bus Transportation for the Mobility Disadvantaged, Proceedings of the Fourth International Conference on Mobility and Transport for Elderly and Disabled People, July 1986, p. 475. Although the objective has not yet been achieved, it remains in place at the time writing.

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Current Policy Current policy in Canada stems from the complex web of technical research and Constitutional, legislative and judicial history outlined above. Moreover, policy appears divided along modal lines, the division reflecting federal versus non-federal modal jurisdictions. With jurisdiction over intercity rail, bus and air transportation, the federal government is pursuing a steady course of technological research and the development of standards both designed to promote full access to fixed-route intercity modes. Although this policy stems more from judicial decisions and principles of human rights rather than a technical analysis of alternative modal alternatives it also reflects the fact that "paratransit" is simply not a practical alternative for most long-distance forms of transportation. Urban transportation policy in Canada, which is under the jurisdiction of Provincial and municipal governments, remains very much a reflection of the specialized, paratransit philosophy. Although a number of Provincial and municipal authorities have given serious consideration to the fixed-route accessible option, there are no fixed-route accessible transit buses operating in Canadian cities today. Why is it that with the U.S. experience geographically so close at hand and with the stimulus of an accessible policy at the intercity level, the urban experience in Canada has remained so firmly one of specialized, paratransit? One reason is that advocacy groups acting on behalf of the disabled have chosen to focus their efforts for the time being at the federal level and thus on intercity transportation. As well, the absence of any significant federal jurisdiction over urban public transport in Canada has meant that the only national focus has been that of the transit industry itself, as represented by the Canadian Urban Transit Association (CUTA). Like APTA in the United States, CUTA is firmly in favour of paratransit and against fixed-route access on grounds of cost and effectiveness. Nevertheless, there are emerging signs that accessible fixed-route transit is emerging as a serious policy alternative in certain parts of Canada. BC Transit of Vancouver in the Province of British Columbia is now looking seriously at the possibility of making fixed-route buses accessible and public hearings were underway in March, 1989. It is probably no coincidence that Vancouver is only a two-hour drive from Seattle in Washington State, the most successful accessible bus system in North America. It is not surprising to find a demonstration effect of human rights on transit policy, an effect that can be expected to take hold on a global basis. We look more closely at global trends next.

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III. EUROPE. NORTH AMERICA AND THE DEVELOPING WORLD: A COMPARATIVE ANALYSIS

The analysis presented in the previous section suggests a framework within which to compare and contrast nations generally. Presented in Figure 1, the framework classifies each nation’s policy response along a continuum defined by specialized transportation at one extreme and accessible fixed-route service at the other. Each policy response is set in the context of the nation’s underlying rationale for policy which is also characterized by a continuum, with transportation as a merit good at one extreme and as a human right at the other. Shifts over time in a nation’s policy rationale and response are shown as separate points in the Figure. As indicated in Figure 1, the analysis suggests three important trends, as follows; o

Policies grounded in the rationale of transportation as a merit good have never led to an emphasis on fixed-route accessibility (note the empty upper-right quadrant of the Figure). Recognition of fixed-route accessibility as a principal policy instrument appears to require the incorporation of human rights into the underlying policy rationale;

o

While all nations initially established policy according to the merit good philosophy, all have shifted, to one extent or another, to a human rights focus as well, leading to progressively more acceptance of fixed-route accessibility; and

o

Attempts to build a transportation policy on the basis of a pure human rights rationale result in vacillation and unstable policies and programs. Instability stems from the absence of a generally accepted doctrine of what constitutes discrimination in the provision of transportation services and

Policy Condition for Full Accessibility The United States, Canada and the European nations all established their initial policies with the objective of improving the mobility and transportation opportunities of disabled people and all concluded that specialized, door—to—door transportation was the most effective means of doing so. Britain, in addition to fostering dial-a-ride services, went further than other nations with the introduction of the Mobility Allowance, a cash benefit for use however the disabled recipient sees fit. Although this is not a supply-side response and should thus not be classified as a specialized service policy, it has common origins in the sense that it anticipated the needs of wheelchair users for door-to-door taxis service.

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FIGURE 1: EVOLUTION OF POLICY IN NORTH AMERICA AND EUROPE: 1960-1989

MAINSTREAM SERVICE

A

SPECIALIZED SERVICE

ECMT denotes European Conference of Ministers of Transport

77

78

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

Only in the United States, and then only with an unfettered human rights policy rationale, do we find an unequivocal emphasis on fully accessible fixed-route transportation. As shown below, however, that combination of rationale and response has proven unstable in practice. In Britain, the Department of Transport and localities have for many years been "seeking ways of improving all types of transport for disabled people"23 as a matter of policy. Starting in the 1970s as a merit-based its purest form, bus operators have been encouraged to use vehicles that are designed to be as accessible as possible to elderly and ambulatory disabled people (including fare concessions), to make low cost modifications to vehicles as necessary, and not to attempt to carry wheelchair users on regular bus services. Instead, wheelchair users were carried by local authority social service vehicles, by voluntary organizations and by the many dial-a-ride services that have started (mainly since 1980). In general, door-to-door service has been preferred over other approaches on grounds of effectiveness in promoting travel and cost. More recently, Oxley24 reports that seven bus operators in Britain have converted full size buses to carry wheelchairs and that while some are used only for private hire journeys, a number are being used to run special scheduled services chosen to serve areas where an above average number of disabled people live. These initiatives stemmed from local decisions based the aim of improving the overall transportation system for disabled people (rather than human rights) and from local analysis that found there to be no single transport mode or system able to provide the level of mobility to which disabled people reasonably aspire. The seven localities all concluded that it would not be practicable to make all public transport accessible to disabled persons. As indicated in the previous Chapter, early initiatives in Canada were also founded without any reference to human rights and apart from a move to make intercity modes of transport accessible to wheelchairs, policies and programs are exclusively separate and specialized door-to-door service. Shifting Rationales Although no other nation has changed tack in the last 20 years as radically as the United States, all have shifted towards a human rights position to some extent. We indicated above how Canada’s Charter of Human Rights and Freedoms identifies a wide range of minorities, including the mentally and physically disabled, and declares that all are equal before the law. In Europe, the clearest statement of principle is to be found in a resolution endorsed by the Council of Ministers of the C G.B. Mitchell and Ann Frye, The Role of the British Department of Transport in Public Transport for Disabled People, Proceedings of the Third International Conference on Mobility and Transport of Elderly and Disabled Persons, October 1984, p. 3-23 24-

Philip R. Oxley, State Carriage Bus Services for Wheelchair-Bound People, Journal of Specialized Transportation Planning and Practice, Volume 2, Number 3, 1986

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European Conference of Ministers of Transport in Paris. Issued in November, 1985, the Ministers recognized that25; o

"One of the objectives of transport policy is to provide a free choice (emphasis added) of means of transport (within national and international regulatory frameworks and economic constraints) to meet the need for safe low-cost mobility for all people, including those with disabilities" and

o

"The wider socio-economic cross sector benefits from transport provision for disabled people should be taken into account by Member governments, both within and between government departments and that, where appropriate, measures should be taken positively to identify these benefits."

Although there is no mention of mobility and transport as a human right in the policy statements above, the notion of free choice is much closer to idea of nondiscrimination than it is to the selective application of certain modes (such as diala-ride service) in order to promote mobility. On the other hand, the Conference of Ministers made a range of more specific suggestions to member countries that are clearly weary of too heavy an emphasis on fixed-route accessibility and thus inconsistent with the notion of free choice. In particular, the Ministers make (inter alia) the following recommendations;26 o

Member countries should meet the need to design local buses to be as easy as possible for people of reduced mobility to use, although not necessarily to make these accessible to people in wheelchairs;

o

Where existing public transport is not accessible to disabled people in wheelchairs, the need for other local transport services to be made available, using accessible taxis, dial-a-ride services with accessible vehicles, or other special transport services, depending on what is most appropriate in local conditions, at reasonable fares;

o

The desirability of providing assistance to disabled people for whom the purchase and operation of a car is deemed to be essential for their work or to enable them to live in the community.

It would appear that the Ministers felt compelled to recognize the notion of free choice as a matter of principle, but were drawn by more technical concerns in application. The consequential inconsistencies might be expected to promote a measure of uncertainty and policy instability in the coming years.

25.

E.A. Frye and M.J. Heraty, Transport Provision for Disabled People in Europe: A Review of Developments, Trends and New Initiatives, Proceedings of the Fourth International Conference on Mobility and Transport for Elderly and Disabled Persons, July 21-23, 1986, p. 41

26

Ibid. p43

80

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

Policy Vacillation and Political Instability As outlined in detail in Section III and depicted conceptually in Figure 1, policies do indeed become less certain and more subject to acrimony and vacillation when their underlying rationale is grounded principally in human rights. Although the United States is the most obvious example, other nations can be seen to be struggling as they attempt to blend policies and programs with the principles of human rights (and the corollary in freedom of choice). This phenomenon is perhaps the most critical issue facing the special-needs transport community today and for the foreseeable future. We have shown that, to one extent or another, human rights as a basis for policy is inevitable in all nations. This being said, uncertain and unstable policy is also inevitable unless the causes of such instability are determined and resolved. That is the subject of the following section. Developing Countries Although the policies of the various nations compared thus far represent very different approaches to the problem at hand, all share the common attribute of having evolved in a context of choice. For the majority of developing nations, the existence of any form of modern public transportation represents a proportionately huge financial commitment compared to that of developed nations and the question of choice is simply not a relevant concern. What is of concern in many economically poorer nations is the provision of subsistence mobility to all; the special problems of disabled and elderly persons may be viewed as a more acute version of the social norm. Katz27 finds that very few developing nations have government sponsored or other formal programs and policies in the area of special transport for the elderly and disabled. On the other hand, he reports that social work professionals of these nations have expressed recognition of the problem through international conferences mainly in the gerontological community. Katz cites one quote from the 1984 African Conference on Gerontology, as follows; "Public and private transportation systems should be expanded to increase access by aging to social services and other travel. The aging should be able to travel at free or reduced fares. Equipment and facilities should be designed that can be used easily by the aging." While the issue of human rights is certainly emerging as a transportation issue in the developing world, it is in the context of access to basic human services rather than the choice among alternative service delivery methods. It is precisely because the choice factor is central to the debate in Western nations that developing countries need to be considered as a distinct case.

27•

Allan Katz, Aspects of the Transportation Problems of Elderly and Disabled Persons in Developing Countries, Proceedings of the Fourth International Conference on Transportation for Elderly and Disabled Persons, July 1986, page 103

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81

IV. ANALYZING THE BASIS OF HUMAN RIGHTS IN THE PROVISION OF TRANSPORTATION FOR DISABLED PERSONS

We believe that the principal cause of unstable transport policies under the human rights rationale is the absence of a firm doctrine of what constitutes discrimination in the provision transport for disabled persons. By way of analogy, the United States suffered one hundred years of instability and division on the question of racial discrimination and it was not until a fundamental doctrine emerged to guide the courts that society came to terms with the issue. That doctrine, which stated and elegantly that "separate is not equal",28 made policy, regulation and judicial decisions thereafter straightforward and consistent. For the most part, however, legislative, administrative, and Court decisions in the United States have been made without a clearly articulated theory of human rights and amidst conflicting analytical studies. The lack of analytic support may in part have been deliberate, stemming from a belief among administrators that, to the public, economic analysis appears callous as a basis for making such sensitive social judgments. Where analysis had been applied, a considerable legal and technical muddle in the use of basic theory and techniques resulted in studies that often helped to confuse rather than elucidate the key policy issues. This section looks in depth at the issues surrounding the evolution of doctrine in the United States, the one nation that has struggled to find a stable policy under a pure philosophy of mobility as a human right. The final section compares the U.S. with other nations in order to derive a workable doctrine upon which all nations can draw in the decades ahead. The Fall and Rise of Economic Analysis Rigorous analysis of personal transportation problems developed gradually over 1960s and 1970s, drawing on various aspects of applied welfare economics, choice theory and the principles of public finance. Together with "second-shelf" techniques much as econometric methods, systems analysis, and operations research, practical methods evolved for conceptualizing human transport problems, framing alternative solutions to them, and quantifying the impacts of various alternatives for input to administrative decision making. At the same time, however, it seemed that such techniques, no matter how sophisticated, came too late to exert much influence in the choice of projects that relate to personal mobility, human dignity, and the host of other factors that contribute to the "quality of life" and human rights. In his 1970 critique of the Roskill Report—a cost-benefit analysis to find the socially least intrusive site for a third London airport—E.J. Mishan remarked: ... excellent as it is, paying lip service to the right principles and secure within its terms of reference, (the Roskill Cost28. The separate is not equal doctrine emerged over a period of a century of civil law in the United States. See in particular, Brown v. Topeka Board of Education, 347 U.S. 483 (1954)

82

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS Benefit Analysis) may have the unexpected effect of contributing only to the public’s growing impatience with economic expertise, and perhaps with economics in general.29

Indeed it was such impatience that led one advocate of adapting conventional buses and railways for wheelchair s to state that: It is an issue that ultimately cannot be decided on the basis of cost-effectiveness, inflation, time, ease of operation, local option, or managerial pragmatism. It is a Constitutional and legal issue— indeed, it is a human rights issue.30 Increasingly, however, the public appears to be losing patience with decision "made emotionally, politically, or judicially" without regard for cost and effectiveness.31 Much debate but little analysis accompanied the HEW and DOT decisions to implement Section 504 regulations that require the adaptation of buses and trains for wheelchairs.32 In 1979, following publication of the DOT rules, the generally liberal new York Times raised the following question: Do the 30 million Americans afflicted with physical or mental handicaps have a right of access, no matter what the cost, to all publicly sponsored activities? ... objections are too easily misunderstood. Integrating the handicapped into everyday life is a valuable social goal. Vast numbers of them are on welfare when they could be doing productive work— if the barriers to their mobility and opportunity were lowered. The nation is belatedly moving in the right direction. For reasons of humanity and sound social policy, it should move faster still, but that hardly justifies making every bus kneel to pick up a few new passengers. The handicapped have a right to respect and to reasonable assistance, not to an unlimited claim on public funds in the name of a dubious principle.33 Asked whether he had anticipated the consequences of Section 504, its principal author, Congressman Charles Vanik, stated:

E.J. Mishan, What is Wrong with Roskill? Journal of Transport Economics and Policy, Vol. 4, NoO. 3, 1970. Statement of John A. Lancaster, Before the Secretary of the Department of Transportation of the United States. September 19, 1978. 31

The Economist, Reagan’s Inheritance. 27 December to 2 January, 1981, p.

22 .

32

Congressional Research Service, Legislative and Judicial History of Section 504 of the Rehabilitation Act of 1973 Pertaining to Transportation for Handicapped Persons. November 1979.

33

New York Times, Sunday, November 18, 1979.

A DOCTRINE OF MOBILITY We never had any tremendous cost,34

concept

that

it would

83 involve

such

That comment alone unleashed a torrent of media criticism.35 Perhaps skyrocketing energy costs, worldwide inflation, and persistent unemployment are responsible for the public’s growing concern for efficiency in public decision making. For whatever reason, economic analysis again appears acceptable in areas previously dominated by seemingly broader political principles. Not that the application of broad political principles need be obstructed by economic analysis. While the application welfare economics, the theory of choice, and the principles of public finance, are not devoid of problems, they can (or can be made to) blend well with the political process so as to indicate policies that accord with society’s broad goals and objectives.36 As shown below, however, a great deal of skill and attention to technical detail is needed in order to achieve a smooth blend of policy analysis and adherence to human rights. The Analytical Problem To be useful, of course, analysis must offer the administrator a practical range of relevant alternatives and a fairly accurate picture of their likely impacts on the range of relevant policy objectives. The application of analytic techniques to the evaluation of the transportation policy regarding the disabled raises a number of special forecasting and evaluation questions by virtue of the unique problems facing disabled persons and the broad array of objectives that public policy seeks to achieve on their behalf. Conventional techniques offer some answers, and innovation is needed elsewhere. The key analytical problems may be classified as follows: o

Identification of objectives;

o

Identification of alternatives;

o

Identification of the target population;

o

Determination of service standards;

o

Demand forecasting;

o

Identification and forecasting of costs;

o

Comparison of the alternatives;

34

See Tim Clark, Access for the Handicapped: A Test of CArter’s War on Inflation. 42 National Journal 1672, 1673, October 21, 1978.

35

Ibid.

36

A jit K. Dasqupta, and D.W. Pearce, Cost-Benefit Analysis: Practice. MacMillan, 1972.

Theory and

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

84 o

Valuation of benefits; and

o

Discounting.

Identification of Objectives. Weaknesses in policy analysis over the 1973 to 1979 period reflect to a large extent the absence of any social or legal theory as to the fundamental nature of human rights when applied to disability. Most policy analyses began with the idea that Section 504 prohibits discrimination against the disabled in the provision of public transportation services in the same sense that civil rights legislation prohibits discrimination on the basis of race.37 For four reasons, however, the usual percept of civil rights— that separate is not equal—does not appear to apply to bus and rail systems. First, inaccessibility of public transit to disabled persons stems not from hatred and bigotry, but from accidents of design and technology and from ignorance about the effects of debility. Second, separate special services (like door-to-door dial-a-ride service) may convey greater benefit than the services used by the general public. Third, affirmative action can take a variety of different forms, each costly, so that pursuing one approach precludes the pursuit of another. And fourth, it is not clear to whom affirmative efforts should extend, since debility varies radically, even among persons with identical physical or mental conditions. This in turn raises a host of questions concerning the equity implications of helping some disabled persons (such as wheelchair users) and not others. An alternative interpretation of Section 504, drawn from public finance theory, is that government views transport as a merit want, "mobility,” a minimum level of which is to be supplied to all irrespective of their physical ability or their ability to pay. A merit want is met by a service that is purchased in an amount smaller than for a social optimum, in part because the purchasers under-estimate the benefits they will receive.38 The recipients of a merit-want service are induced to accept more of it than they would freely purchase by offering it at either no cost, or at a subsidized price. In the case of transportation, Section 504 might be indicative of the government view which holds that disabled persons, because of their physical problems, travel less than they would, and less than they should, were it not for these problems. The issue then is not civil rights, but rather what the minimum level of ability "ought" to be. This interpretation opens the discussion to a range of critical issues that do not emerge under the narrow civil rights connotation. These issues are discussed next. Identification of Alternatives. A narrow interpretation of objectives leads to a narrow view of alternative approaches to meeting the needs of the handicapped. The notion that separate is not equal narrows the range of possible transport modes to one— fixed-route buses (or trains)— and policy "options" revolve around the means of making boarding possible by wheel-chair users, (lifts, winches, and so-on). This in turn ignores three major alternatives, namely; 37

See, Testimony of Richard Page, Hearings before the Committee on Appropriations, House of Representatives—Department of Transportation and Related Agencies Appropriates for 1980, February 1979.

38

By R. A. Musgrave, The Theory of Public Finance. McGraw-Hill, New York, 1950.

A DOCTRINE OF MOBILITY

85

Paratransit, including user-side subsidies; Specially-equipped private automobiles; and Cash transfers to disabled persons. These options are reviewed next. Paratransit. as defined by the Urban Institute, encompasses, those forms of intraurban passenger transportation which are distinct from conventional transit (scheduled bus and rail) and can operate over the highway and street system.39 The Urban Institute has categorized paratransit services into three distinct modes; Hire—and-drive transportation, such as short term rental cars; Pre-arranged (subscription) ride—sharing programs, such as car—pools and door-to-door sub service available on a subscription basis; and Phone-ahead services, that include dial-a-ride service and taxis supplied through provider-side or user-side subsidies. Clearly, then, the concept of paratransit was not developed with the needs of disabled persons in mind. Rather it evolved from a recognition among transportation researchers that door-to-door service would be more likely than fixed-route service to attract the private care user to public transportation, with consequential reductions in congestion, pollution, and associated negative externalities such as delay and disease.40 In fact, such objectives for paratransit proved far too optimistic, largely because the cost to provide a level of service high enough to attract auto users became too great a strain on local budgets.41 Out of the various experiments with paratransit, however, research revealed that costs 39

Ronald F. Kirby, Kran U. Bhatt, Michael A. Kemp, Robert G. McGillivray, and Martin Wohl, Paratransit: Neglected Options for Urban Mobility. 1974.

40

One of the first significant developments in paratransit took place in 1972 when the Traffic Research Corp. devised a system of small demandresponsive, vehicles as feeders to the proposed subway in Washington, D.C. Between 1972 and 1975 at least 50 hail or phone paratransit services were established across the United States, Great Britain, and Europe. One of the first European services was initiated in Maidstone, England by the Denis Hire Car Co. that served the town centre and railway station. See, Svstan Inc. Paratransit Handbook. Vol. 1, February 1979.

41

See Ried Ewing, Demand Responsive Transit. Massachusetts Institute of Technology, Ph.D. Dissertation (unpublished) 1977.

86

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

could be contained if the service was confined to limited segments of the population, such as young children, persons without access to a car, and disabled persons.42 By the late 1970’s the objective of paratransit had thus narrowed to that of serving the transportation needs of particular "disadvantaged" groups. This is not to say that paratransit objectives are entirely "social". Paratransit is also recognized as part of the process of improving the efficiency of public transportation generally through "market segmentation". This is a process whereby each mode of public transportation—bus, taxi, and so on— is used to serve those travel markets to which it is best suited. Thus for certain kinds of trips (e.g., high density line-haul work trips to downtown areas) buses may serve quite well. For other "low density" markets, such as trips made by elderly persons (about half the disabled population is elderly) paratransit may be more useful. Consider for example the following quotation from a study by the Urban Institute.43 It is well known that elderly people value comfort, door-to-door service and ease of getting in and out of the vehicle. They are also more concerned than the average traveler with low fares, and appear to have considerable flexibility with respect to time of travel. Taxi or dial-a-ride services which offer cheaper fares for travelers willing to adjust their schedules somewhat to suite the taxi or dial—a—ride operator appear to have considerable potential for serving the elderly. Although the paratransit literature abounds with technical detail on alternative service configurations (such as many-to-many versus many-to-few origin/destination patterns, alternative dispatching methods, etc.) virtually no recognition is given to the fundamental conflict between certain configurations and service requirements as defined under Section 504 regulations. A key conflict stems from the ride-sharing objective of paratransit systems—that is, while ride sharing necessitates advance reservation to permit optimum dispatching, Section 504 regulations protect disabled persons from "unreasonable" wait times as compared with those associated with regular bus service. User-side subsidies offer one means of overcoming this problem, as discussed next. User—side subsidies represent an alternative to the provision of subsidies directly to transit authorities for their operation of specialized door—to—door transit. Under the user-side technique— as popularized by the Urban Institute—taxi tokens or scrip are distributed at reduced rates to eligible users, such as disabled persons. These

42

See Ewing’s (ibid) description of experiments in Batavia, New York and Haddonfield, New Jersey.

43

Urban Institute, op. cit. The Urban Institute characterizes the elderly and disabled travel market as a low density demand of the type well suited to paratransit.

A DOCTRINE OF MOBILITY

87

are exchanged for conventional taxi rides and since most taxi systems operate on short notice this obviates the problem of long-advance waiting periods.44 It should be noted, however, that the problems associated with advance reservation did not motivate the concept of user-side subsidies and its use may not be suitable for all disabled persons. User-side subsidies grew out of the recognition that the costs of paratransit for disabled persons could be reduced if the non-unionized taxi industry were to be utilized in place of heavily unionized transit labour. Taxi vehicles are not suitable for all disabled persons, however, such as wheelchair users who cannot transfer into a conventional auto, and thus far, the provision of userside subsidies has not led many taxi-operators to introduce lift-equipped vehicles into their fleets. This is probably because demand has not been strong enough to justify the investment.45 Some transit operators thus offer a supplement to userside subsidies using small lift-equipped vehicles to carry the most severely disabled users.46 Others have purchased lift-equipped vehicles and leased them to the local taxi operator. Although user-side subsidies have been implemented in a number of U.S. cities, the prospective cost savings do always materialize. This is because of federal labour protection legislation under Section 13(c) of the Urban Mass Transportation Act of 1964, that guarantees transit employees collective bargaining rights. As a result, some taxi companies have demanded union-level wage rates for services delivered under user-side contracts with transit agencies. Private, specially adapted self-drive cars—or rather, government subsidies for their purchase or use— have been ignored as an instrument of public policy under Section 504, despite the heavy auto-orientation of American society. A number of studies appearing in the physical rehabilitation literature point to the added independence gained by severely disabled persons following driver training, and a number of countries have instituted public programs to help the disabled purchase specially equipped vehicles.47 The "Mobility" program in Great Britain, for example, provides severely disabled persons with low interest loans and debt service subsidies for this purpose. Why this approach has been overlooked in the U.S. is unclear, although one probable reason is that Section 504 applies only to programs in receipt of federal financial assistance. In other words, the motivation for concern over 44

For a review of a number of user-side systems, see, Bruce D. Spear, Evidence from UMTA’s Service and Methods Demonstration Program Concerning the Travel Behaviour of the Elderly and Handicapped. October 1978.

45

Interview with International Taxi Association Rockville. Maryland (U.S.A.) October 1984.

46

A combined systems of user-side subsidies and transit authority-operated service exists in Milwaukee, Wisconsin.

47

David Lewis, The Use of Specially Adapted Cars in Providing Transportation for Handicapped Persons, paper presented to the 7th Annual Conference on Transportation for the Handicapped, Orlando, Florida, October 1981.

88

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

transportation for the disabled has been civil rights and access to existing public services, and not necessarily the provision of the most useful means of serving their various needs. Stated differently, it would appear that too narrow a theory of human rights can have the ironic affect of narrowing the range of choice available to the disabled. Despite the political context, the potential for car ownership among the disabled appears high. According to the author’s analysis of the U.S. Health Interview Survey, less than a fifth of all wheelchair users of driving age are licensed to drive compared with over 95 percent of the non-handicapped population.48 Moreover, 62 percent of wheelchair users interviewed answered "yes" to the question, "Does disability or a health problem prevent you from driving a car?" Many rehabilitation experts argue that proper training and special equipment can enable a majority of such individuals to get behind the wheel.49 Income transfers—the provision of cash rather than facilities—Uias also been ignored as an option in the United States, probably for the same reason posed above to explain the lack of attention to private cars.50 Nevertheless, it could prove more efficient to offer cash, rather than "guess" at the services people want, only to find them underutilized.51 On the other hand, it is unclear whether the handicapped population is large enough, or has a travel propensity great enough to encburage private sector provision of public transport vehicles they can use, even a^ter stimulating more travel through the provision of cash subsidies. In Britain, where cash subsidies represent the mainstay of national policy regarding transportation for the disabled, attention to taxi—design is motivated by direct government intervention and regu|ation. It is clear from this review of alternatives that no single mode can serve as a unique object of policy analysis. Yet, with the separate-is-not-equal doctrine as a basis for analysis, needs and modes can never effectively be matched. Identification of Disabled Persons. Effectively matching needs and the accurate identification of the appropriate target population. estimated size of the disabled population bears directly upon evaluation of alternative policy options. This is because the cost of

modes requires Moreover, the the economic providing door

48

For further analysis and a description of the Health Interview Survey, see Chapters II and III.

49

See, for example, Frank Hammond Krussin and others, Handbook of Physical Medicine and Rehabilitation. 2d. ed., Saunders, 1971.

50

The United States has shown resistance generally to providing cash when payments—in—kind can be made instead. The food—stamp program is a good example.

51

The mobility allowance program in Great Britain provides a cash sum each week for transportation, although users are not required to use the money for transportation purposes.

A DOCTRINE OF MOBILITY

89

to door dial-a-ride service is almost directly proportional to the number of disabled persons that qualify for the service. The cost of putting lifts on transit buses is more or less fixed regardless of the number of users, although the corresponding cost per trip (measure of cost-effectiveness) is directly related to use. To date, studies appear to overstate sharply the number of disabled persons who are unable to use regular public transit. Among the 16.1 million adult metropolitan residents in the United States with a physical or mental impairment that limits them in activity, 4.6 million are unable to carry on any major activity, while another 8.3 million are limited in the amount or kind of major activity they can manage. The remaining 3.2 million are limited, but not in a major activity.52 Moreover, only 2.7 million, about 3 percent of all adults in metropolitan residents, cannot use regular transit without the help of another person; of these about 1.3 million could use regular transit with factory installed improvements now being fitted to new buses, such as special suspensions to lower the front steps on buses. This leaves 1.4 million disabled persons who cannot use transit without the help of another person. These population estimates are drawn from the National Health Interview Survey,53 a study of 42,000 households made in 1977. Most policy studies to date, however, are drawn from a survey commissioned by the U.S. Department of Transportation,54 and undertaken by Grey Advertising, Inc. That study estimated 7.4 million metropolitan residents that are "transportation handicapped", defined as persons who cannot use transit "as effectively" as other persons. The implication of this definition is that affirmative efforts must extend to persons who simply have more than average difficulty in using regular transport services. This has results in a grossly distorted picture of the costs of providing improved services to those in real need of help, and decisions have been misguided accordingly. Determination of Service Standards. While the size of the disabled population has the strongest influence on the comparative economics of alternative service improvements, the quality of service probably ranks second in importance. Obviously, on-call dial-a-ride service is considerably more expensive to supply than service requiring a 24 hours reservation; on the other hand on-call service is also considerably more beneficial. The question of what constitutes appropriate service quality is immersed in controversy and confusion. A popular American theory of human rights suggests that disabled persons should be guaranteed to level of service "equal" to that of regular transit available to the general public (see Annex I-A). The notion of equality is, of course, open to broad interpretation. The American Coalition of Citizens with Disabilities (ACCD) states that since the user of public transit "need decide to travel no longer in advance that the average headway plus travel time to the stop", advance booking times for 52

David Lewis, Equity in Urban Transportation for Handicapped Persons. Traffic Quarterly, (forthcoming).

53

Op. Cit., U.S. Health Interview Survey, 1977, (unpublished).

54

U.S. Department of Transportation, Technical Report of the National Survey of Transportation Handicapped People. October 1978.

90

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

dial-a-ride service should be equally short (say about 30 minutes to 45 minutes).55 The common practice requiring 24 hour reservation for dial-a-ride service is thus regarded to be a denial of civil rights and below a legal minimum standard. They hold that separate services, in lieu of adapting regular buses with lifts for wheelchairs, actually constitutes discrimination within the meaning of Section 504 unless the fare and travel time are numerically equal to bus fares and travel times. The problem with this argument is that it draws conclusions about consumer preferences on the basis of political sentiment rather than actual consumer preferences. To make rational comparisons of fixed-route transportation and doorto-door dial-a-ride service from the viewpoint of the welfare-maximizing consumer, it is necessary to account for the relative importance that he attaches to the disparate characteristics of these modes, such as the different amounts of walking, waiting, and stair climbing involved.56 It is possible, for example, that because of the measured preferences of individuals for less walking time, less time waiting outdoors, and less time climbing stairs—advantages that dial-a-ride offers over fixed-route transit— disabled persons may be indifferent between dial-a-ride requiring advance reservation of, say three or four hours, and regular fixed-route transit service.57 Many studies nevertheless evaluate the economics of dial-a-ride service on the assumption that it must require no more advance notice than the time it takes to get to a bus stop. This notion of equal service obviously ignores the disparate attributes of transit and dial—a—ride, and leads to a level of dial—a—ride service that is not only extremely costly to supply, but which consumers may regard as far superior— not equal— to regular transit service. Again, this distorts cost comparisons, and in consequence administrative decisions have been distorted as well. Demand__Forecasting. Exaggerated population estimates and service quality requirements inevitably have led to exaggerated demand forecasts. To compound this problem, for any given population and specified level of service the demand for public transportation has itself been consistently overestimated. A great deal of work in the literature58 on the forecasting of travel demands of disabled persons draws on the concept of "latent demand" defined, implicitly, as the amount of travel that would be undertaken at zero price to the consumer, or otherwise defined as the difference between the travel rates of handicapped and non—handicapped 55

Dennis Cannon and Francis Rainbow, Full Mobility: Counting the Costs of Various Alternatives. Synergy Consulting Services, 1980.

56

D.A. Quarmby, Choice of Travel Mode for Journey to Work: Some Findings, Journal of Transport Economics and Policy, Vol., No. 3.

57

See, Domencich and McFadden, Urban Travel Demand. 1977.

58

See for example, Sandra Rosenbloom, Transportation Needs and Use of Social Services: Reassessment. Traffic Quarterly, Vol. 32, July 1978, Abt Assoc., Inc., Transportation Needs of the Handicapped. Cambridge, Massachusetts, August 1979. Lester A. Hoel and others, Latent Demand for Urban Transportation. Carnegie-Mellon University, 1968.

A DOCTRINE OF MOBILITY

91

persons. The only means of obtaining estimates of latent demand under the first definition is by posing hypothetical questions of sample survey respondents— "how much would you travel if, " ... questions that inevitably lead to exaggerated claims— a "wish list" of trips to be made regardless of cost or convenience.59 Such concepts pay little if any attention to applied choice theory, such as the work of Lancaster, 60 Goodwin, 61 Baumol, Domencich and McFadden, or others who have attempted to bring micro-economic analysis to bear on models of travel demand. These analysts attempt to explain observed travel behaviour in terms prevailing opportunity costs, service attributes and other factors that influence choice. Not surprisingly then, when lower than expected demand has materialized, its causes have been misinterpreted, the most serious problem being confusion over the effects of supply (capacity), and demand (choice). 2 In virtually all cities offering dial-aride service, use has fallen radically short of expectations.63 Many analysts attribute low use to a shortage of vehicles or to deficiencies in service quality, ignoring the availability of, and consumer preference for a superior alternative— namely the private car.64 Lower than projected use occurs even where advance reservation times are short and fares low, again, because of the availability of a 59

A graphic example of this is to be found in Department of Transportation, Comments on Transportation for Handicapped Persons. June 1980, an analysis offered in support of the initial DOT Section 504 regulations. The use to be made of lift-equipped transit buses was projected to be 55 million trips a year on the basis of a national survey of "latent demand". The most successful experience with lift-equipped buses to date is in Seattle, Washington, where about 3,000 trips are made monthly. Based on the DOT forecasts, however, Seattle could expect 42,600 monthly trips.

60

Kelvin J. Lancaster, A New Approach to Consumer Theory, (in) The Demand for Travel: Theory and Measurement. R.E. Quandt Ed., Heath Lexington Books, 1970.

61

P.B. Goodwin, Human Effort and the Value of Travel Time. Journal of Transportation Economics and Policy, January 1976.

62

Op. Cit., Cannon.

63

Bruce D. Spear and others, Recent Evidence from UMTA’s Service and Methods Demonstration Program Concerning the Travel Behaviour of the Elderly and the Handicapped. October 1978.

64

Ibid. Three years after the installation of lifts on 157 transit buses in St. Louis, only two lift-assisted trips are made daily. The popular explanation for this is the mechanical unreliability of the lifts, and the lack of system wide-route coverage, (supply factors). A survey of wheelchair users in St. Louis who decided not to use the lift-equipped buses reveals, however, that it is the availability of, and preference for a private care that explains their decision, (life unreliability and limited coverage where listed by only 1 percent of the respondents).

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

92

private car.65 The widespread belief that capacity and service constraints are the only factors underlying low use has probably resulted in a reluctance among some localities to implement special services, in the mistaken belief that a huge demand (and hence cost) would stem from relatively high quality dial-a-ride service. This is to be detriment of the relatively small number of persons who need and appear likely to use the service. Attempts to bring conventional demand analysis to bear on the measurement and forecasting of travel by disabled persons are conspicuously lacking. Identification of Costs. In comparison to the costs associated with conventional fixed-route public transport, little is known about the cost of adapting it for disabled persons, and even less is known about the cost of non-conventional paratransit transport modes (like dial-a-ride), their load characteristics, and their relationship with travel demand. A major gap lies in the understanding of paratransit productivity— usually expressed as the number of trips per vehicle hour of service. Since hourly vehicle costs are largely a function of wage rates and thus only partially under the control of the transit authority, productivity is a major policy variable in the determination of cost. The literature has very little to offer in the way of models to help understand the determinants of paratransit productivity, however. Nevertheless, transportation theory would suggest that productivity is a direct function of many of the service quality factors addressed in the DOT proposed final regulations. In planning paratransit service under those regulations, localities will need an understanding of such relationships. Comparison of the Alternatives. To facilitate rational choices among alternatives it is important that the options be compared against some valid criterion. Some options require a large initial capital investment but relatively low operating costs, while others display the opposite profile of expenditure. Benefits of alternative transport improvements also accrue at different rates. For many such policy problems, Cost-Benefit Analysis is a useful technique for solving the comparison problem. It is a little understood point, as pointed out by Beesley and Gwilliam that "Cost-Benefit Analysis, even with its extensions to individuals gains and losses effects on income distribution, is a wholly inappropriate means of comparing alternative merit goods." Cost-Benefit Analysis is grounded in a fundamental assumption—that individuals know what is best for them, and that policy is made on grounds of consumer gains, corrected for possible "resource" considerations, perhaps weighted according to income effects.66 Section 504 is grounded in a diametrically opposite assumption—that disabled persons today purchase transportation in a n amount smaller than for a social optimum, and that they should be induced to accept more of it than they would freely purchase, by offering it at a subsidized price, (and by making a range of service adaptations to accommodate their unique physical needs).

65

Urban Mass Transit Administration, User Side Subsidies for Shared Ride Taxi Service in Danville. Illinois: Phase 1. Final Report, June 1977.

66

M.E. Beesley and K.M. Gwilliam, Transport Policy in the United Kingdom. Journal of Transport Economics and Policy, Vol. XI, No. 3, September 1977.

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The most acceptable alternative is to perform a range of different comparative exercises, and to let the decision maker apply his own weights (either numerical weights or sheer hunch) to reflect the relative importance of each. In comparing costs, generated trips, cost per trip, and other measures of effectiveness, proper discounting techniques can, of course, still be applied. What bears emphasis is that the extent of public subsidy that gives rise to the benefits should be made explicit, and the judgments that give rise to the level of subsidy (equal service standards, fares, eligibility criteria, and so on) should be spelled out clearly. Two special problems encountered in comparing alternatives—the definition of benefits, and discounting— are dealt with below. Definition of Benefits. The twin concerns of civil rights and mobility discussed above raise definitional problems not typical in transport studies. Typically, a new trip generated by the transport improvement, or a time saving for an existing trip that arises because of an improvement, can be assigned a value using conventional techniques. But no conventional means exists by which to estimate the intrinsic value of bus trips made by wheelchair users who could not previously use the bus, but who made the same trip before as an auto passenger in more comfort and less time. Non-discrimination thus raises a new problem in the general class of problems that pertain to the valuation of intangibles. Work in this area could build on that of Mishan67 and Litchfield68 in developing an approach to the problem. Discounting. The common problem of choosing between projects that require large initial capital investment but low operating costs, and those with the opposite profile of expenditure characterizes the choice between fixed-route transit adaptations for wheelchairs, and specialized services like dial—a—ride and taxi—fare subsidies. To facilitate valid comparisons between the costs and benefits of such projects requires that their net present values serve as the basis for comparison, a requirement that calls for an appropriate rate at which to discount future costs and benefits. Theories of public finance differ as to the correct rate of discount to apply to public expenditure projects. Feldstein,69 who argues for the use of a social time preference rate ( at less than the market rate of interest), also argues that the discount rate must reflect public policy and social ethics. Whether this calls for the application of a discount rate modified by the unique conditions facing the disabled, (for example, greater risk of death and its potential impact on their relative desire for consumption at different points in time) is a question that can only be decided judgmentally by those involved in making final policy decisions.

67

E. J. Mishan, Cost-Benefit Analysis. Unwin, 1971.

68

N. Litchfield, The Planning Balance Sheet. Journal of Regional Studies, 1968.

69

M. S. Feldstein, The Social Time Preference Discount Rate in CostBenefits Analysis. Economic Journal, Vol. 74, 1964, pp. 360—79.

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V. A DOCTRINE OF HUMAN RIGHTS FOR TRANSPORT AND MOBILITY

The previous section suggests that social and economic theory (the theory of consumer choice and preferences) and related analysis can enable those who set policy to make decisions that coincide with the basic demands and values of disabled society. Unfortunately, this has not been the case in the long, arduous debate regarding transportation for the disabled. Why should this be so? After all, most other areas of transport policy have not been plagued with such bitter controversy. We believe the problem lies in the absence of a clear and broadly acceptable underlying doctrine of human rights as applied to the problem of transport and mobility. "Doctrine" is more fundamental than policy; indeed, a doctrine is a formulation of the principles on which a government proposes to base its actions or policy. Without doctrine, social and economic theories have little foundation and it is thus no surprise that policy analysis has carried us only so far. Without an accepted doctrine of human rights, one that provides a valid basis for defining discriminatory practices in transportation, experience demonstrates that a stable policy framework is impossible to achieve. Many nations are now beginning, inevitably it seems, to be embracing human rights as a basis for policy. Yet without a valid doctrine of human rights for transport and mobility, legislators, transport providers and consumers will clash perpetually over questions that relate to the welfare and rights of disabled persons. Can Segregation Offer Equality? Can a broad, workable doctrine be identified and institutionalized as a basis for policy? The analysis presented in Section IV indicates that the doctrine of "separate but equal," which has effectively governed the provision of urban public transportation in Western cities, is eroding as a basis for transport policy. The doctrine of "separate but equal" states that the segregation of classes in public facilities or services does not constitute a denial of basic rights if the benefits conveyed are equal for all classes. The doctrine was first articulated in U.S. law. In 1896, a one-eighth black citizen named Plessy was denied access to an all-white rail car and required to ride in a car reserved for blacks. In considering his appeal, the Supreme Court of the United States wrote that; ’We consider the underlying fallacy of the plaintiff’s argument to consist in the assumption that the enforced separation of the two races stamps the colored race with a badge of inferiority. If this be so, it is not by reason of anything found in the act, but solely because the colored race chooses to put that construction upon it ... Legislation is powerless to eradicate racial instincts or to abolish distinctions based upon physical difference, and the attempt to do so can onlv result in accentuating the difficulties of the present situation.70 70.

Plessy v. Ferguson 163 U.S. 537, 16 S. Ct. 1138, 41 L. Ed (256) 1896

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The "separate but equal" doctrine was invalidated in the United States as a basis for racial segregation in 1954 when a group of black children maintained that the Topeka, Kansas Board of Education was violating their right to equal protection under the law by requiring them to attend separate elementary schools. In that case, Chief Justice of the U.S. Supreme Court Earl Warren wrote that, "We come then to the question presented: Does segregation of children in public schools solely on the basis of race, even though the physical facilities and other "tangible" factors may be equal, deprive the children of the minority group of equal educational opportunities? We believe it does ... Segregation of white and colored children in public schools has a detrimental effect upon the colored children. The impact is greater when it has the sanction of law; for the policy of separating the races is usually interpreted as denoting the inferiority of the negro group. A sense of inferiority affects the motivation of a child to learn ... Whatever may have been the extent of psychological knowledge at the time of Plessy v. Ferguson, this finding is amply supported by modern authority. Any language in Plessy v. Ferguson contrary to this finding is rejected."7* The two decisions above demonstrate that doctrine is a reflection of both the social norms and values of the day and of the state of scientific knowledge. The "separate but equal" doctrine as a basis for separate paratransit service has been broadly accepted because of a poor understanding of the role of mainstreaming in psychological development and because technology has not been available until recently to make mainstream transit accessible. Today however we recognize the importance of integrating disabled persons into everyday life and technology is becoming available to make public facilities accessible to the most severely disabled. As well, the segregation of disabled persons is proving to be fundamentally objectionable to many people as a matter of principle, regardless of the relative effectiveness of specialized, door-to-door transportation. Many of the most ardent defenders of separate specialized service ten years ago are now questioning their own values, just as former Governor George Wallace of Alabama has rejected his own 1950s philosophy of equal quality but racially segregated public schools. But where most would now reject the notion of "separate but equal" as a substitute for racially integrated institutions, its philosophical obverse — that of "separate is never equal" has proven to be fallacious and unacceptable as a basis for defining what constitutes discrimination in the provision of transport services for disabled persons. Many disabled people simply cannot move around by means other than specialized services. And, as established in Section IV, many others would elect not to use accessible fixed-route service if offered the choice, simply because they prefer the comfort and convenience of private, door-to-door service.*98

71.

Brown v. Board of Education (First Decision) 347 U.S. 483, 74 S. Ct. 686, 98 L. Ed. (1954)

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A Doctrine of Mobility as a Human Right If separate is not equal and yet some individuals require the technology of separate service, what doctrine of human rights would protect those disabled persons who neither want nor require separate treatment? We believe that the doctrine of free choice offers the answer. That is, we would argue that separate services for the disabled can be regarded as equal if they exist in the context of free choice. Stated in the form of a legal protection, this doctrine of mobility as a human right would state that: "Separate is not equal in the absence of choice". Not as elegant in its simplicity or ease of interpretation as "separate is not equal," such a doctrine permits the application of a merit good philosophy while the element of free choice protects the disabled individual against the denial of his or her human rights by facilitating the choice to use regular facilities, in part or in whole, as an element of transport policy. It should be noted that the element of choice under this doctrine rests with consumers, not providers; while this point might seem facile to some, it will be significant to those who for years have been fighting for the right of transit providers to select the appropriate mix of services for disabled passengers, just as they do in the provision of service for the general public. A doctrine, it must be recognized, is neither law nor policy; it is merely a statement of generally accepted values in a form that provides an unequivocal basis for law and policy. The doctrine suggested here is not expected to dissolve sharp constitutional and legal differences among countries, differences that reflect valuesystems shaped by the unique political and sociological history of each nation. "Separate is not equal in the absence of choice" is silent, for example, on the question of whether the choice is that of the individual or the class. If choice rests with the class, for example, a community could decide by plebiscite whether to equip buses with lifts. If the choice rests with the individual, then only a single person with a preference for lift-equipped transit would necessitate equipage. The answers to these questions will vary of course according to the constitutional and legal framework of each nation. Countries and localities will always need to establish their own laws, policies and programs that accord with local needs, preferences and economic means. The doctrine would, however, provide a needed foundation for lasting legal and policy decisions. Diffusing the Doctrine How is a doctrine institutionalized? In countries, doctrine is either written down in constitutions (the United States) and charters of rights and freedoms (Canada) or it gradually becomes self-evident, part of an un-written body of constitutional principle (Britain). In many cases doctrine is developed through a body of judicial decisions (the separate-but-equal doctrine in the United States exists only as a precedent of constitutional law). On an international scale, doctrine is diffused through bilateral and multilateral agreements, legal decisions and more subtle forms "intellectual technology sharing." In the case at hand, recognition of the emerging doctrine and broad international discussion of its validity and acceptability is the next logical step. If it proves acceptable, diffusion will likely occur rapidly through various media.

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APPENDIX JUDICIAL HISTORY PERTAINING TO EQUAL TRANSPORTATION FOR HANDICAPPED PERSONS By far the most substantial judicial history pertaining to transport and disability exists in the United States. In fact, most other countries have no judicial history at all in the area and those that do, in particular Canada, have only one or two significant cases thus far. Although sharp constitutional and legal differences among nations make direct legal comparisons of little value, the struggle with to establish philosophies and tenets by the U.S. court system is of great value to other nations in their efforts to anticipate the difficulties ahead. What follows thus largely American, although international comparisons are made where possible. Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. sec.794, basically prohibits discrimination, exclusion or denial of benefits against otherwise qualified handicapped individuals by any program which receives federal financial assistance or under any program or activity conducted by any executive agency or by the United States Postal Service. This section is similar to the guarantees given on the basis of race under Title VI of the Civil Rights Act and is the most important federal statute concerning discrimination against handicapped persons. Section 504 as amended states: 794. Nondiscrimination under Federal grants and programs. No otherwise qualified handicapped individual in the United States, as defined in section 706(6) of this title, shall, solely by reason of his handicap, be excluded from the participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving Federal financial assistance or under any program or activity conducted by any Executive agency or by the United States Postal Service. The head of each such agency shall promulgate such regulations as may be necessary to carry out the amendments to this section made by the Rehabilitation, Comprehensive Services, and Developmental Disabilities Act of 1978. Copies of any proposed regulation shall be submitted to appropriate authorizing committees of the Congress, and such regulation may take effect no earlier than the thirtieth day after the date on which such regulation is so submitted to such committees. Numerous cases have been brought under section 504 and regulations have been promulgated. Major regulations to date are those promulgated by the Department of Health, Education and Welfare at 45 C.F.R. Part 84 and final regulations implementing section 504 have been issued by the Department of Transportation. They have been strongly criticized and suits have been filed to prevent the regulations from taking effect. This appendix discusses the legal issues concerning transportation and section 504. First, the legislative history of section 504 will be examined in an attempt to determine whether the Congress had considered the issue of access to public transportation. Secondly, key cases which have been brought under section 504 concerning transportation will be discussed.

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MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS I.

The Legislative History of Section 504 and Transportation for Disabled Persons

The legislative history both on section 504 in general and on section 504 and accessible transportation in particular is very sparse. Joseph Califano, the Secretary of HEW, was quoted as stating that the "Congress enacted the legislation without legislative hearing and with virtually no floor debate in either House. There is thus little Congressional guidance on the host of complex issues raised by section 504’s far reaching prohibition against discrimination."1 Similar statements have also been made by other commentators and in one of the major cases under section 504, Llovd v. Regional Transportation Authority.2 However, there is some language in the legislative history which may be of interest.3 The House Report and the House and Senate Conference Reports did not discuss section 504 in any detail; they merely described the section. However, in the Senate Report there was some language discussing the history of the legislation and its findings and purposes. It was stated there that hearings held as part of the Committee’s consideration of the Rehabilitation Act of 1972 highlighted certain areas including: ... the lack of action in areas related to rehabilitation which limit a handicapped individual’s ability to function in society, e.g., employment discrimination, lack of housing and transportation, services and architectural and transportation barriers ...4

Statement by Joseph A. Califano, Jr., Secretary of HEW, HEW News, April 28, 1977, at page 7. Quoted in A. Levitan, "Discrimination Against the Handicapped in Federally-Funded State Services: Subpart F of Rehabilitation Act Regulations," 12 Clearinghouse Review 339 (October 1978). 2

T. Clark, "Access for the Handicapped—A Test of Carter’s War on Inflation," 42 National Journal 1672, 1672-1673 (October 21, 1978); Llovd v. Regional Transportation Authority. 548 F.2d 1277, 1285 (7th Cir.1977).

3

The House Report. H. R. Rep. No. 244, 93 Cong., 1st Sess. (1973); the Senate Report, S. Rep. No. 318, 93d Cong., 1st Sess. (1973); the House Conference Report, H. Conf. Rep. No. 500, 93d Cong., 1st Sess. (1973); and the Senate Conference Report, S. Conf. Rep. No. 391, 93d Cong., 1st Sess. (1973), were searched for language on the intent of section 504. In addition, the debates in the Congressional Record were examined under H. R. 8070 which was the bill which became the Rehabilitation Act of 1973.

4

S. Rep. 318, 93d Cong., 1st Sess. (1973).

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The Senate Committee on Labour and Public Welfare which considered the Rehabilitation Act of 1973 further stated that "The Committee reiterates its strong belief in the original purposes and format of the Rehabilitation Act of 1972."5 Similarly, the Congressional debate on the Rehabilitation Act of 1973 did not discuss section 504 in any detail. However, in a statement by Senator Dole, a co-sponsor of the Senate version of the Rehabilitation Act, the general goals of the Act were discussed. Senator Dole stated: The primary goal of this bill is to assist handicapped individuals in achieving their full potential for participation in our society .... I believe this bill will work to the real benefit of America’s disabled. This bill contains the State plan requirements, the individualized written programs, strong emphasis on research and training, and anti-discrimination provisions ....6 The most comprehensive discussion of Congressional iütent concerning section 504 was found in the Senate Report to the Rehabilitation Act Amendments of 1974. Although section 504 was not amended by this Act, the definition of handicapped individual was and in the discussion of this change the Senate Committee on Labour and Public Welfare discussed Congressional intent regarding section 504. It was clearly the intent of the Congress in adopting section 503 (affirmative action) and section 504 (nondiscrimination) that the term "handicapped individual" in those sections was not to be narrowly limited to employment (in the case of section 504), nor to the individual’s potential benefit from vocational rehabilitation services under titles I and III (in the case of both section 503 and 504) of the Act ... Section 504 was enacted to prevent discrimination against all handicapped individuals, regardless of their need for, or ability to benefit from vocational rehabilitation services, in relation to Federal assistance in employment, housing, transportation, education, health services, or any other Federally-aided programs.7 This Senate Report also noted: Section 504 was patterned after, and is almost identical to, the antidiscrimination language of section 601 of the Civil Rights Act of 1964, 42 U.S.C. 2000d-l (relating to race, colour, or national origin), and section 901 of the Education Amendments of 1972, 42 U.S.C. 1683 (relating to sex). The section therefore constitutes the establishment of a broad

5

5

Ibid.

6

119 Cong. Rec. 24589 (July 18, 1973) (remarks of Senator Dole).

7

S. Rep. No. 1297, 93d Cong., 2d Sess. (1974), reprinted in 1974 U.S. Code Congressional and Administrative News 6373, 6388 (1974).

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government policy that programs receiving Federal financial assistance shall be operated without discrimination on the basis of handicap.8 Also it should be noted that the issue of accessible public transportation was mentioned in the Congressional debates on the Comprehensive Rehabilitation Services Amendments of 1978. That Act, P. L. 95-602, added a section 505 to the Rehabilitation Act of 1973 which states in subsection(a)(l): Sec. 505(a)(1). The remedies, procedures, and rights set forth in section 717 of the Civil Rights Act of 1964 (42 U.S.C. 2000e-16), including the application of section 706(f) through (k), shall be available, with respect to any complaint under section 501 of this Act, to any employee or applicant for employment aggrieved by the final disposition of such complaint, or by the failure to take final action on such complaint. In fashioning an equitable or affirmative action remedy under such section, a court may take into account the reasonableness of the cost of any necessary work place accommodation, and the availability of alternatives therefor or other appropriate relief in order to achieve an equitable and appropriate remedy. The last sentence in this subparagraph was added as an amendment in the Senate debates. Senator McClure, who proposed the addition of this sentence, indicated that "(i)ts single function would be to insure that mammoth affirmative action remedies involving substantial construction could not be compelled in instances in which actual damages were comparatively small."9 Senator McClure further discussed the Rehabilitation Act implementation in the absence of a reasonableness test and quoted two newspaper articles which discussed the high cost of converting public transportation so that it would be accessible to handicapped persons. The import of this discussion is uncertain since the language of the amendment would not appear to change the requirements of section 504. The Transportation Department regulations which would require accessible public transportation were brought under section 504. The legislative history of a statue is often used to interpret the meaning of a statute10 but the use of legislative history of amendments to the statutes, such as that contained in the Senate Report on the Rehabilitation Act Amendments of 1974 and the Comprehensive Rehabilitation Services Amendments of 1978, is sometimes given less weight in the interpretation of the original statute. Although comments about an earlier act in a legislative committee report on a subsequent bill are not part of the legislative history of the earlier act and therefore have less probative force than legislative history, they 8

Id. 6390. 124 Cong. Rec. S. 15664 (September 21, McClure).

10

1978) remarks of Senator

See C. Sands, 2A Sutherlands Statutes and Statutory Construction, secs. 48.01 et.seq. (4th ed. 1973).

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are entitled to consideration as an expert opinion concerning its proper interpretation.11 The issues relating to the cost of accessible transportation have also spawned comments outside the legislative history. Perhaps one of the most interesting is one made by the sponsor of section 504, Representative Charles Vanik. He was quoted as stating that "We never had any concept that it would involve such tremendous cost."12 The weight which should be given to statements like this in interpreting statues is somewhat uncertain. The leading treatise on statutory construction has made the following statement: In recognition that there is no necessary correlation between what the draftsman,of the text of a bill understands it to mean and what members of the enacting legislature understand and that the intent of the legislature is the determining consideration as compared to the views of draftsmen, their views are not generally considered proper grounds on which to base the interpretation of an act ... However, if the draftsman’s views were clearly and prominently communicated to the legislature when the bill was being considered for enactment, so as to give reason to believe that legislators’ understanding of the bill would have been influenced by the draftsman’s communicated views and so as to be visible to others who are concerned to understand the meaning of the act, there is reason to invoke an exception to the general rule and attach weight to the draftsman’s views.13 II.

Cases Relating to Transportation for Handicapped Persons Brought Under Section 504

The cases which were found relating to transportation and handicapped persons under this section fall into three main categories: (1) those which discuss whether section 504 creates a private right of action, (2) those which discuss whether section 504 creates an affirmative duty, and (3) those which discuss more specifically the requirements of section 504 relating to transportation. The issue of whether there is a private right of action under section 504 is one which has been the subject of much controversy.14 The leading case on this issue is Llovd v. Regional Transportation Authority. 548F.2d 1277 (7th Cir. 1977), where the Seventh Circuit Court of Appeals held that section 504 established an implied 11

Ibid. sec. 49.11.

12

T. Clark, "Access for the Handicapped—A Test of Carter’s War on Inflation," 42 National Journal 1672, 1673 (October 21, 1978).

13

C. Sands, 2A Sutherlands Statutes and Statutory Construction, sec. 48.12 (4th ed. 1973).

14

For a detailed discussion of this issue see Note, "Enforcing Section 504 Regulations: The Need for a Private Cause of Action to Remedy Discrimination Against the Handicapped", 27 Catholic U.L. Rev. 345 (1978).

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private cause of action. Lloyd was a class action suit brought by persons with mobility-related handicaps who alleged that the public transportation systems of two municipalities violated several federal statutes including the Rehabilitation Act of 1973. The Seventh Circuit Court of Appeals held that section 504 conferred affirmative righSts and that a private right of action could be implied to vindicate these rights. In arriving at this holding the court noted that the language in section 5904 closely paralleled that of section 601 of the Civil Rights Act of 1964 which had been held to provide a private cause of action by the Supreme Court in Lau v. Nichols. 414 U.S. 563 (1973). After this determination, the Court discussed Cort v. Ash. 442 U.S. 66 (1975), and the four factors set out by that case for determining whether a private remedy is implicit in a statute which does not expressly provide for one. It concluded that "Applying the Cort factors here leads to the conclusion that a private cause of action must be implied from section 504". At 1285. Similarly, the other three cases concerning transportation rights under section 504 and a private cause of action also found that there was a private cause of action.15 The comprehensive Rehabilitation Services Amendment of 1978, P. L. 95-602, added a section 505 which discussed remedies and attorney’s fees to the Rehabilitation Action of 1973. Subsection (a)(2) of this section specifically provides: The remedies, procedures, and rights set forth in title VI of the Civil Rights Act of 1964 shall be available to any persons aggrieved by any act or failure to act by any recipient of Federal assistance or Federal provider of such assistance under section 504 of this act. Although there is some uncertainty concerning whether there is a private right of action under title VI of the Civil Rights Act, the Senate debates concerning section 505 discussed the issue and the following statement was made by Senator Bayh. I thank the distinguished Senator from California for taking time to make clear the continuing intention of Congress that private actions be allowed under titles VI and VII of the Civil Rights Act of 1964, title IX of the Education Amendments of 1972 and title V of the Rehabilitation Act of 1973.16 Two cases were found discussing section 504 and transportation which provided that section 504 creates an affirmative duty. One of these cases is Lloyd v. Regional Transportation Authority which was discussed above. The other is United Handicapped Federation v. Andre. 558 F.2d 413 (8th Cir. 1977), which was a suit by mobility-handicapped persons and associations of disabled persons alleging that urban 15

Michigan Paralyzed Veterans of America v. Coleman. 451 F.Supp.7 (E.D. Mich. 1977); United Handicapped Federation v. Andre. 558 F.2d 413 (8th Cir. 1977); Leary v. Craosve. 566 F.2d 863 (2d Cir. 1977). It should be noted that one case which did not deal with transportation has questioned this holding. See Crawford v. University of North Carolina. 440 F.Supp. 1047 (M.D.N.C. 1977).

16

124 Cong. Rec. S. 15593 (September 20, 1978) (remarks of Senator Bayh).

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mass transit equipment which was purchased with Federal financial aid was not accessible to handicapped persons and that this violated section 504. The Eighth Circuit Court of Appeals held that the plaintiffs were entitled to relief and stated: We adhere to the reasoning of Judge Cummings in his excellent analysis in the Lloyd appeal, and find that section 504 does create an affirmative duty n the part of these defendants. At 415. The five cases found which discuss more specifically the requirements of section 504 relating to transportation varied widely. In Snowden v. Birmingham-Jefferson County Transit Authority. 407 F.Supp. 394 (N.D. Ala. 1975), aff’d 551 F.2d 862 (5th Cir. 1977), rehearing denied, 554 F.2d 475 (5th Cir. 1977), the court held that since persons confined to wheelchairs were permitted on county buses even though they had to have someone help them in and out of the bus, the action of the transit authority in purchasing with Federal funds buses which were not designed and equipped for passengers in wheelchairs was not violative of section 504. In Vanko v. Finley. 440 F.Supp. 636 (N.D. Ohio 1977), the court found that section 504 did not require that a regional transportation authority make all its buses accessible to persons in wheelchairs. The district court further stated: ... section 504 of the Rehabilitation Act of 1973, 29 U.S.C. sec. 794, does not require the immediate establishment of services comparable to those provided the general public. Instead, this section’s prohibition of discrimination against the handicapped can be satisfied by the same substantial good faith progress in both the planning and implementation of transit programs for the mobility-handicapped that is sufficient for the purposes of the Urban mass Transportation Act of 1964 and the regulations thereunder. Vague plans for the indefinite future and second rate transit for the mobility handicapped will not satisfy the mandate of these federal laws, but instantaneous conversion to a transportation system that is comparable in ever minute detail is not required either. At 666. A third approach was taken in Bartels v. Viernat. 427 F.Supp. 226 (E.D. Wis. 1977). The district court there held that section 504 was violated by operating a mass transit system which was effectively inaccessible to mobility-handicapped persons and by attempting to purchase with federal funds new buses which were also inaccessible to these persons. In Michigan Paralyzed Veterans of America v. Coleman. 451 F.Supp. 7 (E.D. Mich. 1977), the plaintiffs sought to prevent the Southeastern Michigan Transportation Authority from purchasing public transportation vehicles which were inaccessible to handicapped persons. The court found that the plaintiffs could bring the action but found that factual issues concerning whether the buses which the transit company sought to purchase could permit a wheelchair option made the defendants’ motion for summary judgement premature. Finally, in Atlantis Community v. Adams. 453 F.Supp. 825 (D. Colo. 1978), the Colorado district court discussed an action brought to enjoin the delivery of buses which were not equipped to transport handicapped persons. The court found that the Rehabilitation Act provisions did not sufficiently delineate the duties of the federal officials to enable the court to give these officials directions.

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In Southeast Community College v. Davis. 47 U.S.L.W. 4689 (June 11, 1979), the U.S. Supreme Court for the first time interpreted section 504 of the Rehabilitation Act. Although this case dealt with educational opportunities for handicapped persons, it does have implications for the area of transportation and the handicapped. In its decision of June 11, 1979, the Supreme Court found that section 504 would be preclude a public college from denying a hearing impaired person admission to a nursing program due to a handicap where this handicap might interfere with the ability to perform duties safely and further found that section 504 imposed no affirmative duties to provide modified educational opportunities in this situation. The Court specifically reserved judgement on two other issues which had been presented to it for resolution; that is, whether section 504 gives rise to a private right of action or whether, if this right is found, a handicapped person must first exhaust administrative remedies. The Supreme Court began its analysis of the merits of the case with a discussion of the language of section 504 and noted that it did not specifically compel educational institutions ”... to disregard the disabilities of handicapped individuals or to make substantial modifications in their programs to allow disabled persons to participate.” At 4691. The Court focussed on the requirement of section 504 that an "otherwise qualified handicapped individual" not be excluded from participation in a federally funded program and found that an otherwise qualified handicapped individual "... is one who is able to meet all of a program’s requirements in spite of his handicap". At 4691. The regulations promulgated by HEW under section 504 were seen by the Court as supporting this interpretation. The aspect of the holding overruled the Court of Appeal’s interpretation of "otherwise qualified" which the Supreme Court had characterized as "...prevent(ing) an institution from taking into account any limitation resulting from the handicap, however disabling". At 4691. The Supreme Court then analyzed the issue of whether the college must take affirmative action which would dispense with the need for effective oral communication. The plaintiff had suggested that she be given individual supervision by faculty members when she attended patients directly. She also argued that the College is not required to train her in all the tasks a registered nurse is licensed to perform but that section 504 would be applicable if she were able to perform satisfactorily some of the duties of a registered nurse or to hold some positions available to a registered nurse. This argument was supported by citations to HEW regulations which required covered institutions to make modifications in their programs to accommodate handicapped persons. 45 C.F.R. 84.44. The Court rejected this argument stating: We note first that on the present record it appears unlikely respondent could benefit from any affirmative action that the regulation reasonably could be interpreted as requiring ... In light of respondent’s inability to function in clinical courses without close supervision, Southeastern with prudence could allow her to take only academic classes. Whatever benefits would not receive even a rough equivalent of the training a nursing program normally gives. Such a fundamental alteration in the nature of a program is far more than th22e "modifications" the regulation requires. At 4692.

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The Court further noted that if the regulations were interpreted to require the extensive modifications necessary to include the plaintiff in the nursing program, "grave doubts" would be raised concerning the regulations’ validity. The language of section 501 and 503 of the Rehabilitation Act, 29 U.S.C. Sections 791 and 793, specifically includes affirmative action provisions applicable to federal agencies and contractors by the Court notes that: Section 504 does not refer at all to affirmative action, and except as it applies to federal employers it does not provide for implementation by administrative action .... Here neither the language, purpose, nor history of Section 504 reveals an intent to impose an affirmative action obligation on all recipients of federal funds. Accordingly, we hold that even if HEW has attempted to create such an obligation itself, it lacks the authority to do so. At 4692. The Court specifically rejected arguments which had been raised by a Government amicus curiae brief that portions of the legislative history of the 1974 amendment to the Rehabilitation Act and the legislative history of the 1978 amendments indicating that section 504 required affirmative action were relevant. The Court stated that "....these isolated statements by individual Members of the Congress or its committees, all made after the enactment of the statute under consideration, cannot substitute for a clear expression of legislative intent at the time of enactment." At 4693, footnote 11. The Court further noted that the ".... line between a lawful refusal to extend affirmative action and illegal discrimination against handicapped persons will not always be clear." At 4693. For example, the Court observed that technological advances could be expected to enhance opportunities for handicapped persons and that these advances may allow handicapped persons to participate in programs "without imposing undue financial and administrative burdens upon a State". At 4693. However, the Court found that the types of adjustments in Southeastern’s nursing program which were sought by the plaintiff were not required under section 504 and stated "(s)section 504 imposes no requirement upon an educational institution to lower or to effect substantial modifications of standards to accommodate a handicapped person." At 4693. The implications of the Supreme Court’s decision could be quite far reaching, not only in the area of education but also in other areas such as transportation. The Supreme Court’s discussion of affirmative action and illegal discrimination against handicapped persons could raise some questions concerning the rights of handicapped persons to accessible transportation under section 504. More specifically, although the Supreme Court indicated that there may be situations where a refusal to modify a program to accommodate handicapped persons would be unreasonable and discriminatory, the Court also noted that "(t)echnological advances can be expected to enhance opportunities to rehabilitate the handicapped or otherwise to qualify them for some useful employment. Such advances also may enable attainment of these goals without imposing undue financial and administrative burdens upon a State". At 4693. It could be argued that this language might indicate that Supreme Court would balance the "financial and administrative burdens upon a State" against any argument that a program, such as a transportation system, must be modified to accommodate handicapped persons.

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As was discussed above, two transportation cases were found which provided that section 504 creates and affirmative duty. In light of the Supreme Court’s finding in Southeastern Community College concerning affirmative action, there is some doubt concerning the validity of this type of decision. However, it should be noted that the Supreme Court did find that "situations may arise where a refusal to modify an existing program might become unreasonable and discriminatory." At 4693. Therefore, although affirmative action, such as close, individual attention by a nursing instructor for a nursing student, would not be required under section 504, certain situations may arise where program modification would be required. The reasoning of the Seventh Circuit Court of Appeals in Lloyd v. Regional Transportation Authority, supra, could also be questioned in light of the Supreme Court’s decision in Southeastern Community College. In reaching its determination that there was a private right of action under section 504, the court in Lloyd relied heavily upon the legislative history of the 1974 amendment to the Rehabilitation Act. There is some doubt concerning whether the legislative history of the 1974 amendments is an appropriate indication of Congressional intent regarding section 504 since the Supreme Court in Southeastern Community College specifically rejected the use of this legislative history to indicate Congressional intent with regard to the requirement of affirmative action. It should be emphasized, though, that the Supreme Court specifically declined to determine whether section 504 gives rise to a private right of action. And, in addition, it could be argued that section 504 of the Rehabilitation Act which was added by the Rehabilitation, Comprehensive Services and Developmental Disabilities Amendments of 1978, P.L. 95-602, indicates that a private right of action may be found. The Supreme Court’s decision in Southeastern Community College v. Davis significantly limited the interpretation of section 504 from the interpretation given the sections in several lower court decision. Although the Court’s specific holding was quite narrow, it has broad implications for the general interpretation of section 504. The Court’s decision in Southeastern Community College has already been cited in a brief asking for a preliminary injunction to bar the Department of Transportation’s regulation under section 504 from taking effect.17 SUMMARY Serious questions have arisen concerning the use of section 504 to provide for accessible transportation for handicapped persons. Many of these are left largely unanswered by the legislative history and the cases brought under section 504. However, there are some indications that transportation inaccessibility was considered as a form of discrimination that section 504 was meant to remedy. There are even fewer guidelines concerning exactly what is required for accessible transportation under section 504 and the few cases which have discussed this issue have arrived at divergent decisions.

17

National Journal 1175 (July 14, 1979).

TRANSPORT FOR ELDERLY AND DISABLED PEOPLE IN DEVELOPING COUNTRIES Margaret Heraty Transport Consultant 1.

INTRODUCTION

This paper is necessarily very generalised but its aim is to explore and explain the differences between developing countries and those developed countries with which most of the Conference delegates or readers of the proceedings will be familiar. There should therefore be an initial apology to delegates (or readers) from developing countries, to whom much of the contents will be all too obvious, and to the very many people and organisations (listed in section 8) who were good enough to provide with very detailed information which has had to be summarised or glossed over in this broad overview. 2.

THE NUMBER AND NATURE OF DISABLED PEOPLE

There is little information on the number of disabled people in many developing countries (some of which do not even have an accurate population census), and there is little need for it except in rare cases where benefits or assistance is provided by the state. Where data are available, they tend to be based on medical definitions of illness rather than functional definitions of disability. However, it does appear that the generally recognised figure of 10 percent of the population being "disabled" in the sense of mobility-impaired applies, or is on the low side. The proportions of elderly people also vary, depending on local definitions and on the prevailing levels of life expectancy and birth rate (the higher the birth rate or the lower the life expectancy, the lower the proportion of elderly people). Some examples illustrate this variation: Hong Kong Jordan Guyana Kenya Malawi

13.5% over 60 8.7% (men over 60 (women over 55 6% over 60 years c. 5% over 55 4% over 65 107

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Although the proportion of frail elderly people is often lower than in developed countries, and many children disabled from birth die young for want of medical care, the numbers of disabled people are inflated by local conditions. Diseases, malnutrition, bad weather, insanitary conditions, road accidents and war or civil strife, are all more prevalent and their effects are exacerbated by poor medical care, especially in rural areas. For example, road traffic accidents in Nigeria are estimated to disable (temporarily or permanently) 26,000 people a year. In Nicaragua, people disabled from war alone appear to comprise 17 percent of the population (half of them civilians); the World Health Organization (WHO) estimates that about 10 percent of the population are severely disabled and around three percent of the population are paraplegics or tetraplegics (about 10 times the usual proportion). Civil strife or war can also inhibit attempts to assist with medical treatment and rehabilitation by national resources or external agencies. In terms of the effects of disability on mobility, one example from Malawi will serve to illustrate the problems. The 1983 Survey of Handicapped People, which concentrated on the most disabled 3.6 percent of the population, found that 29 percent of the respondents over five years of age had problems with mobility; of those 18 percent could move only with human or mechanical help, while 10 percent (three percent of all disabled people) had to be carried everywhere. 3.

TRANSPORT IN DEVELOPING COUNTRIES

It would be simplistic to say merely that the provision of transport for disabled people is almost non-existent in developing countries, without explaining the context in which such provision might be made or would be needed. Most developing countries have transport systems which are deficient for the needs for all people and for the carriage of goods. Lack of resources in the public sector leads to bad roads, overcrowded trains, a heavy reliance on the private sector for bus and shipping services, and a weak government infrastructure in terms of the implementation and administration of policies and legislation to control or guide the private sector.

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Low incomes mean that fares have to be kept low, with little or no government subsidy. Low fare revenues, combined with the expense and difficulty of obtaining spare parts, exchange controls and so on, lead to the vehicles used in public transport being the cheapest and most utilitarian possible, in poor condition, old and unreliable. Buses are frequently converted from trucks, or are trucks. The level of service provided, judged by any parameter, is often inadequate for the needs of the local community. Car ownership is generally very low; bicycles are popular in some countries but not in others. Personal mobility is often confined to walking, which can be done over great distances and carrying heavy loads. As an extreme example, in Nepal 50 percent of the population live at least one day's walk from a motorable road; 15 percent live more than one week's walk away. 4.

THE SOCIAL CONTEXT FOR ELDERLY AND DISABLED PEOPLE

Disabled people in developing countries are usually very poor. Many people disabled from birth never go to school (two examples: 58 percent of disabled people surveyed in Malawi had had no education at all; WHO estimates that 98 percent of disabled people in Malaysia are illiterate). They, and many other disabled people who have had some education, often do not or cannot work, at least in the formal sector; this distinction is important. For example, 67 percent of disabled people in Malawi, from the same survey, did not undertake formal work, but 70 percent had some responsible activity. This comprised farming or fishing in 39 percent of cases, household duties and/or livestock herding for 26 percent, two percent local businesses (especially agro-industry such as brewing beer), one percent pottery or other crafts; however, only 12 percent of the people interviewed received any pay or profit on a regular basis and a further 20 percent only did so occasionally. In developing countries, there is usually no statewide provision of welfare benefits and, even where some form of assistance is available, people are ignorant of it or are prevented by illiteracy or remoteness from applying for or benefitting from it. This is especially true in rural areas.

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Charitable agencies frequently have to provide food for residents or attenders at special schools or rehabilitation centres. The one exception to the general lack of provision is that some financial support is given in most countries to people who became disabled while in the armed forces. Medical treatment may be inadequate, but rehabilitation is almost non-existent. WHO estimates that 98 percent of people in developing countries who need rehabilitation do not have access to it. Thus there is almost no training in money skills, orientation or many of the many other factors which are important to mobility. One exception is Pakistan, where the new National Institute for the Handicapped and the Mobility Centre for the Blind are working on coordinating medical, para-medical and social welfare services nationally to this end. Limited provisions are made for special schooling or technical training and these often consist of residential establishments. Sheltered employment is sometimes also available with residential care. These facilities are usually provided by voluntary agencies, often with external or expatriate assistance. Conversely, there are usually few residential homes for elderly people. Transport demand is therefore low, as many disabled people have little reason and/or no ability to travel. At the extreme, in Kenya elderly and disabled people are not allowed to travel alone at night, in case they are knocked down or have some other problem: it is not clear whether this should be regarded as a kindness or a limitation - perhaps both. On the good side, the extended family system in many developing countries caters for the physical needs of a disabled or elderly person who is effectively housebound and, when a disabled person does venture out, kindness and concern from complete strangers is not uncommon. 4.

BASIC MOBILITY

Of greater concern than the lack of provision of transport, is the unavailability of appropriate mobility aids: calipers, prostheses, crutches and wheelchairs.

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Visitors to developing countries are often struck by the sight of disabled people wheeling themselves in homemade carts or on low "skateboards". Mobility aids are not only in short supply, they are frequently inappropriate in design for the person or the local conditions, and are often relatively very expensive. Some governments supply aids, some only do so in special cases (for example, ex-military, or the very poor), some do not do so at all. In Afghanistan, where leg amputees are disproportionately common because of the large area of the land which has been mined, the Kabul Hospital had 1,600 requests for artifical limbs within 72 hours of opening a specialist department in March 1989. In Dhaka, Bangladesh, the Rehabilitation Centre has made 1,000 wheelchairs in the last 10 years, using local materials including bicycle parts, but the supply is miniscule compared to the demand. Action on Disability and Development, based in the UK, works in training and design, and has set up workshops throughout the third world, dealing with basic mobility aids. But wholesale provision of appropriate equipment is sorely lacking. The Malawi survey found that in the previous 12 months, only three percent of the severely disabled people surveyed had received help from outside the household of any kind (including clothes and money); of this three percent, 11 percent had received crutches, seven percent shoes or calipers, two percent wheelchairs and 10 percent spectacles. As might be expected, the proportions were lower in rural than in urban areas. Even when aids are available, local conditions impede mobility. There is a graphic example in a report from one UK-based agency of a 13 year old girl in India with polio-paralysed legs who spends all her time sitting in a tiny crowded courtyard shared by three other families, preparing sandalwood paste for an income of two Rupees (10 UK pence or one Swedish Crown) a day. She has a family to provide her basic needs, but because of the time she spends sitting, she has developed contractures in her knees which prevent her wearing calipers. She could crawl to the end of her alley, but beyond that is a deep and wide gutter; in the last few years she has only once been outside her courtyard, and never been to a shop, or seen a bus or a tree. The picture is vivid, but the questions are asked: what use would a wheelchair be -

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her alleyway is too narrow, the kerb is too steep, schools are inaccessible - she would still need help to carry her chair over the obstacles; how could she ever begin to pay for its maintenance, or even face a previously-unknown world? Would having a wheelchair not be a source of more frustration than liberation? In rural areas, the situation is even more dire. The same report cites the case of a woman who is, similarly, paralysed but whose home is a small village. She lives alone, supporting herself with some work at home on cotton processing. Because she does not want to be seen by others as she crawls in the street, she has not left her home by daylight for 20 years. She could use a wheelchair but has no way of getting to the state capital to apply for a government grant: she could not get on a bus, and would not know where to go; even if she obtained a grant, there is no one to collect the wheelchair for her? or deal with its subsequent maintenance. In general, therefore, having a wheelchair or the possibility of obtaining one does not necessarily afford mobility, especially if the disabled person's home is on an unmade road and accessed by a plank over a stor;m drain. The provision of dropped kerbs and ramped entrances to buildings has to be low in the priorities of a country which cannot even afford to maintain its primary road network. In many places, where it is essential to carry a disabled or elderly person, to medical treatment for example, wheelbarrows or homemade litters are used: perhaps not very dignified but certainly practical. It is probably worth pointing out, also, that most developing countries do not and cannot have guide dogs for the use of blind people, for a variety of reasons: the health of the dogs (who would suffer greatly from the weather and/or disease), for religious reasons precluding the keeping of dogs in a household, and because of the expense of buying, training and feeding them. 6.

TRANSPORT PROVISION

In the light of all that has been said above, it is not surprising that the provision of special or adapted transport for disabled and elderly people is almost entirely lacking in many developing countries and, conversely, that few disabled or elderly people

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travel. However, there are some provisions and concessions which should be mentioned, and it appears that more are gradually being provided as time goes by. Free or cheap travel on public transport is a common (although by no means universal) provision and occurs in a range of countries at all stages of development. Even in the poorest countries of Africa, bus drivers often will not take a fare from an obviously disabled traveller, even a complete stranger and in defiance of company rules. Formalised systems exist in many countries (e.g. Hong Kong, Guyana) and more commonly apply to disabled schoolchildren only or to blind people (e.g. Jordan). Malayan Railways offers such a scheme, including on its services to Singapore (although Singapore itself has nothing similar on its own urban transport). Very few countries offer special financial relief with car purchase or operation, or special parking provisions: as a rare exception, in Hong Kong disabled people are allowed to park in meter bays free of charge. Where data are available, it is clear that the numbers of disabled drivers are pitifully small (30 out of 2.5 million population in Singapore, perhaps 700 out of 5.6 million in Hong Kong). Some countries forbid disabled people to drive at all (e.g. Nigeria, Malawi). Technical advice on vehicle adaptation is usually unavailable, although some governments or voluntary societies provide a small number of special vehicles or "invalid cars": the Jordanian Government issues some on special occasions, the Kenyan Government pays some costs of invalid cars, the Malaysian Association for the Physically Handicapped provides handpowered tricycles in limited numbers. It is difficult to legislate on vehicle design or fare scales when public transport is provided by the private sector. Perhaps for that reason, railways and airlines, which are often government-owned, tend to make better provision for disabled people; for example, Nigerian Railways uses ramps to facilitate the carriage of people in wheelchairs. As one encouraging example, the Government of Kenya has recently instructed all transport companies to make better provisions for diabled people. Building codes at present rarely reflect the needs of disabled people. Hong Kong is a rare exception: new

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buildings now have to be accessible, the Government is retro-fitting its own buildings as far as possible, and a Roads Code is being drawn up. Already a three-mile stretch of Nathan Road (a major shopping centre in Kowloon) has dropped kerbs along its length, and there are many audible crossing signals throughout the city. But, of course, Hong Kong is not a true "developing country" in most respects, especially in terms of resources. Elsewhere adaptations may be made by organisations on a voluntary basis? for example, many schools, universities, banks and similar buildings have been made more accessible in Kenya. The Government is able to work towards legislation for all public buildings now that a start has been made. The Government of Guyana is considering a Policy Paper on the Rights of the Disabled which may also lead to legislation there. Special transport services are generally provided, where they are provided at all, by voluntary agencies, and generally give access only to special schools, training centres, hospitals and sheltered employment. In Nigeria, the Government has introduced a "quota system" for the employment of disabled people, but there is no parallel provision of special transport to enable disabled people to take up the job opportunities. Again, Hong Kong has made some positive moves towards special service provision, including trials of a "Rehab Taxi" and the introduction of a "Rehabus", following a Working Party report in 1985 on the Transport Needs of the Disabled. The Rehabus service operates 25 buses on 23 scheduled routes and carries 285 disabled people to work, school, training centres and medical treatment on a regular basis. However, the waiting list for this service is over 100 people long, and there are about 100,000 disabled people in the Colony. Provision elsewhere is on a very limited basis. In Malaysia, there is one fully-accessible and finelyequipped bus in Kuala Lumpur which is used mainly for taking disabled people out in groups? it is hoped to extend this to have one in every state. In Guyana, the Rehabilitation Centre and the Institute of the Blind each have one bus, for the use of people going to and from medical treatment.

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There are few reported cases of special transport being provided for "optional" trips (for example, travel for shopping, visiting, social, leisure and religious purposes). The Rehabus in Hong Kong operates a dial-a-ride service in the off-peak and at weekends carrying 18,000 trips per annum, as well as running scheduled services on recreational routes. Singapore has recently had a major review of transport needs, carried out by the local Section of the Chartered Institute of Transport. This commented on the lack of provision in Singapore and recommended a wide range of actions to the Advisory Committee on the Disabled. Even in Hong Kong and Singapore, which both have, inter alia, new and sophisticated mass transit systems, little or no provision is yet made on mainstream public transport for the frail elderly or disabled passenger. It is hardly surprising, therefore, that in other developing countries, which do not have the financial resources of these two economic powers, provision is limited and piecemeal. Many voluntary agencies are trying hard in a small way. All are well-meaning and most are effective. But there is little government help. Kenya's Government provides medical facilities, orthopaedic boots and calipers, and is aiming to set up a fund to provide other facilities to disabled people, but this will be composed of voluntary contributions from the public, which the Government will only administer. 7.

CONCLUSION

There is certainly little coordination of efforts and insufficient exchange of technical and practical operating ideas and experience, between people working in the field of transport for disabled and elderly people in the third world. The lack of resources in most developing countries means that any provision has to be at minimum cost; local conditions mean that provisions have to be appropriate to design and technology. The goodwill is there but a lot needs to be done. Conferences such as this can give a focus and an impetus to the immense task which confronts developing countries throughout the world in trying to cater for all the needs of elderly and disabled

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people: including food and shelter as well as mobility. The task needs to be undertaken in collaboration with elderly and disabled people and with the help of bilateral and international agencies (despite the absence of any UN coordinating body for transport matters). Its importance is obvious when one considers that there are probably about 300 million disabled people in the developing countries of the world. 8.

ACKNOWLEDGEMENTS

The author is extremely grateful to the following people who have kindly contributed their time and efforts to provide the information contained in this paper: Guyana A .B . Adams, Hon. Corresponding Member, Chartered Institute of Transport (CIT); Guyana Transport Services Ltd. The Assistant Secretary, National Rehabilitation Committee, Ministry of Health Hong Kong Father J. Collins SJ, Wah Yan College, Kowloon R. T. Meakin, Assistant Commissioner for Transport (New Territories), Transport Department India Lt Col H.W. Davis, Karnataka Ex-Services League, Bangalore V. Krishnamurthy, Board Member, The Association of the Physically Handicapped, Bangalore Dr C. Prabhakar, Medical Superintendant, Red Cross Home, Bangalore Jordan HRH Princess Majda Raad, Al-Hussein Society for the Rehabilitation of the Physically Handicapped Dr Majdi Sabri, Hon. Corresponding Member, CIT; Royal Jordanian airline Kenya S. R. Obade, Hon. Secretary, CIT; Lecturer, Coast Institute of Technology, Voi P.E. Mwaisaka, Permanent Secretary, Ministry of Transport and Communications, Nairobi Libya A. Ashiabi, General Secretary, National Committee for Care to Disabled Persons Malawi R.L. Bailey, Traffic Consultant, United Transport Malawi Ltd

TRANSPORT IN DEVELOPING COUNTRIES

R. Buckley, United Transport Malawi Ltd R. lies, United Transport Malawi Ltd P .R . Jere, Hon. Secretary, CIT D. Frenkel, Exec. Secretary, Malawi Against Polio P.T.K. Nyasulu, Acting General Manager, Malawi Railways Ltd. Malaysia Kok Yun Lim, Social Services Department, Kota Kinabalu Lee Tain Chew, Hon. Corresponding Member, CIT, East Malaysia; Sabah Ports Authority, Kota Kinabalu R.L. Lynch, Transport Consultant B. Majaham, Director of Social Services Department, Kota Kinabalu Nigeria J.O.P. Ajai, former Hon. Secretary, CIT; Asst. Traffic Manager, National Ports Authority Pakistan Brig S.S.A. Qasim, Hon. Secretary, CIT Siraj S. Shamsuddin, Director, Ministry of Health, Special Education and Social Welfare Singapore M.G. Gray, Chairman, CIT; Coopers & Lybrand Sri Lanka F.D.C. Wijesinghe, Hon. Secretary, CIT Switzerland Ms D. French, World Health Organization, Geneva Tanzania H. M. Bantu, Hon. Secretary, CIT; Head, Transport Operations Department, National Institute of Transport Trinidad and Tobago Sr A. Dickie, Principal, Lady Hochoy Home, Cocorite Dr I.M. Ghany, Medical Chief of Staff, St Ann's Hospital, Port-of-Spain D. L. Gittings, Vice-Principal, Cascade School for Deaf Children, St Ann's E. N. Isaac, Hon. Corresponding Member, CIT; Public Transport Service Corporation Uganda I. S. Nsubuga, Hon. Secretary, CIT United Arab Emirates M. Flanagan, Hon. Corresponding Member, CIT, Dubai; Managing Director, Emirates airline United Kingdom Ms J. MacKeith, Nicaragua Health Fund, London Dr A. Poteliakhoff, Secretary, Medicial Association for the Prevention of War C. Underhill, Director, Action on Disability and Development

117

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Zimbabwe D. Abbott, Administrator, RESCU Sheltered Employment Capt A. Andrews, Matron, The Salvation Army Bumhudzo Hospital Home, Zengeza, Zimbabwe Mrs J .D . Bukutu, African Rehabilitation Institute R. Chiwara, General Manager, Zimbabwe Omnibus Company, Bulawayo D.L. Cruttenden, Chairman, CIT, Harare Section Sr Gaudiosa, Superior, Emerald Hill School for the Deaf, Harare Mrs I Gross, ILO/ARI Rehabilitation Staff Training and Research Programme for Africa Major C Kanouruka, 0/C Forces Convalescent Centre, Nyanga Capt M. Karengesha (Salvation Army), Superintendant, Enterprise and Ralstein Homes, Bulawayo Sr E. Kühner, Sister in Charge, St Joseph's Clinic, Harare J. Malaba, Central Statistical Office L. Mandiki, Assessment Officer, Zimcare Trust for the Care and Education of the Intellectually Impaired D.R. Meyer, Managing Director, Surgimed (Pvt) Ltd Major P.S. Ndhlovu, Social Secretary, The Salvation Army R.H. Rutherford, Chairman, Senior Citizens' Club, Harare Mrs E.T. Sithole, Executive Director, National Association of Societies for the Care of the Handicapped (NASCOH)9 9.

BIBLIOGRAPHY

Action on Disability and Development (1988), research reports and proposals (various). Ajai, J.O.P. (1988), The Provision of Mobility for Disabled and Elderly People [in Nigeria]. Al-Hussein Society for the Rehabilitation of the Physically Handicapped (1987), Annual Report of the Amman Centre for the Education and Rehabilitation of the Physically Handicapped, Jordan. Central Registry of the Disabled (1988), Summary of Major Statistics of the Half-Yearly Statistical Reports Dated 31 March 1988, Government Secretariat, Hong Kong. Chartered Institute of Transport (Singapore Section) (1988), Report to the Advisory Council on the Disabled on: Transport for Disabled People in Singapore.

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Chiwara, R.J.K. (1988), Bus Management in Zimbabwe, Developing World Transport, ed. Heraty, M.J., Grosvenor Press International, London, U.K. Collins, J. (1984), Transport for the Disabled in Hong Kong, Third International Conference on Mobility and Transport of Elderly and Handicapped Persons, Conference Proceedings, Tallahassee, Florida, U.S.A. Collins, J. (1986), The Need for Public Transport Accessible to the Disabled, Fourth International Conference on Mobility and Transport for Elderly and Disabled Persons, Vancouver, B.C., Canada. El-Karmi, Col Y. (1987), Annual Report, Jordan Sports Federation for the Handicapped, Amman, Jordan. Elshabani, A.O, The Mobility and Transport of Handicapped Persons in Developing Countries: The Case of Jordan, Third International Conference on Mobility and Transport of Elderly and Handicapped Persons, Conference Proceedings, October 1984, Tallahassee, Florida, U.S.A. European Conference of Ministers of Transport (1986), Transport for Disabled People, International Comparisons of Practice and Policy with Recommendations for Change, ISBN 92-821-1106-7, OECD. European Conference of Ministers of Transport (1986), Transport for Disabled People, Developing Accessible Transport: The Role of Demand Responsive Services, ISBN 92-821-1120-0, OECD. European Conference of Ministers of Transport (1987), Transport for Disabled People, International Coordination and Standardisation of Measures and Policies to Promote Mobility, ISBN 92-821-1119-9, OECD. Hong Kong Society for Rehabilitation (1988), Papers from the Annual General Meeting. Journal of Tropical Pediatrics (June 1987), Vol. 33, Supplement 1, Medical Needs of Africa, Oxford University Press. Katz, A. (1986), Aspects of the Transportation Problems of Elderly and Disabled Persons in Developing Countries, Fourth International Conference on Mobility and Transport for Elderly and Disabled Persons, Vancouver, B.C., Canada. Krishna Murthy, T.G., Sethi P.K. and Ward, A.E., Low Cost Mobility Devices. Macheso, C.N.H. (1988), A Report on Provision of Mobility for Disabled and Elderly People in Malawi. Ministry of Labour and Social Services in association with UNICEF (1981), Report on the National Disability Survey of Zimbabwe, Department of Social Services, Zimbabwe.

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National Committee for Care to Disabled Persons, Law No. 3 of 1981 on Disabled Persons, Secretariat for Social Security, Socialist People's Libyan Arab Jamahiriya. National Statistical Office (1987), Survey of Handicapped Persons Malawi 1983, Government Printer, Zomba, Malawi. Rehabilitation Division, Education and Manpower Branch (1987), Review of Rehabilitation Programme Plan, Government Secretariat, Hong Kong. Services for the Physically Disabled (1987), Review of Hong Kong Rehabilitation Programme Plan. Werner, D., Where There is No Doctor: a village health care handbook, OXFAM with TALC. Working Party on the Transport Needs of the Disabled, June 1985, Rehabilitation Division, Education and Manpower Branch, Government Secretariat, Hong Kong. World Health Organization (1982), Community Based Rehabilitation, Report of a WHO Interregional Consultation, Colombo, Sri Lanka, 28 June - 3 July 1982, RHB/lR/82.1, WHO.

T O W A R D S M O B IL IT Y A S A H U M A N R IG H T

Barbro Carlsson, Chairman The National Society for Associations of the Disabled, Sweden

The Situation from Disabled People’s Point of View 1.

The opinion held of a person, their value in societies throughout the world, is determined by his or her status as a disabled person, their level of dependence and independence. This informs our community bodies, organizations and systems and determines the conditions for our power and/or powerlessness as individuals. This holds true in a larger context, as well as in our personal, day-to-day experience. It is easy, in our society, to formulate principles on what should be done. The implementation of our goals is more difficult. It is then that we are faced with the question of whether the aim is to affect just some people or everyone. The greater our goals, the greater the demands of solidarity placed upon other people in society. The less we attempt, the greater chance for selfishness.

2.

The U N ’s World Action Programme for the Disabled, passed by the General Assembly in 1982, addresses this problem. The goal is equality and full participation. The Programme is designed to promote development which gives disabled people the same living conditions as other members of society, regardless of the level of development. The Programme is deemed radical and forwardlooking because it so unequivocally states that it is the governments of all the nations in the world which have full responsibility to see that people with functional disabilities have the possibility to achieve the same living standards as other citizens. The Programme kicked off the UN Decade of Disabled Persons. In August 1987, the UN organized a meeting of experts in the field in Stockholm, hosted by the Swedish government. The aim of the meeting was to follow-up and assess the work achieved during the first half of the decade. Reports from the different regions of the world showed that the Programme’s results are still rather modest. We who took part in the meeting therefore agreed on a number of recommendations as a base for the General Secretary’s report to the General Assembly. One of these was a special convention to provide and maintain the Disabled and their families with basic civil rights. The thought behind the convention was and is to hopefully be able to speed up development in the sphere of disabled people’s concerns worldwide. This is in keeping with our continued efforts to get human rights to encompass and work for everyone. It is our right to be able to move around freely. 121

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3.

The possibility for everyone to develop into a free and independent human being is one of the goals of a democratic society. Such a development is a pre-requisite for each and every person having the possibility to be an active member of society. And a democratic society cannot be considered as such unless everyone can take part in its activities and decision-making process. It is also in society’s interest to cooperate in creating conditions conductive to everybody’s participation in the society. A disability is not in and of itself a disability, but to a large extent is only regarded as such when tied in with the disabled person’s surroundings. We must consider society’s willingness to change, to tear down obstacles. Our handicaps arise when we cannot use public transport, like trains or buses, when we are shut off from jobs, education, cultural events and information. When we cannot get medical care and the practical help we need. With such an environmentally-dependent outlook, disability becomes a public concern and not exclusively the individual’s. It becomes, then, a question of whether there is enough political will in our society for changes which would make a difference.

4.

For those of us with physical disabilities, regardless os where we live in the world, it is imperative to make our needs heard and our demands realized; we still have to plead for our rights. We must continually argue for our cause and make it clear that we live more vulnerable and dependent lives than others. Those who for their own existence are deeply dependent on others always live in a strictly limited environment. Socalled free choice is severely limited. It is most often illusory. This fundamental experience has been and is the driving force in the Swedish Disabled Movement’s fight for participation in society. Even if the Swedish welfare state, in comparison with many other countries in the world, has achieved much there is still much more to be done. The Swedish Disabled Movement consists today of 30-odd organizations which together comprise more than 400 000 members. The Handicapped Associations Central Committee (HCK) is an umbrella organization, working on the national level, with 27 members. There are also cooperative organizations in the administrative provinces and in certain cities and countries. The Swedish Disabled Movement has grown stronger over the years with the development of the welfare state. The Movement has participated in and led development, while at the same time the

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creation of the welfare state has enabled us to build our organizations and through them take part in changing society. 5.

Swedish democracy has its roots in its popular movements. There is nothing quite like it anywhere in the world. These ideological popular movements have meant a lot in our society, which we even sometimes call "a popular movement society”. "It is against this background that the Swedish Disabled Movement should be seen. The disabled people’s movement is nothing new to Sweden. In the same manner as the other great popular movements, its roots can be found in the 18th century. The Swedish Disabled Movement is today a fighting, humanistic movement, having as its fundamental goal the equal value and equal rights of all people. We have a common policy programme which includes the most important parts of our society. Our right to be able to move about in the community is one of the most important aspects of our programme. The right to a good life means for us the provision of necessary services: daily help with practical matters, medical care, work and much more. But it also means, to a large extent, the ability to move around freely in society. Our right to get around is as vital as anyone else’s, as it is an important condition for an independent and active life. For those of us who live in highly-developed countries the contrast becomes especially obvious when public transport is primarily designed for people who can move around easily and not for us. This is true for many highly-developed nations.

6.

At Rehabilitation International’s congress in Tokyo last Autumn, members from one of the Japanese Handicap Organizations asked us to take part in a demonstration to make Tokyo’s subway accessible. The demonstration took place and it will be interesting to hear whether it was effective. Many of us who have physical disabilities would naturally be able to use subway systems, buses and trains of the vehicles and terminals were designed with our needs in mind. And really, the problem isn’t about special needs or adaptations, but rather providing a high-quality public transportation system that everyone could use. How do we do that? Well, the answer naturally depends on where we live in the world. To take Sweden as an example, I believed before that we would be able to achieve this with the help of the Handicap public transport accessibility law passed by our parliament exactly 10 years ago. This law owed its origin to the Disabled's Movement’s demands that public means of transport should be accessible to all. We believed then, 10 years ago, that this law would achieve the same

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breakthrough that ~ in spite of its deficiencies ~ its counterpart in the construction industry accomplished. That is, the paragraph in the building regulations which deal with accessible apartments and offices. Unfortunately, such a development in public transportation has not yet taken place, with the exception of domestic airlines service, which functions well. 7.

In Sweden, if not everyone’s needs can be met through a general service, we usually compensate by providing specialized service. Accordingly, we have made up for the deficiencies in public transport by providing nationally- and locally-sponsored travel services, frequently by taxi. Many of us also need even more specialized services. But this is not the real problem. The problem occurs when this specialized service competes with the general public transport system. For example, when it isn’t developed as quickly, or when it receives limited resources in comparison. We can notice a conflict inherent in the system between, on the one side, a firm and highly-developed comprehensive welfare policy, and on the other, a specialized policy for the disabled with limited, directed programmes for particular groups. It is a conflict which occurs in all spheres of our society when we don’t take into account, from the very beginning, everyone’s needs.

8.

The right to be able to move around freely is of the utmost importance. It enables us with physical disabilities to participate and therefore influence the development of democracy in our country. As I mentioned before, the result of the UN meeting in 1987 was the creation of a number of important recommendations. Many of them are about strengthening the disabled people’s own organizations, all around the world, in accordance with the goals stated in the World Programme of Action. These show a new and clear awareness of the importance of the organizations of disabled people. I am convinced that the only way to get further in our work to realize the Programme - to realize full participation and equality — is to, through our organizations, get the basic knowledge and experience communicated to the larger community by us, who are disabled. It is only with the participation of disabled people themselves that our reality can be articulated and eventually changed. I hope that this conference can lead to developing a greater level of awareness and, consequently, more and better programmes and services in every country, around the world.

PLENARY SESSION III: A CONFERENCE SUMMARY OF WORKSHOP SESSIONS

A CONFERENCE SUMMARY OF WORKSHOP SESSIONS by Professor N. Ashford Professor of Transport Planning Loughborough University of Technology Leics., U K.

For mobility to be considered as a human right for the disabled and the elderly, it is apparent that transport needs an advocate of nation-statesman status: a Wilberforce, a Lincoln, a Gandhi or a Monnet who, by example and influence, will for once and all time help us eliminate from society the argument that to provide mobility to the transport disadvantaged is a question of economics rather than social justice. The 5th International Conference on Mobility and Transport for Elderly and Handicapped Persons is a forum of the U.S. Transportation Research Board Committee which has now promoted five conferences within a span of eleven years. Those in the field of transport have seen the development of this area of interest over a period of twenty years, since the first stirrings of realization of the problems of mobility deprivation by planners in the United States. Disabled persons and the elderly have always known the problems of immobility and isolation.

The

difference now is that the planners and providers are now being made aware of the scale and details of the problem and are learning how to make provision. Interactions at conferences such as this sensitize engineers, planners and administrators to take account of the general social needs and ambitions of the elderly and the disabled. A criticism often arises that these conferences concentrate on what has been achieved rather than examining the degree to which solutions have penetrated the entire problem. This may be so, but it should not be forgotten that advances in some countries over the last fifteen years would have been inconceivable twenty years ago. This progress shows what is achievable technically. The questions which 125

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remain are now largely political. In attempting to summarize some of the more important aspects which have been brought out in discussion here, the following would appear to be the most important:

Travel Needs and Travel Patterns 1.

The general integration of the disabled into the social and economic life of the community is still very limited and the transport infrastructure still largely militates against such integration.

2.

In the developed world, the demographic profile is changing, giving a greater proportion of the elderly. These older persons are richer, fitter and more accustomed to the use of the motor car. In all countries, the increase of life span means that the numbers of disabled and frail are increasing, because the elderly form a significant and large proportion of the disabled.

3.

There is strong evidence that the elderly who are accustomed to using the car will change behaviour patterns to forego trips rather than use non-car modes.

4.

Existing specialized public transport systems reach only a small proportion of eligible users. This is a function of many factors including inadequate information and marketing, serious problems with service quality and significant eligibility and trip restrictions.

5.

Traditional public transport service could be made more useful to all travellers if special effort is made to cater for the intellectually disabled through signs, coherent visual information aids and other guidance and advisory mechanisms.

Political Perspectives and Policies 1.

It should be recognized that disabled persons should have equal rights to fulfillment and development.

Transport and mobility can combine to

maximize an individual's participation in society. It is interesting to note that Canada is the only country to state equality of rights for disabled persons in its

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constitutional documents. 2.

Human rights and the degree to which these are protected is as valid a criterion in the planning or design of infrastructure as cost effectiveness. The Canadian experience shows how much can be done with political commitment.

3.

Where resources are limited, as in developing countries, the lack of mobility provision bears hardest on the young, the elderly and the disabled to the degree that in most cases their basic human right to mobility is denied.

4.

At the top level, politicals have little interest in the problem of mobility for the disadvantaged and refuse to fund adequately this area.

5.

With respect to developed countries, much can be done with simple techniques and thoughtful planning. In some cases, more resources are required. Solutions now are not a question of developing technology, in that already good technology exists to make transport systems available. Provision is now a question of legislation, and perhaps above all, the political will to enforce such legislation.

6.

In the words of one of the speakers we may observe that planners are in general "affluent, car-users, male, engineers and fit". Perhaps more crucially it could be added that politicians are by large, affluent, car users, male, lawyers and fit. To ensure that the needs of the transport disadvantaged are considered in planning, it is often necessary for their advocates to use the tactic of public embarrassment to achieve the necessary aims when inadequate or thoughtless schemes are produced.

7.

In most developing countries, the disabled are usually deliberately left out of the transport process. In Africa for example, the technology referred to in this conference simply does not exist. In Latin America also, transport is geared to the needs of the able bodied who work. It must, however, be recognized universally that without transport the disabled cannot work and therefore cannot in any way be integrated into society. This applies as much in developing countries as in the developed world.8

8.

An interesting approach to the solution of transport for the disadvantaged comes from the American Association of Retired Persons (AARP) which

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recommends public subsidies be paid directly to the users (user side subsidies) to encourage the market to respond with the supply of suitable transport. In developed countries with suitable legislation, stable public policies may bring the desired results in terms of transport supply. It is hard to see it working in less developed nations. 9.

It should always be remembered when designing any system that it is always cheaper to build in accessibility than have to pay for a retrofit. Given the growing universality of recognition of the need to provide accessible transport, future schemes should be designed and planned for the maximum possible accessibility from the outset.

10.

The voluntary transport sector is a valuable adjunct to formal transport provision. However, planning for voluntary transport is, by its very nature, most difficult.

Enhanced Mobility 1.

The road safety problem for elderly road users is complex: •

The aging process is not homogeneous to the entire population nor is the process evenly spread within the individual.

•

There is a range of types and degrees of disability associated with the aging process which requires a flexible and extensive range of solutions.

2.

There are strong indictions that decreased individual mobility leads to a significant increase in accident risk, even when taking into account decreased exposure due to limited desire to undertake trips. Safety measures should aim to reduce risk to the elderly through environmental improvement and education of all road users.

3.

Improving safety for the elderly and disabled without restraining mobility cannot be reached through one particular type of measure. A package is required of complementary measures: infrastructure improvement, education, enforcement in a coordinated programme.

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129

The scale of the accident problem for elderly road users is not known because: a.

the long term consequences are not well enough documented;

b. there is inadequate data on footway accidents (falls). There is a need for more complete data collection systems. 5.

It is hard to find measures of environmental improvements to enhance mobility and safety which do not benefit all road users. These measures must be on a systems basis which give no discontinuities in movement capability.

6.

No solution is valid everywhere and where infrastructure improvements for different groups conflict, priority would normally be given to the most commonly found disability group.

7.

There is a need for training seminars for designers and decision makers to ensure that there is a wide understanding of the needs of the elderly and handicapped. This understanding still does not exist.

8.

Engineering measures alone will not achieve general mobility. There must be education and enforcement of traffic rules and operational procedures.

Private Transportation 1.

There is an increasing requirement for car modifications to: a.

integrate the disabled into the auto-dominated society permitting entry into full social and economic life;

b. keep elderly persons driving longer with no reduction in safety. 2.

Modifications must be:

Reliable Safe Generally available Adaptable to specific needs.

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Assessment centres where modifications can be examined and tested by disabled individuals are proving useful for individuals and to manufacturers.

4.

There is a need for further international and national consideration of the question on deciding limits of whether or not a person should drive, along the margins of physical, sensory or mental abilities. This has to be stressed especially in connection with the upcoming directive of the E.C. Commission on the Introduction of a Community Driving Licence.

5.

There is a strong correlation between general physical fitness and driving performance, emphasizing the need and scope for physical training programmes.

6.

There is also strong evidence that elderly drivers have more difficulties negotiating intersections, where more than any other group proportionately they are responsible for accidents. This is an area for research leading to training programmes aimed directly at reducing these kinds of accidents.

7.

French evidence presented here, would lead us to believe that the driving style of elderly drivers is cautious and therefore little evidence to support the principle that driving priviledges should automatically be withdrawn at some set chronological age; rather, performance standards should be considered.

Public Transport 1.

The philosophy and ambitions for public transport provision were found to be similar in all countries represented in these sessions. Some countries and some cities were, however, seen to be ahead in the implementation of the underlying way of thinking.

2.

In many countries, provision of accessible urban transport was well advanced. However, measures are urgently required to solve the largely untouched problems of long distance journeys by bus and rail.

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It is difficult to summarize in a few words the major findings from the range of workshops presented at this conference. However, there was a number of wise statements, not necessarily in the papers, which are worth remembering. A few are paraphrased here: •

Planners should plan transport systems for the disadvantaged to enable them to reach the same places and to do the same things as able bodied people. The mobility demands of the disabled are largely similar to those of the fit.

•

A handicap occurs when the demands of the surroundings are greater than an individual’s ability to deal with these demands. Reduce demands and handicaps disappear.

•

Separate service is not equal in the absence of choice.

•

Societies are not truly democratic if all cannot participate.

•

Only when disabled individuals and their organizations are truly involved in the planning and operation of transport systems will society really take care of their needs.

We have come a long way in the last twenty years but there is still much that remains to be done. In examining the future where transport systems are really accessible it is as well to think along the lines of Robert Kennedy: ’’Most men think about things as they are, and wonder why. Great men think of things as they might be and ask why not”.

PLENARY SESSION IY: WHERE TO GO FOR THE NEXT DECADE PANEL DISCUSSION

Ministry of Health and Social Affairs

1989-04-28

Deputy Minister Bengt Lindqvist

The Fifth International Conference on Mobility and

Transport for Elderly and Disabled Persons

Sweden's Deputy Minister of Health and Social

Affairs, Mr Bengt Lindqvist, will be taking part in the Fifth International Conference on Mobility and

Transport for Elderly and Disabled Persons. The

Conference, to be held in Stockholm on 21st-24th May 1989, will have as its motto: Towards Mobility as a

Human Right. Mr Lindqvist will be taking part in a panel debate on 24th May 1989. Prior to the Conference, Mr Lindqvist tenders the following observations.

Policy for the Disabled

The principle of universal equality of dignity and rights is the very foundation of policy for the

disabled. The aim must be to fashion society in such a way as to make it accessible to all citizens.

Persons with functional impairments must be given

opportunities like anybody else of receiving a good education, taking part in working life, enjoying

secure and decent housing conditions, taking part in recreational and cultural activities of different

kinds and generally leading an active, independent

life. The aim is to achieve full participation and

equality. Measures on behalf of the disabled ought

primarily to be a community responsibility. 132

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133

Questions concerning the disabled are an

international concern. The changes in store for

countries in the Third World will mean heavy demands

on their policies for the disabled. It is important that the industrialised world should support these

countries with regard to questions concerning the disabled.

Focusing measures for the disabled on persons with

mobility handicaps

Opportunities of travelling and getting about are

fundamentally important to the individual person's

quality of life. This makes transport questions of the utmost importance in the process aimed at fulfilling the policy aims of full participation and equality for the disabled.

General measures are needed in order to maximise the availability of public transport, and special

measures to cater to the specific communication needs of the disabled.

Sweden has a relatively advanced system of public

transport. This facilitates travel for many disabled

persons, but the modification of rolling stock to

suit the disabled leaves a great deal to be desired.

Legislation has been passed to accelerate the

adjustment process. The law now says that public

transport must be planned and designed so as to make the maximum possible provision for the needs of the

disabled. We should not be foreign to the idea of introducing legislation as a means of helping the

disabled to achieve full participation and equality. Special services of various kinds have been set up in

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Sweden. Above all these comprise municipal transport

assistance, national transport assistance and car

allowances. These special inputs are wide-ranging and they mean a great deal to many disabled persons.

There is also a close connection between the extent to which public transport is adapted and the volume

of special inputs needed. For reasons of disabled

policy and national economic policy alike, the aim should be to improve the accessibility of regular

public transport, thereby reducing the need for special inputs.

PLENARY SESSION IV

Sir Peter Baldwin Disabled Persons Transport Advisory Committee United Kingdom

This Conference has been splendidly organised as a consultation, with everyone here seeking to one single aim. That aim is mobility for everyone. We are far from achieving it yet. There are 6 million people in the United Kingdom for whom there is transport which they can use only with great difficulty, or not at all. There are over 140 million people in that state in Western Europe alone. In this sort of society mobility is very important to life and living. In the United Kingdom more than £1 in every £5 of consumers * expenditure goes on transport and communications. That is more than on housing, more than on food and more than on education, recreation and entertainment taken together. Your consultation has extended to all aspects of this matter, as it affects life in urban and rural conditions, in the Western World and in the Third World. That helps us all to see that there may be more important aspects of the matter than have been in our own experience; and numerous aspects of the matter which have not received enough constructive attention. But let us avoid the temptation to blame the latter on people who are not here - the politicians, the operators, the manufacturers. This is a cause on which we should all draw together, draw in others too - and stay together, with the huge advantage of the friendships and understanding which this fine International Conference has fostered. The provision of mobility is a matter of using resources. It is not necessarily a matter of drawing more heavily on a nation's resources. The cost to a nation of leaving a large proportion of its people without mobility may well be more than the cost to that nation of providing mobility for them. But it is a fact that the financial systems which have supported the provision of transport have been devised, generally, for systems of transport which do not provide service door-to-door; and they will need to be developed so that this shortcoming is remedied in the total system. The development of the system itself towards mobility for everyone requires deployment of understanding of the situations of individual people who do not have mobility now. That involves systematic consultation, which must be general, sensitive, practical and local; and its' results should emerge in the main systems of transport (the aircraft, the ferries, the trains, the buses and the trams), the separate systems of accessible transport where the main systems continue to lack accessibility, and in the rest of the transport system, including the taxi trade.

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It is surprising «that the system of transport which is nearest to the individual for local needs, namely, the bus, generally still uses designs dictated by old forms of transmission of power rather than the need for the passenger to get on or off with ease. I was delighted to hear more colleagues from West Germany stressing the need to introduce vehicles designed to provide low, unencumbered laws for ease of access and of use. I regard that as expressing in practical form by far the most important immediate lesson from the consultations which this Conference has generated. It is a lesson which must permeate the design, planning, financing and operation of public road transport services in all forms, from the largest bus to the taxi, for fixed route services and for door-to-door services. The results of research, analysed experience, controlled experiment and continuing debate must be marshalled and used in education and training of the managers and operators of transport systems, and of their suppliers. But even these changes will not achieve our aim unless there is also wholly effective provision of information. Only then will potential users be attracted to use what is available, and given the confidence to make journeys which up to now they have not been able or have not dared to attempt. Only then, too, will the scope of the market be fully apparent. This is a vast and detailed subject, which remains to be tackled - the sooner the better. Consultation remains the first and continuing requirement; and it can easily fall short. Who here, for example, knows the needs of deaf people? We must all go on trying, seeing the needs of others as an obligation on ourselves. Our friends here in Sweden who have been our generous hosts, and their colleagues who have worked with them to set up this excellent Conference deserve our warmest thanks and congratulations, not only for their achievement but also for their continuing example.

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Statement at the Fifth International Conference on Mobility and Transportation for Elderly and Disabled Persons

Stockholm, Sweden, 21 - 24 May 1989 Prof. Dr.-Ing. Günter Girnau, Director of VÔV (German Association of Public Transit Authorities, Cologne/Germany) Let me give you my opinion right at the beginning: Mobility is not only of vital interest for all peoples, mobility is a human right - and not a luxury good for few. But this sounds like a declaration only, the important question is, how to reach the ambitious aim: "Mobility for all people". By saying this I am of course well aware that there are big différencies concerning the possibilities in industrialized and developing countries, in rural and congested areas and for all kinds of disabled persons. Reaching the aim is to one part a question of the appropriate technical solutions available; but on the other hand it is an economical problem which exceeds very often the responsibility of the transport undertakings. Therefore it needs political and financial decisions. The solution is manifold: Accessibility of public transport for all - also for elderly and disabled persons - is one important link in the chain, but not the only one. For example: Accessibility does not replace the need for a door to door service with special transport systems, but it may reduce it remarkably. All research studies show: Getting on and off public transport is the biggest problem. In Germany the public transport undertakings are doing some important steps at the moment for the next decade. Let me give some examples and by doing this, I am concentrating on industrialized nations and municipal areas:

1. All new underground or elevated stations (e.g. for subways or commuter railways) will be equipped with elevators; in old stations of this kind elevators will subsequently be added as far as this is possible due to the in situ situation. What is most important: The elevators should be transparent (made out of glass) and should be located

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in a well visible part of the station in order to avoid vandalism (no "around the corner solutions", where elevators are more or less used as toilets). We learnt in the meantime from elevators in big shopping malls and hotels and used their experiences in underground railway stations. 2. At grade stations for light rail transit will be equipped - where ever this is possible - with high platforms and ramps. Because the floor level of normal light rail vehicles lies at 75 to 100 cm above rail, the platform height has to correspond to this level. This often causes problems with town planning because of the visual intrusion. Therefore we worked together with town architects in order to find acceptable solutions - and we did. And since that time high platforms became easier to realize. Whole lines (f.e. in Stuttgart) are already equipped. 3. To avoid these problems in the future, low floor trams for surface operation are developed at the moment in Germany. The floor height will be 34 cm only with an entrance height of 30 cm. Therefore the platforms in the streets only need a height of 25 cm above street level to make the trams easily accessible for all people. These low platforms will not cause any visual problems in towns. At the moment three different solutions of low floor trams are under construction in Germany: - a car, with 10 - 15 % of its length low floor - a car, with 60 - 70 % of its length low floor - a car, with 100 % low floor.

In 1989 and 1990 the first trams of this kind will be delivered.

4. The standard scheduled service bus (SL II) in Germany has a floor height of 71 cm. Today about 100 so called Low-FloorBuses with a floor level of 32 cm are in a test programme. Equipped with a "Kneeling-system" it is possible to reach an entrance height of about 25 cm from street level. That means: With a low platform at stations of 20 cm easy accessibility for nearly all people can be reached. We hope to have in

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1990 a standardized version of these buses available. Looking further ahead: A (revolutionary) new bus appeared already with three prototyps on the market - Neoplan's "Metroliner", a bus in carbon design. Compared to normal buses it is lighter, consumes less energy, needs no double wheels and has from all these points of view ideal requirements for a low floor design. But it is still in an early stage of development. We will start next year a first test programme in some of our undertakings. Summarizing: For the next decade we are on a good path to a public transportation which makes access much easier for all persons. The optimal solution for at grade traffic from our point of view can only be reached by a combination between low floor vehicles and corresponding low floor platforms at stations for trams and buses. From experiences in our own and in other countries (especially U.S.A.) we have learned that the equipment of normal buses and trams with wheelchair lifts is not the ultimate solution for public transportation service on fixed routes - neither for the undertakings nor for the handicapped people: The disabled are treated as "special passengers" and the undertakings have to suffer by accidents, liability claims and maintenance costs. Therefore we in Germany try to eliminate the step of wheelchair equipped vehicles and go directly to the new low floor vehicles together with an appropriate concept for station design. This concept leads to an overall improvement of public transit, to remarkable advantages for all passengers in which elderly and disabled persons are an integrated part; it allows harmonious integration of public transit into the municipal environment, and - what is most important - it is practicable and financially bearable. So I look forward with optimism to the next decade concerning better accessible public transport. In the pragmatic way, I have mentioned, we will easier and faster reach our mutual aims than in the past, where we had studies and research and everything, but not too much practical progress.

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Introductory Statement for Plenary Session 4 "Where to go for the Next Decade" Dr. Hans Aengenendt / FRG Chairman of the Bundesarbeitsgemeinschaft Hilfe für Behinderte / free lance planner

I anticipate the headline of the conference as a fact: To my opinion mobility is one of the basic human rights. We need only care for this right to be actually respected in our countries. In many fields of public transport - air traffic may be regarded as a laudable exception - our built surroundings as well as the relatively high expenses of private transportâtion and special transportâtion systems stand against the right to mobility. In many countries you find good examples of how technical and economic impediments to mobility can be removed, and all these examples clearly demonstrate that neither technical know how nor money are decisive but the sozial willingness to solve the problems. Today the main resistance against the realization of the right to mobility is met in the field of public transport (except for air traffic), and I believe that the leading persons of the public utilities are simply overcharged with these demands. For their economic decisions they need clear political decisions which first of all cover the financial consequences . For the next decade we have to get political decisions for all public transportâtion companies, comprehending the condition that in future public subsidies will be granted only if the subsided traffic systems are made accessible for handicapped people without any restraint. As for the next decade I take an optimistic point of view - of course only if we succeed in obtaining the decisions from those who are respansible for politics on the national, regional and communal levels. The handicapped organizations could play an important role in this context. They should support each other internationally in struggling for these aims. In this sense, I regard this conference in Stockholm as a good and important meeting. I hope it will be an effective first step towards the nineties.

PLENARY SESSION IV

Mr Erling Johnson Chairman, Board of Director American Association of Retired Persons

Monday morning, the observation was made that perhaps mobility is "even more important to the disabled". I would say that without mobility, we are ah disabled - whether we are bound to a wheelchair or confined to a living room. Independence is clearly essential to a rich and fulfilling lifestyle. I am before you to today as a representative of 30 million older americans, but in fact the mobility needs of older persons are universal. We need to maintain our driving capabilities for as long as possible. We need viable alternative transport options for when we can no longer drive; and, we need safe, accessible, pedestrian routes to close - by destinations. In other words, we need the same things that everyone else does. How do we better fulfill these requirements over the next 10 years? Mr Norrbom identifies structural changes that contribute to the increased demand for transportation. Similarly, improvements to transportation support systems will greatly increase the mobility of elderly users. Driving is the primary mode of transportation for older persons today. As has been observed in a multitude of papers presented these last several days, the aging of our populations will increase, not decrease, our overall dependency on the automobile as a means of transport. This is especially true in my country but so it is everywhere else as well. To roadway planners and engineers,I remind you that we make up a sizeable and growing percentage of your driving population. We require more visible signs and markings, adequate lighting to help us navigate, and signals that we can properly respond to. We count on our policy makers to begin the upgrading of our roadway environments today, for our needs will be even greater tomorrow. This international body of research and policy expertise can move the decision-makers. I’d like to think that, 10 years from now, all roadway codes will have been revamped to reflect the upgraded

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standards that are needed. But between now and then, much research has to take place. I propose that when we meet again three years from now, A.

One track of workshops be devoted to specific findings related to environmental up-grading, and

B.

Minimum standards come out of the next conference that policy-makers can work from.

Implementing this proposal requires the stimulation of research efforts in sufficient time to respond with findings. Our interests must be disseminated throughout research communities now. If we are successfull three years from now in establishing base roadway standards, imagine the improvements we can offer in subsequent conferences. But let us apply the logic of established research tracks to other needs as well. Efforts should be directed toward improved screening of driving capabilities. If aging processes place older drivers at greater risk, how can we better identify individual deficiencies before they result in accidents? My organization learned at an earlier conference about one country’s use of the medical community to systematically test vision capabilities. I reported yesterday that we intend to pursue this concept in the United States, going beyond vision alone. I’d like to report to you three years from now that this is a reality, at least as a pilot. If a dedicated conference track allows, other screening concepts will be reported as well. But driving is not the totality of mobility. Our conference theme has been mobility as a right. We need not surrender that right when we stop driving! I learned on Monday that several countries have undertaken inventories of the special transport service options that are available to older persons. The need for such an inventory is critical in the United States - I suspect it is needed elsewhere as well. We should legitimately expect this information to come from our transportation officials. If it is not currently available, get it! Build on the example of countries that have. Once transport information is collected, how do I as an older person learn .about the options available to me? Can procedures be established that more comprehensively tell people of transport alternatives? We are piloting one concept in the United States in

PLENARY SESSION IV

conjunction with state transportation officials. If it is successful, we will advocate its replication across the country. If an appropriate track is established for the next conference, we will also compare our efforts with similar activities in other countries. We’ve learned about the success that BorSs, Sweden, has enjoyed in better tailoring its transport system routes to the needs of its riders. Older persons would welcome established guidelines for transport system operators to follow in adjusting their systems as well. Those riders in greatest need, the elderly, stand to benefit the most. Most important of all is the creation of policies and incentives that generate special transport system development where it is needed.An ambitious goal for 10 years from now is that I could ride to anywhere that I now drive to. ’’Freedom of choice”, to quote one of the conference news releases. It seems that another conference track could be devoted to paratransit system development, specifically. This track would research and develop needed policies and incentives, closely followed by analyses of systems changes, implementation strategies, and pilot evaluations. Progress along these lines is very uneven among countries - our collective knowledge would generate immeasurable benefit for older persons. As a conference participant, I believe that the more we focus ourselves, the better we can focus others. Problem identification must be captured within a continuum that includes problem resolution. As a representative of the older community, I remind you that we are the clients, not the experts or the policy makers. We can also be an effective advocacy force, but we need your direction. Help us to help ourselves. Thank you for your consideration.

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144 MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS Pedro Roberto CRUZ - URUGUAY

FIFTH INTERNATIONAL CONFERENCE ON MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

LOOKING TOWARDS THE YEAR 2.000 What should we expect and for what concrete reason should we strive to ahieve the attainment of mobility as a basic human right? 1. By reason of the effective application of the Declaration of Human Rights, of the Program of World Action and other relevant international agreements. 2. Also, the putting into practice in Latin America of the plans for development which have the PEOPLE as center of their action. It will be necessary to carry out programs which assure their marching in parallel direction with the objectives of widespread development and just distribution.

In this field we fully share the concepts of the Chilean economist, Manfred A. Max-Neef, who stated:

"We shall never cease from insisting that development refers to persons and not to objects. That the purpose of development should not be either for production or consumption, but for the satisfaction of fundamental human needs, which are not only the needs of possession but also the needs of "being". We shall never deny that subsistence is a fundamental need which must be satisfied by means of adequate incomes, nutrition, housing, and work for all. But we shall insist that the protection, the affection, the understanding, the participation, the idleness and the cre-ation, the identity and liberty, are also tremendously essential human needs. Of what protection can we speak in the midst of growing militarization and the armaments race? How could "understanding" grow in the midst of educational systems which keep apart from the real world problems? And how can one speak of participation when the women, the minorities, and even the majorities, are objects of discrimination?"

3. Standardized city designs and of transport media which would make them accessible to EVERY person.

4. Empowering of the institutions for the elderly and for the disabled, adequate formation of leaders, and coordination of the activities to increase their capacity of influence on the decision makers.

The interested people themselves should constitute the principal performers of this change.

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145

MOBILITY - A POLITICAL ISSUE Joshua T Malinga, Deputy Chairperson, Disabled Peoples* International (DPI)

First of all, I must say I am indeed grateful that I have this opportunity to make a presentation to you on behalf of disabled persons and in particular those from the developing countries. I must also congratulate the organisers of this conference for making it possible for disabled persons and elderly persons (and their organisations) to be represented here. I hope I am correct to say that the number of the elderly and the disabled people attending this conference has increased. After listening to the previous speakers in the Plenary and opening ceremonies, I have decided to present two speeches? entitled "Mobility - A Human Rights Issue" which I had written and waited to present here and I would just like to circulate for your perusal and study. My second speeech is entitled "Mobility - A Political Issue" and in this, I want to challenge you and those who are going to host future conferences. 1.

The theme of this conference is appropriate and it calls for action because it talks about human rights and political issues and these just do not happen from rhetoric. We have been saying these things for 2.000 years now.

2.

As disabled people, we know our problems better than any able bodied person no matter what qualifications they may hold.

3.

I think what we need is a model of how we should co-operate and we should define our roles. a)

We are all agreed that what we lack is the political will and that only politicians have the power to make these decisions because they hold power to allocate resources.

b)

I think we are also agreed that disabled people have an important role because they are the consumers and in

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that respect they are the best judges. They have this unique experience of being disabled. c)

Then what role is a professional person supposed to take. To me nothing really other than listening to both the disabled and then get on with the job.

But unfortunately that is not the case and all this is historical. Rehabilitation of the disabled has always been a domain of these professionals and the whole approach has been very primitive to say the least. It is based on the medical approach that a disabled is a sick person and that he needs treatment and care and that disabled people cannot do anything for themselves and they need other people to do things for them and to them. That is a charity approach and not a human rights approach. Charity does not say there is something wrong with society - it says there is something wrong with that individual . I dare say anything people do without the involvement of the people concerned is full of gaps and yet people still feel there is no need to consult disabled people. What I am saying is that disabled people need to be decision-makers. They need power and control and they want to control those resources allocated for their transport system. We want our own perspective that we need to get to work. 4-

Nobody is saying there is no technology and I think we have a great deal of that but what is lacking is resources.

As a person from the developing world, I must say we are speaking the same language like our counterparts in the developed world. While they are fighting to achieve standards, we are fighting for basic rights. But we are all marginalised be it in the third world or first world and we represent the poor and the largest group of powerless people.

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I therefore do not agree with those who say disabled people in the third world are fighting for privileges. Even if there is one bus in Zimbabwe, the disabled people want it to be accessible. Disabled people in Zimbabwe do not have to wait until everybody else is so rich that they will not notice the sacrifice. By the way, the movement of disabled people is the strongest in Africa and a great deal of things are happening there including facilities within the transportation system and most important of all, the government is working with the movement of disabled people and is working on legislation to protect and promote interests of the disabled and also formulate policy on the equalisation of opportunities for the disabled people. This may be the first of its kind in Africa and it has only happened because of the pressure from the disabled and not from the professionals. By the way, as an African, I speak from the position where there are no wheel chairs, crutches, tricycles and of course, no cars. Therefore it is important for this platform to provide solutions and answers and not to say that it has taken England 1.000 years to think about these things and you need to make the same mistakes and then start thinking about human rights is wrong. Zimbabwe does not need to pass through the charity era before introducing the human rights phase. We can do it and we are there! As a traveller, the following is what I experience: 1.

Heathrow Airport - all wheelchairs do not have rims for the disabled people to wheel themselves around because it is dangerous for them to do so and the British Airways will not pay. The question is what is the difference between a disabled passenger in Heathrow Airport and the United Kingdom and Arlanda Airport in Sweden.

2.

In South Africa disabled people are not allowed to travel after 9.00 p.m. because there are no medical people to attend to them. The disabled passenger unit (fork lift) is not part of the South African Airways. It is a special service and only the medical people can handle the disabled people.

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3.

A number of airlines (Australian, Air Afrique and Japanese and others) require a disabled person to have a medical certificate before they board an aeroplane and what does this mean to the disabled. No protection, no insurance and no recourse to the airline should anything happen to you.

My advice to the next hosting country organisation please get disabled people, their representatives and organisations and governments and politicians together to hammer. They have the power and the ability to make decisions. It can be done through their regional structures and let the professional just listen and give professional advice. This is your role and job - just listen and get on with the job - stop talking and talking and talking. Disabled people are tired of listening to you!

SESSION A: POLITICAL PERSPECTIVES AND POLICIES

Freedom of Movement: a Positive Concept Raffaello Belli President "Mobility Commission” o-f A.I.A.S. - Associazione Italiana per l'Assistenza agli Spastici

1.

MOBILITY AS A HUMAN RIGHT

1.1

Essentiality o-f Mobility

The human being distinguishes him/hersel-f from animals by his/her intelligence, which enables him/her to satisfy his/her needs according to an hierarchic order(l). Therefore, in deciding this order, we have to note that: firstly the human being is a social creature, essentially because he/she cannot live separately from other individuals(2); secondly the human being has the right and the duty to try to do his/her best to be able to fulfill his/her qualities disabled people saying that it is government's duty to carry the problems faced by impaired persons. That is, private buses and taxi companies, private airlines, and so on, must allow disabled people to travel together with the public in general without distinguishing them from women, workers, students, university professors, members of Parliaments etc. Another point deals with mobility as a human right and the possibility to interpret any rule (of Constitution, of a law, of a regulation, and so on) in different ways. In these cases it is everybody's duty to adopt the interpretation which allows more mobility for (disabled) people. In the end, as human rights "are conceivable even before and out of the State"(12), it means they have to be guaranteed not only to citizens, but to everybody as a human being(13). That is, domestic antidiscrimination legislation has to protect both native and foreign disabled people equally(14). And disabled people, who are suffering because they are able to drive but forbidden to do so in Southern countries, must also be helped. However, we know well that North-Western countries partially help people fighting for human rights in dictatorial countries. 2.

MOBILITY AS A POSITIVE RIGHT

2.1

Freedom from

Nowdays social rights are on the same plane as the rights of freedoms(15> even because individualism is bound to fail(16); therefore it is necessary to alleviate disabled people from their handicaps every bus should be accessible to disabled persons; 4) in every terminal there should be sufficient help for every disabled passenger, and so on. But these facilities require money, sometimes a lot of money. And here we are faced with a very big problem. 2.2

The Role of the Democratic Systems

In a democracy majority and the government decide how many resources are to be allocated for a certain purpose(23), in this case to allow disabled people to enjoy mobi1ity(24). On the contrary human rights are determined by traditions, civilizations, cultures, conceptions of life, political movements, international declarations and agreements, etc., and consequently by Constitutions. That is, in the order of democratic values the allocation of resources is decided by a procedure which is inferior to that one which determines the number and contents of human rights. The point is that human rights are superior to the Constitutions(25), even because human rights have to protect minorities too. Moreover Constitutions are not able to protect minorities(26). That is, democracy protects majorities' wishes(27) and policy defines collective objects(28): for this reason it is necessary to take away human rights from masses' tiranny(29). Consequently democracy is not enough to protect the individual's(30) and the disabled people's basic rights(31). This because it cannot be accepted that these basic rights depend on other people's preferences. Nevertheless at the moment it seems impracticable to let the disabled decide what is impossible. Therefore it could be the Parliament's and the government's duty to solve any problem, which is not judged as impossible by a court. Such a way could be feasible. However, an impartial judge is a myth(39> and many courts are politically based(40>. But everybody has the right to possess all that is necessary for his/her selfprotection(41). I think the problem is that it is not possible to assure every disabled person the full enjoyment of mobility as long as capitalism exists(42) because nowdays egoism and life are incompatible(43). Consequently, if we like mobility and love life, we have no other choice than to fight for our rights(44). Lastly, we know that every human being has the right to enjoy human rights independently from his/her citizenship. This means that not only natives, but every disabled has the right to enjoy the results of the affermative action of the government towards disabled people's mobility. So, and this is only an example to make my point clear, if disabled people living in Stockholm are allowed to use taxi free of charge, the same possibility should be available to foreign disabled visitors. At first one might think that a world state would be necessary to accomplish such a thing, but I don't think that such a state would be humanly possible. I think a different concept of life is necessary to give the disabled the chance to enjoy fully life and mobility, and to save this planet from destruction.3 3.

URBAN MOBILITY

It is known that urban mobility is the most important one for disabled people(45> and that it can be cheap to have urban public transport accessible to the disabled(46). Nevertheless, for many of these, a big problem remains, that is to go to/from bus stop or underground station. Therefore it is necessary not to forget these people. This means that urban public transport should be accessible to the disabled. But we have to be aware that it is necessary to give priority to urban door-to-door transport(47). In fact mobility is possible without social integration (and it can be lovely: it is enough to think of people who like living alone), while without mobility social integration is not possible, and even life can be impossible.

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References B.A.: B. A. ACKERMAN, Social Justice in the Liberal State, New Haven, Yale University Press, 1980, Italian Edition, Bologna, il Mulino, 1984. G.A.: G. AMATO, Liberta' (diritto costituzionale), in "Enc. dir.1', Milano, Giuffre' , 1974, voi. XXIV, p. 272 ff. L. B.: L. BAGOLINI, fondamento dei diritti umani, in "Riv. int. fil. dir.", 1987, p. 3 ff. P.B.: P. BARILE, Diritti del l'uomo e liberta' fondamentali, Bologna, il Mulino, 1984. P.C.: P. CALAMANDREI, L'avvenire dei diritti di liberta', in F. RUFFINI, Diritti di liberta', Firenze, La Nuova Italia editrice, 1975, p. 9 ff. G.C.: G. CALOGERO, Filosofia del dialogo, Milano, Edizioni di comunità', 1969. E.C.: EEC Council directive, 4th December 1980, No. 80/1263, Enclosure III. B.F.: B. FINNVEDEN, Comparison between different Policy Measures; Examples from Sweden, in "Transport for Disabled People - Developing accessible transport: the role of demand responsive services", European Conference of Ministers of Transport, OECD Publications Service, 1987, p. 21 ff. P.G.: P. GROSSI, Inviolabilità' dei diritti, in "Enc. dir.", Milano, Giuffre', 1974, voi. XXII, p. 712 ff. M.H.: M. HORKHEIMER, Anfänge der bürgerlichen Geschichtsphilosophie, 1930, Frankfurt am Main, S. Fischer Verlag, 1970, Italian Edition, Torino, Giulio Einaudi Editore, 1978. I.M.: Italian Minister of Transports' Decree 23rd June 1988, No. 263. I.T.: Italian Minister of Transports' Decree 27th September 1988, No. 419. L.S.: L. STRAUSS, Natural Right and History, Chicago, The University Press, 1952, Italian Edition, Venezia, Neri Pozza Editore, 1957. U.N.: UNITED NATIONS, Report of the International Expert Meeting on Legislation on Eoualization of Opportunities for Disabled Persons, United Nation International Centre, Vienna, June 2 - 6 , 1986. G. BRANCA, Commentario della Costituzione - Principi fondamentali, Bologna - Roma, Zanichelli - Il foro italiano, 1975, includes also: A.A.: A. S. AGRO', Commento all'art. 3 co. i, p. 123 ff. A.B.: A. BARBERA, Commento al1'art. 2, p. 58 ff. R.D.: R. DWORKIN, Taking Rights Seriously, London, Duckworth, 1977, Italian Edition, Bologna, il Mulino, 1982. And includes Introduction by:

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G. R.: G. REBUFFA, Una teoria liberale dei diritti nel dec 1ino del Welfare State, p. 10 ff. UNESCO, Autor de la nouvelle declaration universelle des droits des 1'homme, 1949, Italian Edition, Milano, Edizioni di Comunità', 1952 includes also: H. C.: E. H. CARR, I diritti dell'uomo, p. 27 ff. S.D.: S. DE MADARIAGA, Diritti del1'uomo o relazioni umane?, p. 65 ff. S.H.: S. HESSEN, £ diritti del1'uomo nel liberalismo, nel socialismo e nel comuniSmo, p. 153 ff. R.K.: R. MC KEON, Fondamenti filosofici e condizioni materiali dei diritti del1'uomo, p. 49 ff. H.L.: H. J. LASKI, Verso una dichiarazione universale dei diritti dell'uomo, p. Ili ff. J.L.: J. LEWIS, Sui diritti dell'uomo, p. 75 ff. A. L.: A. J. LIEN, Riflessioni sulla natura e sul1'esercizio dei diritti del1'uomo, p. 33 ff. L.O.: L. SOMERHALSEN, Stato attuale della questione dei diritti del1'uomo, p. 43 ff. P. T.: P. TEILHARD DE CHARDIN S.J., Alcune riflessioni sui diritti del1'uomo, p. 149 ff. U.O.: COMITATO DELL'UNESCO SUI FONDAMENTI TEORICI DEI DIRITTI DELL'UOMO, Per una nuova dichiarazione universale dei diritti del1'uomo, luglio 1947, p. 364 ff. Q. W.: Q. WRIGHT, Rapporti tra differenti categorie di diritti, p. 203 ff. U.S. DEPARTMENT OF TRANSPORTATION, Third International Conference on Mobility and Transport of Elderly and Handicapped Persons. Conference Proceedings, October 1984, Technology Sharing Program, Office of the Secretary of Transportation, Washington, D.C. includes also: C. F.: C. FORCIER, Transportation for the disabled in Canada: an Overview, p. 3-5 ff. B.H.: B. HALLIDAY, The Canadian Approach to the TransportationHandicapped, p. 2-4 ff. D. V. : D. A. VOGELZANG, Developments in the area of the transportation of handicapped persons in The Netherlands: some sociopolitical, financial and technical approaches, p. 3-16 ff.

(1) (2) (3) (4) (5) (6) (7) (8> (9)

L.S., p. 133. L.S., p. 135; P.T., p. 150. S.D., p. 68; P.T., p. 151. L.S., p. 185. T. HOBBES quoted in M.H., p L.B., p. 11. B.A., p. 330. A.L., p. 38. E.C., point No. 16.

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(10) I.M., article No. 1, point No. 4; I.T., article No . 3, last sub-paragraph. (11) L.B., P- 4. (12) L.B., P- 4. (13) A.L. , P* 34; Q.W., p. 203; U.O., p . 372. (14) A.A., P- 128. (15) H.C. , P- 27. (16) H.L., P- 118. (17) B.A. , pp,. 194 and 196. (18) L.B. , P- 5; H.L., p. 128; P.C., p. XXXI. (19) S.H. , PP-. i58, 160-1 and 164; U.O. , p. 366; A.B., p. 71. (20) B.A., PP-. 331-2. (21) S.H. , PP-. 158 and 160-1. (22) P.C. , pp. XXX and XXXVII-XXXVIII ; G.A., p. 285; A.B. , P106. (23) B.A., pp,. 330-1. (24) B.A., P- 332. (25) G.C., PP-. 94 and 98; P.G., p. 722; P.B., p. 53. (26) R.D., P- 267. (27) G.C., P- 86; L.S., p. 111. (28) R.D., P- 183. (29) R.K., P- 53. (30) R.D., P- 254. (31) D.V., P- 3-16. (32) B.A., P- 445. (33) R.D., P- 438. (34) R.D. 9 D. 260. (35) B.A., pp,, 335-6. (36) R.D., P* 286. (37) B.A., PP-. 359-60. (38) L.S., P- 186; B.H., p. 2-5; U.N., paragraph 47. (39) B.A., P- 445. (40) G.R., P- 48; R.D., p. 227. (41) L.S., P- 275. (42) P.C., pp. XLI-XLII; P.B., p. 14 ; J.L., p. 96; B.A. , P337. (43) L.Q., P- 44. (44) L.S., P- 183. (45) D.V., P" 3-18. (46) B.F., P- 21. (47) C.F., P- 3-5.

PRINCIPLES SUPPORTING AN INTEGRATED MODEL OF MUNICIPAL TRANSPORTATION J. David Baker, B.A., LL.B ., LL.M. Executive Director/Lawyer Advocacy Resource Centre for the Handicapped Toronto, Canada In Canada, debates no longer rage about whether disabled people have a right to travel. Clear guidance has been provided, resolving this issue affirmatively. Similarly, debates about how transportation services are to be provided to disabled people by air, train, inter-city bus and ferry have resulted in a consensus. These modes of transportation must transform themselves to become inclusive of disabled and elderly persons (hereinafter referred to as disabled persons). Progress towards this goal has been disturbingly slow, particularly since the 1984 election of a federal Conservative government, however the goal itself is not seriously challenged. It is at the municipal level that a fundamental debate is raging. To date, the predominant service delivery model has been "paratransit". This policy is based upon the undisputed premise that an accessible fixed route system will not meet the needs of all disabled persons. Less altruistrically, a cost-benefit analysis has been developed by transportation planners which concludes that paratransit is the most cost-effective means of serving this particular market segment. The latter conclusion has been subjected to close scrutiny by disabled people and been found wanting, both because the public finance assumptions upon which it rests are too narrow and because the result would appear to contravene the equality clause of the Canadian Charter of Rights and Freedoms and the Ontario Human Rights Code. Planners Define Equality Transportation planners have attempted to reconcile the principles of equality rights and public finance. They characterize the fundamental issue as choosing between an accessible conventional system and paratransit. The planners assume a level of public subsidization which is neither defined nor justified, but which apparently precludes any option other than paratransit. The ultimate choice is simplified by the fact that an accessible conventional system is defined 156

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as accommodating the needs of a very small group (wheelchair users) while continuing to exclude virtually all other disabled people. No comparable definition is provided of the sufficiency of the paratransit system. However, the offer of any level of service would look good to a person who is and would continue to be excluded from the conventional system modified only by the addition of wheelchair lifts to the sides of buses. This is not the kind of choice disabled people in a country such as Canada have come to expect as their due. Like a person threatened with death, and offered a choice of methods, disabled people will be excused if they question the initial premise, rather than weighing the relative merits of the alternatives presented. Equality Rights in Canada The history of human rights legislation reflects an evolution from a formal to a substantive concept of equality. Initially, it was intended to suppress the malicious and irrational attitudes which underlie the blatantly discriminatory conduct typified by a dominant white majority upon members of visible minorities. This discrimination was readily identifiable when members of different races, known to have comparable capabilities, were treated differently. By 1985, when the equality clause (section 15) in the Charter of Rights and Freedoms came into effect, human rights legislation was being used to remove the barriers which deprived members of enumerated groups, such as the disabled, from experiencing equality of opportunity. Equality theory took a quantum leap forward when the Supreme Court of Canada recognized that factors which adversely impact upon disabled people are inherently discriminatory. The law now required that these barriers be removed unless an overriding justification for retaining them could be advanced. The Ontario Human Rights Commission has established Guidelines on how barrier removal is to occur. They require that disabled people be included in a manner which maximizes their integration and which promotes their full participation in society. In other words, inclusion is the goal, not to be deviated from, unless

7

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sufficient justification can be demonstrated. Segregated treatment in the provision of services, employment or housing is an example of an attempt to accommodate special needs which may not be acceptable unless integrated treatment would pose undue hardship... The priority upon restructuring society to be more inclusive is reflected in the hierarchy established under the Guidelines: At one end of this continuum would be full accommodation that could be done immediately. Next would be phased-in full accommodation, followed by full accommodation accomplished through a reserve fund. Alternative accommodation [i.e., segregated] that could be accomplished immediately would be next on the continuum, followed by phased-in and reserve fund alternative accommodations, respectively. Interim accommodation which is most [integrative] could be placed anywhere on the continuum in addition to alternatives to immediate, full accommodation. The Commission gives a clear example of how a major capital expenditure would be handled: Some accommodations will benefit large numbers of persons with disabilities, yet the cost may prevent them from being accomplished. One approach which may reduce the hardship is to spread the cost over several years by phasing in the accommodation gradually. For example, a commuter railroad might be required to make accessible a certain number of stations per year. As can be seen, the commitment to equality in Canada is now quite strong. Citing the writings of John Hart Ely, the Supreme Court of Canada in its first decision under section 15 of the Charter made it clear it viewed equality as "designed to protect those groups who suffer social, political and legal disadvantage in our society...", going on to conclude, "... the burden resting on government to justify the type of discrimination against such groups is appropriately an onerous one."

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The Court in separate decisions has gone on to accord human rights legislation quasi-constitutional status, meaning it prevails over conflicting legislative provisions. Clearly, the Court recognizes equality guarantees for groups such as the disabled as enhancing rather than detracting from our democratic form of government. Recent American Jurisprudence To date, no significant litigation has been launched in Canada which challenges the almost exclusive reliance upon paratransit. It is suggested that disabled people have demonstrated this restraint because they were led to believe that the current model would be thoroughly re-examined in light of the new Charter and human rights safeguards which came into effect four and two years ago, respectively. To date, no changes in government policy have been announced and it now appears doubtful that such change will occur. South of the border, in the United States, there have been four major decisions in the three years which suggest both that earlier setbacks in the courts dealt to disabled people may be a thing of the past, and that the courts are not willing to accept anything less than an integrated model, rejecting the premise that choice is necessary between integrated and segregated models. In the first case, Maine Human Rights Commission v. South Portland, 508 A.2d 948 at 955-56 (1986), the Supreme Court of Maine rejected the argument that a separate paratransit system constituted a defence. Complainants in this case have demonstrated a violation of their civil rights. They cannot be relegated to a separate system merely because the relief they seek does not solve the multitude of problems experienced by handicapped persons as a class. In the subsequent case of Jones v. Chicago Transit Authority and Regional Transportation Authority, January 18, 1988, the Chief Administrative Law Judge of the Illinois Human Rights Commission found that the respondent transit authorities suppressed demand for paratransit services by intentionally providing inferior service and restricting eligibility. The

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Judge rejected the notion that a less expensive segregated service ipso facto meant the complainants were not entitled to an integrated one. She then went on to state that she could find no persuasive evidence to support the contention that one was cheaper than the other in any event. She concluded by endorsing a "multi-modal” system which would combine an accessible conventional system with paratransit. Next, in the case of ADAPT and Eastern Paralyzed Veterans of America, 867 F.2d 1471 (1989), the United States Court of Appeals for the Third Circuit struck down a transportation regulation allowing municipalities to choose between accessible conventional or paratransit services and went on to strike down a 3% cost cap on the cost of servicing the needs of disabled people. The Court concluded: ... our reading of the regulations promulgated pursuant to ss. 317(c) does not foreclose the offering of paratransit services and the local authorities' discretion in implementing this type of service. Rather, paratransit as the sole means of transportation available to the mobility impaired is not an acceptable option under the statutes. Finally, in the case of Miller v. City of Detroit (unreported), a judge found the City liable for not providing access to D-Dot buses and awarded $2.1 million in damages to the 18 plaintiffs. The judge further ordered that within one year, seven bus lines must be 50% accessible and one year later 50% accessibility should be provided on all other routes. Clearly, the recent American jurisprudence indicates little support for the planner's concept of equality enunciated above. A Bill, expected to be reintroduced soon, entitled the Americans with Disabilities Act, would entrench these decisions by: (A) requiring 100% of all new transportation vehicles be accessible to and useable by persons with physical or mental impairments; (B) requiring that within seven years, 50% of the operators' peak fleet will be accessible; and

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(C) ensure that paratransit be supplementary to accessible conventional services. Incorporating Human Rights into the Planning Process What would happen if politicians or the courts succeeded in sending a clear message to transportation planners that human rights principles are just as fundamental to their functioning as cost-effectiveness or safety? i)

Certainty For the first time, there would be a consensus about goals and what the ultimate transportation system would look like. New facilities would all be planned in the most inclusive manner which was technically feasible. Retrofitting would be done in the most cost-effective way, at the most cost-effective time. The vacillations, delays, and wasted resources which inevitably result as long as the outcome remains uncertain, would become a thing of the past.

ii)

Minimize Risks The planning process is not infallible. Assumptions which made perfect sense at one point in time, with the passage of time are often proven wrong. Thus, projections about labour costs, technological developments, traffic patterns, and service demands which form the basis for selecting one type of paratransit or another may be misguided. Conventional transportation planners are subject to similar constraints, however, their mistakes have very different consequences. When something breaks down which affects everybody, it gets fixed. Price is no object. When something breaks down which affects a minority with little political clout, fixing the breakdown is a much lower priority. Disabled people have been left off the bus long enough to understand this fact of life, whether intuitively or consciously. Their bitter experience has led them to regard "special" services with a healthy dose of scepticism. If they are "mainstreamed" they will come to recognize the advantages that flow from being a part of the silent majority.

162

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

(iii)

Consistency Public finance involves a static process of calculating costs and benefits, and establishing policy directions based upon a pre-arranged level of subsidy. Government typically makes financial decisions on an annual basis as part of the budgetary process. Even at its best, it is extremely rare for government to commit itself to projects extending over more than a five year period. Democracies are notorious for their myopic obsession with winning the next election. Human rights impose an irreversible obligation to integrate, and a long-term obligation to allocate resources up to the point where to do so imposes an undue hardship. This would represent a fundamental shift in the terms of reference within which transportation planners ply their trade.

(iv)

Inclusive Proponents of paratransit are usually the first to argue for a hierarchy of needs. Once established, this hierarchy is useful for priorizing the distribution of scarce resources or denying eligibility. The hierarchy usually treats those who are functionally unable to use the conventional system (e.g., those with cognitive or developmental disabilities or uncontrolled epilepsy) as lower priorities than those who are physically unable to use them. This distinction is conveniently justified on the basis that such an inability is more difficult to prove. In reality, however, it is based on an unprincipled awareness that those groups on the bottom rungs are less able to press their demands through the political process. The fact is that their needs are every bit as great. Equally discriminatory assumptions are used to evaluate the importance of rides. If budgets were ever cut, the blatant biases underlying these distinctions would become immediately apparent. With an aging population and an increasingly mainstreamed group of disabled people, growing demand for a parallel system will duplicate the effects of budget cuts.

MUNICIPAL TRANSPORTATION

v)

163

Mainstreaming the Mainstream During the 1970s, the feasibility of paratransit (i.e., Dial a Bus) was assessed for use by the non-disabled population. It was concluded that it was too expensive, despite a policy objective of increasing ridership while reducing traffic congestion, fuel consumption and emissions. A recent planning document prepared by the Toronto Transit Commission suggests the economics of including disabled persons amongst the riderships of such a demand responsive "Community Bus" service would make it a more appealing option. Once planners start to plan inclusively, it appears likely that the assumption that conventional services must always be "fixed route" will be called into question. This trend will accelerate if non-disabled people demand higher levels of service, and the public continues to view the environment and improving the quality of urban life as desirable objectives. The inclusion of non-disabled people on paratransit would not only overcome the social stigma generated by a segregated service, but would ensure equal levels of service to all, since non-disabled people would take their transportation business elsewhere if service levels were allowed to slip.

Conclusion It is submitted that the efforts by transportation planners to adjust human rights principles to the dictates of current public finance will inevitably fail. They will fail because they are inconsistent with strongly entrenched human rights guarantees, because disabled people are rejecting "choices" which offer no real choice, and because they are internally contradictory according to their own terms of reference. Based on the foregoing, I conclude that it is public finance which must adjust itself to incorporate human rights principles, rather than the reverse. Transportation planners can follow the American example and engage in a wasteful and divisive conflict with disabled people. Alternatively, they can cut their losses and work cooperatively with

164

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

disabled people to implement necessary changes in a rational way. The disabled community in Canada has patiently waited to see which course the planners and their political masters will choose. It would appear this period is now coming to a close. Once the adjustment has been made, policy decisions will not be immediately self-evident. A decision will have to be reached about what constitutes an equitable level of subsidy for transportation services, including a premium amount designed to overcome the effects of past discrimination. This level of subsidy will have to be reviewed annually until an integrated system has been achieved. Within the annual subsidy, decisions will have to be made which respect the rights of all disabled people to have equal opportunities to travel, mindful of the ultimate objective of making the conventional services useable by all. Retrofit is always an option, but alternatives such as the accessible community bus should be weighed before undertaking a major program of retrofit. No new transportation facilities should be constructed which are inherently discriminatory. Thus, human rights principles do not replace the need to balance competing interests altogether. Neither do they ensure that the ultimate objective of an integrated system will emerge full-blown overnight. They do, however, change both the tone and the substance of the discussions which inevitably goes on between a government and its disabled citizens. When this occurs, society will have taken a quantum leap forward.

The Voluntary Sector Contribution Paul Beecham Research and Development Officer i.

Introduction - Chapter 1

The following paper is intended to show the contribution made by a voluntary sector based project towards mobility as a human right. The project in question is Birmingham Community Transport which between February 1983 and September 1988 encompassed three units:- Project Operations (Group Transport and Furniture Service) Ring and Ride (Individual Transport Services), and Research and Development Unit (Research and Development). These 3 units developed their activities and grew in size over the period and now operate as totally separate entities although they still work in close liaison with each other. 2.

Continuation - Chapter 2

2.1

Project Operations

Project Operations has always adopted a policy of investigating the transport needs of disadvantaged people, and where possible tried to design services to meet these needs. Our basic model is a city based charitable project supported by the local authority who fund two posts, those of Co-ordinator and Assistant Co-ordinator. The purpose of the project is to provide transport for community groups, mainly those specialising in helping frail elderly or disabled people. To this end we operate five welfare minibuses. We also operate a furniture recycling service. Whilst we collect people's unwanted household furniture free of charge, when we supply it to people on low incomes we do make a small charge. With the funds generated from this activity we can subsidise the minibus work and support the project. To ensure that the furniture reaches people who need it most, we ask that they are referred by a supporting agency. Another important facet of our work is Shared Transport Service. This is a scheme that encourages the various voluntary groups within the community to share their vehicles. 165

166

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

This development began when research showed that there was a large number of vehicles in the area, belonging to community groups, that were underused. We believe that if we could encourage these groups to allow non owner groups to use the available down time it would help solve the serious shortage of welfare transport in our area. It was also hoped that this would in turn lead to closer co-operation within the voluntary sector. This has proved to have been correct. After a quiet beginning, Shared Transport Service is an established part of the transport scene in the city 'of Birmingham. Obviously the biggest problem was gaining the confidence of vehicle owners, who were reluctant to risk their most valuable asset, by allowing outsiders to drive it. Shared Transport Service now has thirteen vehicle owning members and last year provided 37,098 passenger rides. The management committee now want to take the scheme one step further by splitting the very large operational area of Shared Transport Service into four smaller areas; each will have its own Co-ordinator who will be responsible for transport in his or her own area. We believe that much greater co-operation can be achieved through smaller areas. If this is successful the saving made on capital costs of providing minibuses that are grossly under used will offset the costs of the area groups. Also in the last year the project has undertaken 52023 passenger rides and 1114 furniture supplies. It became obvious to the project as long ago as 1982 that although we were providing transport to many people in many ways our services were directed in the main to voluntary groups and that many of the people travelling with these groups had a need for an individual transport service. We recognized at that time that for anybody not inclined to be a member of a group there was no transport provision whatsoever. We were only too glad therefore to pass on this information to a Research and Development Unit (for which funding was gained in 1983) in order to promote the need for such a service.

VOLUNTARY SECTOR CONTRIBUTION

2.2

167

Research and Development Unit

The Birmingham Research and Development Unit was first established in February 1983 as a branch of the National Advisory Unit for Community Transport. Since June 1988 it has become known as the West Midlands Branch of NAU and has widened its remit to cover the West Midlands area. When first established in 1983 its brief included research for and development of a transport service for individual mobility handicapped people in the Birmingham area, the need for such a service having been recognised not only by the Project Operations Unit but also by West Midlands County Council who *at that time were prepared to offer a small grant of approximately £11,000 towards the establishment of such a service. The first task of the Unit therefore was to raise awareness within the County Council of the scale of the task required of them. This was done using a number of indicators of need:a

b

c d e

f

g

The extent of passenger journeys and mileage provided for mobility handicapped people (albeit on a group basis) by the Project Operations Unit in the past The 1981 Population Census, in particular number of pensioners, numbers of pensioners living alone, numbers of pensioners living alone and without access to a car National Travel Survey data excluding journeys to work Information on numbers of disabled people held by statutory organisations ie Social Services and Education Departments Information held (usuallyanecdotal) by other appropriate voluntary groups ie W Midlands Council for Disabled People, Birmingham Co-ordinating Committee for the Handicapped The Department of Transport "rules of thumb" that 10% of the population were mobility handicapped and/or that 2.5 times the numbers of Registered Disabled had a mobility handicap Experience of the operations in the UK and abroad. Using this information we were able to convince the County Council that £11,000 was not going to go very far in dealing with the transport needs in Birmingham as a whole and therefore what was required was an experiment on a specifically targetted area. In this way the resources

168

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

available could be matched to the needs of that area and therefore be used to discover the extent and patterns of trip demands of people with a mobility handicap. It was expected that the evidence gained in this way could then be used to go back to the Council to gain further funding for expansion of the service and at the same time to assist in improving the service design to make it more effective and efficient. It could also be beneficial to other transport planners and operators both locally and nationally as a source of information. The service started in November 1983 and was known as Ring and Ride. The strategy employed has worked 'extremely well and has been refined into what is now known as the Ring and Ride Methodology. This can be summarised as a rigorous objective approach involving short-term compromises towards the longterm aim of an accessible public transport system: service design elements are optimised in terms of prospective passenger requirements and characteristics. Note that this is not the traditional voluntary sector approach. As well as having been adopted in a number of areas of the UK it has enabled the Ring and Ride service in Birmingham to expand to cover approximately a third of the city at this time. The evidence has also been used to justify funding of other services in Dudley, Walsall, Coventry and Sandwell in the 1988/9 financial year and Solihull and Wolverhampton in the 1989/90 financial year. Between them these 7 areas make up the whole of the West Midlands and it is hoped that as they expand, travel for people with mobility handicap will become possible across the whole of that area. There is however much more to be done by way of development work. In particular the Research and Development Unit is looking at using information on current trip patterns as a guide to designing fixed route and semi-fixed route services both inside and outside the current Birmingham area of operation. We are also looking at the introduction of a single-occupancy mode (accessible taxis) offsetting awkward journeys from a scheduling point of view on to this mode and thus enhancing opportunities for multiple occupancy on Ring and Ride vehicles. Generally we are also using the information gained from operation to try to persuade other operators

VOLUNTARY SECTOR CONTRIBUTION

169

to improve access, both physical and psychological, on other modes of transport including buses, trains and Light Rapid Transit, as it is only by such improvements that we can hope to achieve the long term aim of the Ring and Ride Methodology, which is to provide an integrated accessible transport system.

170

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

Only when such a system exists will individual mobility handicapped people be able to travel freely using whatever mode of transport is appropriate to their particular journey requirement and mobility handicap. 2.3

Ring and Ride

Ring and Ride was first established in November 1983. Background work on areas of need, size of area, eligibility, type of vehicle etc had already been researched by the National Advisory Unit. The decision to use specially adapted Mercedes 370D's was made, and these were to be converted to *a much higher standard than conventional welfare type vehicles. Specially adapted steps were fitted to the front entrance, and a tail lift was fitted to the rear of the vehicle, allowing wheelchair users and users who were unable to climb the steps means of access. At first the takeup in usage was very slow, but once a few people had found confidence in trying something new, word of mouth and our own publicity started to pay off. Contact was made with the Social Services who allowed us to have meetings with the Home Help Workers. Because these workers have access to people who have become housebound they were able to talk to these potential users and help them overcome their psychological barriers to going out. Within a period of months the service was providing 1560 trips per month, and by the time the second vehicle was available in May 1984 we were working to near capacity. Within one year of starting up 3,400 trips per month were being carried out with 2 vehicles. In July 1985 a further 3 vehicles were purchased and the operating area was increased to 20 square miles. Again in July 86 another 2 vehicles were added, further increasing the area of service to 27 square miles. By this time other problems were starting to s,how, recruitment of staff through job centres was not ideal, we were having to give training not relevant to their job and this had adverse effects on the

VOLUNTARY SECTOR CONTRIBUTION

171

day to day running. All staff were only employed for i year on a special employment programme and this also meant a constant turnover of staff. Mobility handicapped people who were registering to use the service had now grown to 4,000 and one of our major problems was the inability of the users to get through on the telephone. Even if they kept trying and managed to get through later in the day they were then told "sorry, we are fully booked". To try to overcome this problem the operating area was divided up into 4 zones each with a separate phone number, but even though this helped the situation to start with, it did not take long for the usage to return to maximum. A further advancement on this zoning has been tried, and »areas now book morning or afternoon. In March 1986 funds were again available to increase our fleet by a further 6 vehicles, and delivery of these was made in June of that year. Because these additional buses were offered to us at very short notice and not as part of a planned expansion, applications for additonal staff had to be made to the employment programme who then could not guarantee the levels which we required. All prospective employees had to be unemployed for a minimum of 6 months and in some cases 1 year. Because of these problems we were still unable to operate 4 of these vehicles even after 9 months because of the shortage of staff. Over the period when the service was growing, it was noticed that when the service was operating in a small limited area of 5 square miles, an average of 1750 trips per month was possible, but when this increased to 20 square miles the average trips reduced to about 1,400. Now the area has again increased to 27 square miles this average has not decreased any further. Although Birmingham had a more realistic staffing level than other parts of the country, we were always working on a very uncertain and precarious footing and this was not the ideal way to operate a service. We were however able to show there was a very great need and that all mobility handicapped people should be leading a more normal life. ' The problems which were becoming more and more evident was now making it necessary to secure more

172

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

permanent funding in order to give the service a better future, and in July 1988 a new company was formed to operate a Ring and Ride service throughout the whole of the West Midlands. Funds of £823,000 are available for 1988/89 with £2,000,000 in the next financial year. In August 1988 the first 14 permanent drivers were employed and in September/October a further 58 staff were employed covering all vacancies within the service. The service now has a much more permanent and sound future and with full manning levels our efficiency and reliability should increase in the future. With ten operational vehicles plus 1 multiple 'occupancy we are now expecting to carry out approximately 200,000 trips at a cost of about £3.50 per trip which includes all ongoing costs, capital and headquarters costs. It is felt that after 5 years there are still many new developments to be looked at, multiple occupancy vehicles, interchange facilities, integration with existing transport, the list can go on. The only thing that slows us down is the availability of resources to meet the need which we can all show is there. We are becoming a victim of our own success. Chapter 3 - Conclusion As can be seen, the Birmingham Community Transport project has developed considerable experience both in discovering and presenting the needs of the mobility handicapped and in operating services to meet these needs. The Research and Development Unit has produced a number of publications that outline the work that has been done in far greater detail than can be covered here and these are available nationally through its link with NAU. This link has also enabled the project to benefit from the experience of other operators, both statutory and voluntary, known to NAU. It has not, however, been all smooth sailing, and I would like to mention just two difficulties encountered in Birmingham and, I am sure not unknown to other voluntary sector based organisations everywhere.

VOLUNTARY SECTOR CONTRIBUTION

173

i5 the credibility given to voluntary One organisations. It has often been the case that the knowledge and experience gained has been underrated or cursorily dismissed not only by those that consider themselves professionals but also by others in the voluntary sector. This makes the task of raising awareness doubly difficult and we would ask all to consider any work done on its own merits rather than judge it by the type of organisation doing the work. Secondly in working with various sources of grant aid, each with its own criteria for funding, time scales and other uncertainties, it is extremely difficult to plan a structured approach to development. This coupled with changes in whom we »have to deal with caused by alterations in Local Government structure, such as the abolition of the West Midlands County Council and establishment of the West Midlands Passenger Transport Authority, and changes in the legal framework such as the 1988 Transport Act has not made it easy to raise the awareness of those we are working with. We have found ourselves on many occasions dealing with a new set of officers or Councillors all of whom have to be made aware of previous experience and practice in order to understand the reasons for the proposals for development that are placed before them. Continuity is very important if a planned approach towards an integrated accessible transport system and therefore towards providing mobility as a human right is to be adopted. At the same time it must be said that without the assistance of statutory authorities in providing finance, advice and input on specific areas (computerisation, vehicle design) and the support of officers and Councillors we could not have got as far as we have. In particular, in this context, we have to thank West Midlands Passenger Transport Executive, West Midlands Passenger Transport Authority, Manpower Services Commission, Birmingham City Council and the now defunct West Midlands County Council.

174

No.

of Trips

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS TOTAL NUMBER OF TRIPS EACH MONTH

Month of the Year

A 1987 Trip-based Urban Transportation Strategy - still ignoring the needs of elderly and disabled people Irvine Lavery Lecturer in Transport Studies University of Ulster, Northern Ireland Pamela Anderson Research Assistant University of Ulster, Northern Ireland (Miss Anderson will not be attending the Conference) 1.1

INTRODUCTION

This paper is difficult to write as it contains much criticism of the transport planning of the authors’ native city, particularly as the paper is presented at an international conference. However, the fundamental right of all citizens to have access to some form of public transport is of such importance that narrow concepts of national pride must take second place to ensuring that strategic transport planning automatically includes the needs of mobility impaired citizens. In 1987 a nine volume report entitled the "Belfast Transportation Strategy Review" was published. The Review was commissioned by a local government department at a cost of £1.2 million and was conducted by a major transport consultancy company. The aims of the Review, upon which the public transport services of Belfast until the year 2001 are based, were to determine transport demand, identify existing transport problems and to predict future need. The review virtually ignored the needs of the mobility impaired citizens of Belfast, indeed, in all of the nine volumes a total of one line could be said to be directly addressed to their problems. This paper is essentially a case study of transport planners neglect and the procedures taken to rectify such neglect. 1.2

GENERAL BACKGROUND

The Belfast Urban Area covered by the Review has a population of 500,000, of which 51% of households have no access to private transport. Car ownership varies enormously within the urban area, in some parts of Belfast car owning households are higher than 80% but in other areas ownership is less than 20%. It is therefore somewhat surprising to note that it is generally acknowledged that Belfast has one of the best road systems in Europe but also one of the worst public transport systems in Europe. In Northern Ireland as a whole in the decade 1976/77 to 1985/86 only 14% of total transport funding was allocated to supporting public transport (the general level of subsidy to the bus company which has a monopoly operation in Belfast is approximately 11%). The high level of 175

176

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

funding for roads has ensured that Belfast has a low level of traffic congestion but it also means that the most affluent section of the population enjoys the greatest allocation of transport funding. One must wonder how this has happened. 1.3

TRANSPORT PLANNING IN BELFAST

Although transport planning is largely involved with statistics it is not an absolute science and the attitudes and perceptions of planners invariably influence the provision of infrastructure and services. It would not be an exaggeration to say that Northern Ireland has a love affair with the motor car and is consequently a very "car conscious" society. Surveys show that very few well educated, affluent people use public transport at all. Yet it is such people who are involved in transport planning and it is the authors’ belief that the social background of local planners in Belfast makes them unappreciative and unaware of the mobility problems of the majority of their fellow citizens who have no access to private transport. There is no formal transport planning authority in Belfast which has the role of formulating and monitoring social objectives for public transport. Much of the United Kingdom transport legislation does not, at present, apply to Northern Ireland and thus not only is local policy at variance with national policy, in some areas of responsibility it does not even exist! There is no local government policy in Belfast with regard to public transport minimum service or accessibility levels. The government department responsible for the oversight of public transport, the Department of the Environment (N. Ireland), has consistently refused for a number of years to set up any type of authority with responsibility for transport planning. Thus, it was considered of paramount importance to change the opinions and perceptions of those government officials who are able to bring about change in transport legislation in Northern Ireland. The recently completed Review used as its base a 1976 Review of a 1968 conventional land use transportation strategy which was road based. This road-based strategy caused concern within the Department of Transport Studies in the University of Ulster that the needs of mobility impaired people would continue to be ignored. Consequently, in 1985 when the consultants commenced compiling the data for the "official" Review, tripartite funding was obtained from:' The Northern Ireland Council on Disability; Age Concern (Northern Ireland); and The University of Ulster;

URBAN TRANSPORTATION STRATEGY

177

to conduct a project entitled, "Transport for Elderly and Disabled People in Belfast". The project was based on the premise that mobility impaired citizens would continue to be ignored and had a two-fold obj ective: (i) to bring to the attention of local government transport "providers" the needs of such citizens that the consultants ignored; (ii) to show how such needs could be met. The method for doing so was to prepare research reports (five were eventually produced) to be presented to the anticipated public inquiry into the Belfast Urban Area Plan. An overriding concern in the presentation of the reports was to attack policy and not individuals who were implementing policy. It was believed that the government officials responsible for transport planning (or with the lack of it) were competent well-meaning professionals who were unaware of the mobility problems of approximately 50,000 of their fellow residents of Belfast and who, if made aware of such needs, would attempt to meet the needs. The public inquiry had the additional advantages that media interest would ensure that evidence to the inquiry could be made known to a large number of interested people and that the evidence would have to be responded to by the professionals responsible for transport planning. 2.1

THE CONSULTANTS1 TRIP-BASED SURVEYS

The consultants conducting the Transportation Strategy Review were thorough in data collection and analysis with estimates of travel demand being determined from the following: (i)

Household Interview "Previous Day Trips" Survey (2,000 households surveyed)

(ii)

Roadside Interview Surveys (32,800 Roadside Questionnaires and 11,000 Posted Questionnaires)

(iii)

Public Transport On-Vehicle Surveys (Interviews and Posted Questionnaires)

(iv)

Education Journey Surveys (at place of education)

(v)

Employment Journey Surveys (at work place)

(vi)

Traffic Volume Census

178

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

(vii)

Parking Surveys

(viii)

Journey Time Surveys

From the above it can be seen that the worst fears of the researchers were justified, all the data used was trip-based. Such trip-based statistics are of course essential as a base in which future demand can be forecast. However, one finds it astonishing that in the mid-1980Ts consultants still ignore the needs of those people unable to travel. The premise still appears to be that: IF YOU DO NOT ACTUALLY TRAVEL THEN YOU HAVE NO DESIRE OR NEED TO TRAVEL Thus it was decided by the researchers that a needs-based survey should be conducted in order to provide documented evidence of transport neglect. The researchers were conversant with large scale needs-based surveys which had been conducted elsewhere in Europe and knew that because of lack of financial resources their own results would have little statistical significance. However, it was considered important to produce local data to negate any argument that "such information does not apply here". 2.2

THE UNIVERSITY OF ULSTER NEEDS-BASED SURVEY

The survey was in the format of a household travel survey which contained conventional questions such as trip purpose, trip destination, and mode of transport used. In addition, the questionnaire was designed to permit intercommunication with mobility impaired people with regard to their various needs for accessible transport. In addition to ascertaining the number of actual trips made, the reasons for absence of travel were noted. Demand was seen in terms of the characteristics of the individual, the incidence of disability and the modes of accessible transport available. Forty-five questions were asked and the concluding section was in the format of a trip-based analysis of transport "demand". The main purpose of the latter was to show the inadequacy of basing demand solely on actual journeys made. To ascertain the validity of the questionnaire a pilot survey of fifty people was carried out in the summer of 1986. This survey showed that time constraints would not permit the visiting of individual households so in the autumn of 1986 fifteen Day Centres/Workshops/Voluntary Groups were visited throughout the Belfast Urban Area. At the locations 200 mobility impaired people were randomly selected and each was given a structured interview. Of these 200, 66% were female, with 59.5% of the total being aged over 60 (33.5% were aged

URBAN TRANSPORTATION STRATEGY 70 or more years old). The most common age group was 70-79 years. The age breakdown is given in Table 1. TABLE 1:

AGE BREAKDOWN OF PEOPLE INTERVIEWED

AGE 5 15 16 18 27 24 28 52 15

0-19 20-29 30-39 40-49 50-59 60-64 65-69 70-79 80+

%

Cum. !

2.5 7.5 8.0 9.0 13.5 12.0 14.0 26.0 7.5

2.5 10.0 18.0 27.0 40.5 52.5 66.5 92.5 100.0

Of the 200 subjects, 56 reported being unable to get out and about on foot and some 190 said they have some difficulty using public transport. Only 5% were able to use the bus without any problems with 62% unable to use the bus at all. Of those who at some time travel by bus, only 27 do so more than once a week. Table 2 summarizes respondents ability to use a bus. TABLE 2:

ABILITY TO USE A BUS

Not at all Only with assistance Unassisted with difficulty Without any difficulty

124 19 47 10

% 62.0 9.5 23.5 5.0

Only 9% use public transport as a means of going shopping, 48% never get to Belfast city centre, with only 16% going once a month or more. Table 3 shows the number of trips a person made on the day previous to the interview (a return trip is classed as two separate trips). TABLE 3:

TRIPS MADE ON PREVIOUS DAY

of Trips 0 2 4

No. of Respondents 113 71 16

200

% 56.5 35.5 8.0

100%

Table 4 shows the travel mode for the previous day journeys. Only 1% of the respondents used a bus to make a journey, with 7% walking. In general, respondents aged over 60 were less likely to have made any journeys on the previous day and 70%

179

180

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

of the 119 aged over 60 made no trips on the day before. distressing to note that

It is

56.5% OF THE RESPONDENTS HAD MADE NO TRIPS ON THE PREVIOUS DAY TABLE 4:

MODES OF TRAVEL USED

MODE

No. of Respondents

Own Car Passenger in Car Taxi Taxibus Bus Social Services Minibus Walk Voluntary Agency Coach No trips made 2.3

3 17 1 2 8 30 14 12 113

% 1.5 8.5 0.5

1.0

4.0 15.0 7.0 6.0 56.5

THE CONSULTANTST ACCESSIBILITY MEASURES

Accessibility measures were a particularly contentious area as "Accessibility to bus services was measured partly in terms of catchment areas surrounding bus stops. On the assumption that a six minute walk is the ideal maximum to any stop, 85 per cent of the Belfast Urban Area would be accessible to any stop"(l) It was the authors1 contention that a "time measure" was inappropriate as a six minute walk for a healthy adult can be spatially considerably different from that of an elderly or infirm person. Indeed, basic textbooks have emphasized this problem for a number of years. Marvin L Manheim points out in "Fundamentals of Transportation Analysis" Volume 1, that, "time is not always synonymous with distance from the viewpoint of consumer behaviour. For example, numerous surveys have shown that walking distance is a very important determinant of bus ridership - very few people will walk more than a quarter of a to use a bus. Thus walking distance should usually be one of the service parameters used to predict ridership on a bus system"(2). The consultants would seem to have agreed with that statement as the distance measure was converted to distance in a different volume of the Review: As a method of highlighting !deprived1 areas, a bus service catchment area map was produced, covering the bus network in the urban areas of Belfast. This entailed plotting parallel boundaries 300 metres on either side of the bus route and thus it followed that an average 400 metre bus stop spacing would imply a maximum walk to the bus stop of 500 metres. This is a distance which could be walked in about six minutes"(3).

URBAN TRANSPORTATION STRATEGY

181

One must ask why time was used at all, unless it was a way of obscuring a distance measure that is excessive. Walking distance, of course, is a major deterrent to travel for mobility impaired people but the distance used in Belfast was 100 metres more than that of comparable British cities i.e. 500 metres instead of 400 metres. In the 1976 Review a time measure had also been used, however, the time parameter used was five minutes. Thus accessibility standards had actually decreased in Belfast in the decade from 1976 to 1986! Several months before the public inquiry the Department of the Environment was requested to provide accessibility data using a distance of 400 metres but the reply was that "the information about accessibility requested in your letter is generally not available". The department was also unable to supply any information with regard to bus stop locations. 2.4

UNIVERSITY STUDENTST ACCESSIBILITY MEASURES

Due to the lack of the above information one week before the Inquiry four students from the university were asked to locate on maps any places in their local areas which they considered were situated over 500 metres from a bus stop. Having identified the "possible problem locations" on the maps they then went to the areas, noted the bus stop locations and measured typical walking distances from houses to bus stops. This mini-survey showed that walking distances to bus stops in excess of 500 metres were quite common and seven examples were found of distances in excess of 700 metres, two of which were in excess of one kilometre. It should be noted that the areas surveyed were inner city or "typical" suburban areas. Thus, at the Inquiry the claim was made that four students in one day identified more "accessibility problem areas" than a team of professionals did in two years! It also became apparent at the Inquiry that the consultants used straight line measurements and not walking distances i.e. because of street configurations in some locations, people with wings were a few hundred metres from bus stops but those residents without wings would be required to walk excessive distances to bus stops! Accessibility was considered in different sections in three of the Review volumes but the information given was so convoluted and ambiguous that only a person with some knowledge of accessibility would have the confidence to challenge the consultants on accessibility standards. Accessibility problems with regard to actual buses was also considered by the researchers but will not be discussed in this paper.

182 3.1

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS TO PLAN OR NOT TO PLAN - THAT IS THE QUESTION

In an exchange of letters before the Inquiry a spokesman for the Department of the Environment (NI) stated that none of the bus service studies "addressed the problems of the elderly or disabled directly". The Department funds a 50% grant for new bus purchases by the local bus company but has consistently pursued a "hands-off" policy with regard to bus operations. The consultants expressed concern at the low comfort levels of the buses and reference was made to the fact that "the DOE is responsible for establishing policy with regard to the level and quality of service provided to the public and, in the future, they may wish to introduce guidelines for the types of vehicles purchased through the grant system"(4). Perhaps the most disappointing aspect of the DOE’s attitude to transport planning was the statement that the needs of elderly and disabled people, "could not be addressed in detail in a strategic review"! Where else can such needs be addressed but in a strategic plan? It would seem that after several years of conferences and much quality research on mobility/accessibility problems there is still some way to go before all planners will directly address mobility and accessibility problems of elderly and disabled people without being pressurized to do so. 3.2

CONCLUSION, OR, A NEW DAY IS DAWNING

In Northern Ireland planners for, and providers of, transport services for mobility impaired people have steadfastly maintained for some years that such services fall into the category of health or welfare. Such attitudes are changing and there is now an acceptance (somewhat reluctant) that everyone has a right to some form of public transport and that it is a transport and not a health or welfare issue. The researchers were influenced by the goal of Swedish policy with regard to transport provision for elderly and disabled people which has been summed up in two words - integration and normalization^). In pursuing this goal the researchers inspected some of the many services which are now being provided in many areas of the United Kingdom and made three proposals to the Inquiry: (i) the setting up of a working party to investigate how two hundred of the existing buses used in Belfast can be modified to make them more accessible. (ii) the provision of a wheelchair accessible bus service to visit the various suburbs of Belfast at least once a week;

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a commitment to fund a "pilot" Dial-a-Ride service for (iii) Belfast. The Report of the Public Inquiry into the Urban Area Plan (which was held in June 1988) has not yet been published but by September 1988 the local Department of the Environment had made financial provision for the inception of a pilot Dial-a-Ride service in the financial year 1989/90. Discussions have also been held with regard to the other proposals. The Public Inquiry was an excellent opportunity for promoting the right of everyone to an accessible public transport system. The tactic of showing the need in an objective, well researched and well presented manner has already changed the opinion and perceptions of the local planners and the need is beginning to be met. However, this case study shows that those concerned with the right of everyone in a community to some form of public transport must be constantly vigilant to ensure that planners are aware of transport needs and the methods by which such needs can be met. REFERENCES: 1.

Belfast Transportation Strategy Review, Final Report, Volume 1, HMSO Belfast 1987, page 59.

2.

Marvin L Manheim, "Fundamentals of Transportation Systems Analysis, Volume 1 : Basic Concepts", The MIT Press, U.S.A. 1980, page 65.

3.

Belfast Transportation Strategy Review, Final Report, Volume 3, Section 4.3.2. HMSO Belfast

4.

Belfast Transportation Strategy Review, Final Report, Volume 6, Section 6.1.2. HMSO Belfast

5.

Stahl A. "Public Transport or special provision finding the right mix", Proceedings of Conference, Transport Without Handicap - A Priority for Europe, Department of Transport, London, June 1987.

GONFERENGE ON MOBILITY STOCKHOLM - bwEDEN:

JOSHUA T. MALINGA

a ITI)

TRANSPORT FOR DISABLED hID ELDERLY PEOPLE

21 - 24 MAY, 1969»

- DEPUTY CHAIRPERSON DISABLED PEOPLES* INTERNATIONAL (DPI)

I-I03ILITY - A HUMAN RIGHTS ISSUE

Introduction

Independence is firmly bound to mobility. To be immobile is to be dependent. To be as independent as possible is one of our main aims as disabled persons. As long as our mobility is frustrated, we cannot hope to achieve a reasonable measure of independence. For this reason I see mobility as a human rights issue, and like so may if not all human rights issues, this touches political questions. Our point of departure on deciding what are rights and what are privileges depends upon the political stance we adopt and upon the nature of our own political environment. Some people accept their political environments, others strive to change them, either through democratic means or when these are impossible, by means of revolution. As disabled persons, we find ourselves being governed by the non-disabled, be they extreme conservatives or left wing revolutionaries. Either way we have to deal with what they decide, tie have to educate governments to accept their responsibilities. The World Programme of Action Concerning Disabled Persons - WPACDP is a key document in this respect as it clearly lays down the areas of government responsibility. Moot governments are not complying with it, many seem to be unaware of it. Now transport vehicles and systems are being introduced which are not accessible to disabled persons and this is a contravention of the Norld Programme of Action Concerning Disabled Persons (NPACDP), which also mentions renovation as an opportunity for adaptations to be made, but renovations of transport equipment are continually being carried out with no thought for including adaptation, when frequently all that is needed is the application of common sense. NO SPECIAL PROVISION FOR SPECIAL NEEDS

Our architects, vehicle designers and engineers have decided that any person who does not walk upright, unaided and with the ability to climb steps sometimes as high as half a meter should not want or need or be allowed to use public or private transport. That is the only conclusion that can be reached when we examine our physical environment especially to do with transport. People who fail to meet these criteria are regarded as naving special needs which have to be specially provided. Frequently, these special provisions which are inconvenient, waste time, have to be arranged in advance, do not work satisfactorily and most importantly, cause the user to spend extra, money. Cur problem as I see it, is lack of control. Me do not have any control over our physical environment. Why? Because we totally lack control over our political environment. The one is linked to the other. Architects, vehicle designers and engineers to not work in a vacuum, they respond to political direction and control and that is exercised by non-disabled persons. 184

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Therefore, of course, our needs are still regarded as being *special1• My proposition here is that this is a totally wrong concept. Designers of transport systems should he instructed by their political masters to envisage the wheelchair as normal. Escalators are fir& and I am not condemning them but beside every escalator there should be a lift - that works! There always seem to be assumptions made to the effect that disabled persons never need* or do not want to get to certain places. My view is that mobility is a human right for all citizens and that it is the responsibility of the state to ensure adequate provision of public transport and that it i3 accessible to all and at a price that all can afford. There is very little need for special provisions if this criteria was met. There are some of us whose disabilities are such that we cannot avoid using special equipment, but most, the vast majority of us could manage perfectly well on ordinary public buses, trains, trams or underground railway systems, if these were only accessible to us. MOBILITY - A COMMON SBN3B APPROACH

There are vast amounts of money to be made for companies and their share holders in the manufacture of 'Special Equipment* for disabled persons. Some of this equipment is essential and makes our lives liveable. My contention is that a lot, if not most of it would be unnecessary if public transport systems were designed with accessibility to ALL citizens as a pre-requisite. This would probably increase the costs of transport for all but in the long term I believe the overall costs to society would not be greatly increased if the savings to individuals on special needs of transport were taken into consideration. At the moment these costs are borne by the individuals themselves and by special funds and charitable organisations. Why is this? Why should some citizens have to be provided for outside the mainstream of provisions? One conclusion I have reached is very simplet Vested interests. Too many dividends, salaries, jobs, research scholarships and profits are at stake to allow common sense and appropriate technology to prevail. So we have very clever scientists inventing complicated and costly wheelchairs that can climb steps, instead of the obvious and logical solution of getting rid of the steps. There are instances I can recall of people whose mobility is markedly improved by using a conventional piece of non-special mobility equipment, a bicycle. A young boy in ray country ha„s a clubfoot and he found the 12 kilometre walk through the bush to school very painful. My organisation helped him obtain some special foot wear, but these were expensive, required frequent repair and renewal, they were heavy to 'wear and made his feet sweat. They did not really solve the problem. But a bicycle did. Just an ordinary bike. He became completely mobile, he was even giving lifts to his young friends. Thereas the special footgear had accentuated his disability and contributed to his differentness from his fellow school boys and girls, the bicycle emphasized his ability to compete with his fellow and to contribute also.

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Another friend of mine has a spinal problem that causes him to bend double when walking unaided. His mobility is severely restricted. The walking aid with which he as provided is clumsy, slow and draws attention to his disability. But he rides a bicycle perfectly and for short distances, wheeling the bicycle serves much better than the walking aid. These are just two examples of how a conventional everyday piece of mobility equipment succeeds in meeting the mobility needs of those disabled persons when the »special aids» manufactured at considerable cost by technicians and prescribed by doctors after assessment by physiotherapists had failed to meet the mobility needs of the persons concerned. This example does not mean that we do not need doctors and paramedics, or that vie do not need 'special aids'. Par from it, we need them, but we need them to be more imaginative; they must be much more responsive to what we, in the wisdom of our own individual situations say that we need. The assessments - if they are necessary must be participatory. The professional staff must listen to us because we are the experts about our needs, not them. Another area that I want to discuss briefly is the ever decreasing numbers of staff that are involved in public transport. This is an area of interest and concern to many groups, not only disabled persons. Old people and children, women and late night travellers; we all feel comfortable when there is a bus conductor to help us off or on. We feel reassured at the eight of some railway staff amongst us on the platform. Younger, non disabled, middle class males hardly need the services of such people and that is probably why they are disappearing as these are the decision making class and gender; but anybody who is vulnerable to attack by thugs, or who needs a hand when boarding or alighting is discouraged from using under-staffed services. As persons with disabilities with restricted access to transport facilities, especially private transport, we need to have access to public transport, we need to feel safe and comfortable when using it. Human Rights in public transport for disabled persons means that we are demanding equal opportunities and the achievement of equivalent standards to the rest of society. Nomenclature is very important in the forming of public attitudes in this regard. Far too frequently one notices that the minibuses with lifts at the back ’ which are used by persons in wheelchairs are embl^zzoned with the word "Ambulance". These are not ambulances, they are adapted minibuses. The passengers inside are not patients, they are not sick, they are not abnormal. They are ordinary citizens going about their daily business, using a vehicle adapted to meet their needs. We must refuse to get into such vehicles when they are labelled as Ambulances. To the majority of disabled persons in my country, this would be an irrelevant debate, If you use a wheelchair in Zimbabwe, the bus crews and other passengers carry you into the vehicle and put you on a seat.

MOBILITY - A HUMAN RIGHTS ISSUE They put the wheelchair on the roof of the bus* So much for independence - but at least you get where you want to go* We have succeeded in getting front seats allocated to disabled persons and on our trains ramps are available at stations* At other places they just lift people down by hand* When looking at different countries and environments one is struck by the similarities of problems that we confront* People who live in large urban centres in Africa have almost identical mobility problems to those who live in European cities and the main cause at least, is the negative attitudes of the non-disabled decision makers•

187

PUBLIC TRANSPORT IN LATIN AMERICA Pedro Roberto CRUZ 1.

THE REALITY - Chapter 1

In this part of the world, in which lives more than 10% of the world population, elderly people, persons with disabilities and other handicapped groups, do not count with the appropriate transportation means, neither in quality nor in quantity. 1.1 Omnibuses, tramways, microbuses, trucks, the railways and subways are mass public transportation media which are not available without help. Besides, in urban transport in most cases there is no space available, for example, for a wheel chair. Therefore, despite the goodwill of two or three passengers, it would be impossible to include his wheelchair,making his transportation senseless. Apart from that, we must view the matter from the point of someone who wishes to move around the city independently, just as any other citizen, without having to depend on the generosity or goodwill of other people. There are some exceptions. In certain countries there are vehicles that have been adapted to permit the ingress of a wheelchair. But practically none of these vehicles renders a regular service nor do they cover even 0.5% of the demand. We must therefore conclude that apart from very rare exceptions which only serve to confirm the rule, urban public transport is inaccessible for the elderly and for the disabled with direct or indirect motor problems. As Josefina Bravo Brash said: "To board a public transport vehicle, even for the common population is both difficult and dangerous. For the disabled it is an unsurmountable problem when he has no one to help him. Collective transport does not offer any security or facilities for the disabled." 1.2 The only accessible medium is the taxis but this also has several drawbacks: a) it is generally very expensive and therefore, resorted to only in emergencies; b) the drivers do not look with sympathy on a passenger who gives them additional work and often look the other way when hailed; c) in the important cities, the taxi services are often insufficient at peak hours and on rainy days. 1.3

In rural areas the outlook is even more desolate. 188

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The progressive devaluation of agricultural produce drives thousands of workers, especially the young people, towards the cities in search of opportunities. There they go to increase in great numbers the slum belts of the cities, living in huts or precarious dwellings on the outskirts of the cities, without water or sanitation facilities. A few, very few, manage to get steady work with the good pay they set out to get, but the majority hardly manage to survive and many turn delinquent. Meanwhile, the land is little by litte depopulated. Rural schools are closed down through lack of pupils, and the care of the roads is abandoned as the companies lose interest in maintaining regular bus lines to places with hardly any customers. This is aggravated by the fact that Latin America, in the best of cases, has no more than an average of 22% of paved roadways. Who then remains out in the country? Side by side with the great properties, leased and habitually managed by land administration companies, we find the small holdings, with scarce production, with crops that hardly permit survival, where only elderly and disabled persons appear to live. Here the dramatic situation reaches its climax.There are no possibilities of bettering transport means, making them accessible, because there is simply nothing to improve. There is no public transport or, where available, so irregular or so far from the homestead that makes mobility impossible. 1.4 To sum up, the reality of public transport in Latin America is dramatic for the elderly and disabled. Here is an example: a short time ago we were in a Central American country in which the basic transportation media are the buses and the trucks. The buses are practically at a standstill during the night, and the rest of the time are replete with people with their heads and shoulders sticking out of the windows and many other "passengers" are out on top grasping a hold wherever they can. As to the cargo trucks they are also used for passengers and are the most popular b ecause of the low fares, but in them, men, women, children, old people, all travel standing up with precarious holds to the sides of the trucks. Accidents are frequent and many passengers are killed or suffer serious injuries and fractures . How can one solve the problem of the elderly and the people with disabilities when the common citizens,

190 MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

without disabilities, are daily risking their lives when going to their work, to a health center, or simply on business of some kind or other? 1.5 There are problems that are common to rural areas, the villages, and small towns, and even to capital cities of some countries, such as the lack of repair of pavements and sidewalks and the impossibility of getting technical aids. 1.5.1 As mentioned before, only 22% of the roads in Latin America are paved. In most cities the state of repair of pavements and sidewalks is the responsibility of the town halls and town councils. Sidewalks are full of holes, uneven surfaces, numerous excavations for light, water or gas repairs whcih drag on for months, making the zone impassable for all, and needless to say, totally impassable for the very old and for disabled persons. Sidewalks are in the same state, made even worse because the majority are not well paved but simply covered with small paving stones or tiles or are merely tamped-down earth. This makes a dangerous surface and in many cases prevents the elderly and the disab led to even leave their houses because of the impossibility of going out on them. This type of barrier is not only a serious obstacle for the motorhandicapped people but is likewise extremely dangerous for the blind. 1.5.2 B ut to get to a public transport medium, in thousands of cases, requires technical aids, wheel chairs, walking sticks, crutches, etc. And the majority of the motor disabled persons in Latin America have serious difficulties in obtaining these aids. In the majority of countries, the interested people must acquire them on their own at very high prices. If out of reach, as usually happens, they must request them from private beneficense institutions or some public or parastatal social security body. But what is granted does not get to cover even 50% of the demand. Many of those who have wheel chairs, lacking any other more appropriate means, use them to go to their jobs, sport clubs, etc., generally covering several kilometers per day. Due to the complexities of transit and the bad state of the pavements, the chairs often suffer damages, worse even, their users are permanently exposing their lives to danger. Those unable to get wheel chairs and are obliged to travel, do so using small wooden benches and go hopping from one place to another, or drag themselves on rustic carpets.

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II.

191

THE CAUSES - Chapter 2

In Latin America public transport has not been designed with a view to public comfort but strictly to financial gain. Heavy long-range transport, railroads, truck or river boats are fundamentally used for the transport of agropecuarian produce and minerals to the ports for exportation. Secondarily, they fulfill the duty of carrying to the cities at low cost the pauperized rural workers who go to form part of the jobless mass of cheap labor hands for the industries, as mentioned before. Short-stop trains and buses transport laborers and employees from the suburbs to the factories and offices. This has led to devise the transport media solely for those who actively participate in the production process. Obviously, one cannot count among them the children, the elderly, nor the disabled people. There are economic circumstances and socio-political factors that to our way of thinking determine this situation, as we shall briefly explain. 2.1 Latin America becane apart of the occidental world with the Spanish conquest in the XV century. The criterion of the Spaniards and Portuguese, dominant for centuries in this part of the world, was one of APPROPRIATION of riches rather than the creation of riches in our territories. "To make America" was a very popular expression until well into the XXth century. The basic idea was: travel to our continent, work hard and make sacrifices for a time to amass the largest possible amount of money to help out the family left behind in Europe. This served to create an "opportunist" mentality in the ruling and business classes, who are fundamentally concerned with the short-term deals which permit rapid gains with little risk. On this murky substrata the European and North American industries constructed a "savage capitalism" as has been said by some sociologists. This style of the economy process predominant in Latin America is based on the search for quick gains by the fastest method and with the least possible overhead. Financial speculation is a leading favorite. Long-term investments with profits in the far future do not appeal. As to activity on the land, it is actively exploited with poor technical equipment, using cheap labor which does not demand great investments.

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Industries strive for quick profits through tax evasion and by ignoring as far as possible some legal commitments such as social security payments. 2.2 Exchange relations with the international trade are clearly disadvantageous for the Latin American countries. The great majority base their economy on the sale of raw materials, and depend in the last instance on the price fluctuations on the international market, which are beyond their control. That is not so with manufactured goods which since the end of the second world war have been steadily increasing in price. This disadvantageous relationship prevents any possibilities of development, diminishes the working possibilities for all Latin Americans, whether disabled or not, and also cuts down fiscal inputs which might permit elaborating a social policy on behalf of the elderly and other handicapped groups. 2.3 Another factor with the same dislocating qualities as the foregoing is the foreign debt. All together, the Latin American states sink an average of 30% from their profits in the payment of interest on the hundreds of thousand millions of dollars owed to the principal international banks. This veritable expoliation is today a matter of the utmost concern at international level, and piles its adverse effects on the factors already named to form a kind of "Chronic Crisis". 2.4

This Chronic Crisis breaks down as follows:

2.4.1 Inflation: reaching an average of 35%, but in some countries it has reached the harrowing cipher of 1.000% per annum. Inflation devours salaries, in themselves quite low, and underlines the lack of confidence of the investors in long-term operations. 2.4.2 Unequal distribution of income: The LatinAmerican social structure shows enormous disparities in income, going from incredible riches to the most appalling poverty and hunger. The average Latin American per capita income is around US$1,600 per annum. But in Brazil, for example,showing an average per capita income of US$2,200 - one can find some of the greatest private fortunes in the world and in contrast, every year during the dry season thousands die of hunger within a zone measuring almost as much as the whole of Europe, and which is known as the "North East".

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Unemployment; The populations are predominant2.4.3 ly young, constantly multiplying, so that the possibility of obtaining jobs becomes increasingly difficult, faced with a demand that is considerably lower. The increasing participation of women in production, the massive emigration from the land to the cities, and the recessive adjustment policies led to a situation where unemployment and subemployment have become a constant in the Latin American region. To palliate this situation, the governments seek to augment their bureaucracy which in turn increments their fiscal deficit by reducing the pensionable age limit and unemployment insurance and other like arbitrations. Such measures empty the coffers of the social security organisms, preventing them from apportioning reasonable allotments, and consequently making the crisis ever larger. 2.4.4 As a corollary to the above, social and political instability has become an almost permanent form of life in the region. The children, the elderly,and the handicapped are the principal victims of this situation . III.

THE CONSEQUENCES - Chapter 3.

The impossibility of using the common transportation media and the almost inexistent special transport, bears down on the elderly and the disabled, underlining their marginality, empoverishes their communities and quickly increases the number of people whose basic human rights are disregarded, among them the right to freely travel from one place to another. In the case of the people with disabilities, this barrier constitutes an unsurmountable obstacle to the access to an appropriate rehabilitation, to the acquirement of a necessary formation. As regards the elderly, it keeps them from adequate medical aid, from participating in the social life and other community activities, all of which magnifies their solitude and casts them into deep depressions. This shameful situation is in fact a real form of genocide, a collective crime, consummated under the heavy cloak of ignorance, disinterest, and irresponsibility.

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IV.

THE SOLUTIONS - Chapter 4.

4.1 In the first place we shall refer to what are NOT solutions, meaning those measures undertaken by the developed countries with the best intentions but which have proved ineffectual and, in some cases, having contrary effects. 4.1.1 The generic declarations, proclamations and proposals that are not accompanied by concrete actions. The leading groups in Latin America are not easily impressed by ethical proclamations or calls to the "recognition of inalienable rights". The majority of countries of this region give ear and greater attention to the "right of force" rather than to the "force of right". 4.1.2 Donations and contributions of funds destined to state or private institutions which "declare" they are working for the elderly or for the disabled but who do not take them into consideration at the hour of adopting decisions. There should not be any kind of financial support for this type of institution when they do not allow participation in their resolutions of the people most concerned, or who do not enjoy the confidence of the organizations of elderly or disabled people within their countries. 4.1.3 Donations and contributions of funds to selfhelp organisms that do not positively prove the authenticity of the destination given to the funds received which were clearly meant for the improvement of the conditions of the disabled or elderly people. An organization that destines from 15 to 20% of its resources to maintain a costly bureacracy is not really a selfhelp institution. 4.1.4 The promotion of small cooperative workshops for the local manufacture of technical aids, vehicle adaptors, etc. Their intention is indeed praiseworthy from all points of view: a) to give work to disabled people; b) to lower costs; c) the making of articles adapted to the needs and conditions of the locality. However, in practice the results are poor because: a) there is work enough for a ridiculously low number of persons, the majority of which already hold jobs, not only because they need the money to increase their income but also because it is the kind of work for which they have been prepared, at a satisfactory remuneration, b) production is usually very

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low and therefore the costs are heavy. If the materials have to b e purchased on the local markets the price - for example of a wheelchair - turns out to be more or less the same as one to be found on the commercial circuits. In many countries bordering on another with more favorable exchange rates, the contraband of technical aids is priced at two or three times less than the value reckoned by the selfhelp institutes. We know many cases of such workshops that started with great enthusiasm and were forced to close down, with great frustration for all, due to such circumstances; c) as to the "local needs and conditions", they are not a mystery that only we Latin Americans can unravel. The demand is only for solidity and low costs. We have seen and used wheel chairs and canes made at workshops of disabled persons which were not inexpensive and not especially solid. The people of ICTA and other similar institutions might be of great help in the designing of materials as we suggest in the following point. 4.1.5 The donation of equipment, machinery, technical aids, etc., generally second-hand, without knowledge of local specifications and without knowing if the receiving country or institutions are in a condition to make the necessary adjustments, adaptations or repairs in an efficient and economically feasible way, is not advisable. 4.2 Let us now turn to what might be the REAL solutions at mid- or short-terms. 4.2.1 When referring to mid-term measures we mean the projects that could be put in practice within a time period not exceeding three years, as for example: 4.2.1.1 Accessible mobility and transport are unthinkable in cities and towns crammed with architechtonical and urbanistic barriers. Pavements and sidewalks should be in perfect conditions, stations and points of departure in general, of every type of public conveyance, should be made usable in their totality by the elderly and other persons with any kind of disability. Very strong pressure should be exerted on town councils and municipalities and communes by the interested communal entities. A joint action should be undertaken to the effect that very long-term loans at low interest rates should be granted by the international financial agencies to permit carrying out these projects .

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The same type of loans should be at the dis4.2.1.2 posal of Latin American public service institutions for two purposes: 4.2.1.2.1 To make accessible the accesses to railroad platforms and stations and, since the trains already have their characteristic wide doors, they could easily be made u sable b y the elderly and disabled. 4.2.1.2.2 To construct elevators or lifts at the subway stations which would permit everybody to use this important means of locomotion. 4.2.1.3 The great problem of adaptation for accesibility of the buses lies in their construction on high truck-chassis. And this situation will hardly be changed in Latin America before the next millenium, not only b ecause of the heavy investment load that would be required to create a chassis or basic structure to permit the construction of low-floored vehicles, but because the awful state of the avenues, streets and pavements demands there should be a height under the flooring sufficient to prevent accidents or damages due to pot-holes, bad patches, and ruts. In view of the above, the only solution that occurs to us is to design low cost kits, safe and adaptable to the various types of buses that will permit including a hydraulic or electrically-powered platform with a lifting capacity of 250 kilos with a height of one meter, which could be worked by the conductor without leaving his seat. 4.2.2 As to the short-term projects, we refer to those that might be implemented at once. The studies have been made, the needs are perfectly well known, it only lacks the political willpower to bring them into practice. For example: 4.2.2.1 First of all it would be essential to create sources of work for the elderly as well as for the disabled people. For everybody who needs work and is in a psycho-physical condition to fulfill some kind of task should have the opportunity to do so. For "mobility" and "transport'' it is always necessary, in great or lesser measure, to have the required means and the enormous majority of the Latin American can only obtain them by working. Among the disabled people, at least a third of them are of an age and in condition to work. Well established reports show that in this sector, within our region, the number of jobless people comes to 50% •

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In this case, the greatest importance 4.2.2.1.1 should be given to private initiative and private institutions. "Supersoft" loans should be available for the establishing of small industries, the installation of businesses and the creation of service centers manned by elderly and disabled people. It should be clearly demonstrated through studies of the markets that these suggestions are reasonably feasible. One should also undertake the formation of managerial staff and in-between posts that will ensure an efficient administration of the companies, of even small dimensions. 4.2.2.1.2 In all the Latin American countries two to four percent of the vacancies occurring in state or municipal public administrations should be reserved for elderly or disabled persons who have proved their capacity for a specific task. 4.2.2.2 Urban transport should be complemented with facilities or services that permit a more particular attention in special cases . 4.2.2.2.1 Tax exemption and any other type of benefits that may help to acquire an own car - nothing luxurious - should be extended in all the Latin American countries with the same benefits to cover their usage such as gas, oil, license, patent, insurance, etc. The use of an own car is not only a solution to the problem of transport, but it also means opening the door to the social life, generally inaccessible to the elderly and disabled persons. 4.2.2.2.2 One should extend to the city and town councils of Latin America the system we have observed in Europe as regards the use with prior reserve of station-wagons and microbuses for the transport of persons with serious mobility disturbances. This mechanisms at a cost for the users similar to the bus ticket, is especially useful for those who are unable to use public transport media and do not own a car. This system, with a low cost and relatively simple operation, might be put into practice immediately at least with an experimental character. 2.2.2.2.3 A mechanism of subsidized bonuses for the accessible use of taxis such as the one used in Spain, might be a very good complement to the system in the preceding paragraph and could also be put into practice without delay.

198 MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

The great majority of Latin American coun4.2.2.3 tries urgently need to have available technical equipment and aids. Of course, the second-hand materials donated, especially if in excellent condition, are a quick and obviously very economical solution. However, itis very important to make sure, as stated previously, that the institutions who receive them are capable of undertaking their operation and maintenance. 4.2.2.4 Special consideration should be given to the matter of wheelchairs. It is essential to find the manner that this necessary material is made easily accessible to all who need them. We believe the solution, not necessarily original but merely born of common sense, would be to design a basic simple model, which could be constructed with common materials in any place, of standard measurements, without painting and chrome fixtures,solidly built, that could be sold in parts to be assembled by the interest person or his family and/or friends. 4.2.2.5 Finally, in regard to the use of airplanes, in spite of the international agreements in force, there are still many features lacking in regard to the comforts they should be able to offer to elderly persons and people with disabilities. There are some basic points which could be solved in short time. 4.2.2.5.1 A considerable number of seats should be furnished with retractable armrests. This additional comfort is essential as in the economic or tourist class the airplanes have very little passenger space. This inconvenience which to the generality of passengers may appear banal, for elderly and disabled people may signify the difference between a routine trip or one that is a real torture. Very often the many hours of travel in a constricted space provokes in these people painful cramps, contractions, phlebitis, and even lesions produced by the rubbing against orthopedical apparatuses. An urgent reform in this aspect should be stressed. Not only more than the usually available space is required, but also the water closets should be placed at a height technically appropriate in regard to the floor, i.e. 50 centimeters, with supports and holds on the walls, and with faucets with uncomplicated taps. 4.2.2.5.3 In many Latin American airports one does not find the "tubes" which permit the easy entry and exit under cover of the passengers. Even in European countries, there are times when the "tubes" are not sufficient to cater to all planes. At other times it is considered more expedient to lift and lower a

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199

disabled passenger in arms when they are unable to use the boarding steps. This method is extremely dangerous both for the carried and the carriers, and it should be completely set aside. In its place one should adapt the following procedures. 4.2.2.5.3.1 When flights are announced specifying the transport of persons with reduced mobility,these persons should be given priority rights in the use of the borading "tubes". 4.2.2.5.3.2 When the above procedure is materially impossible, after all the other passengers have been accommodated, then use should be made of the vehicle used for the loading and unloading of the planes' personnel and their appurtenances. *

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HELT HY PU BLIC PO LICY LOR THE A U TO NO MO US L I V I N G ,MOVI NG AND T R A N S P OR T A T I O N OL PEOPLE WITH SP ECIAL NEEDS ARGYRO B. L E V E N T I ARCHITECT - PROGRAM DIRECTOR EOR PEOPLE WITH SPECIAL N EE D S - M I N I S T R Y OE E N V I R O N M E N T , P H Y S I C A L P L A N N I N G AND P U B L I C W O R K S In A n c i e n t G r e e c e , one of the t w e l v e G o d s of M o u n t O l y m p u s , V o l c a n the B l a c k s m i t h , God of fire and in fact h u s b a n d of V e n u s and the p e r s o n i f i c a t i o n of T h u n d e r and L i g h t n i n g , was d i s a b l e d . This m e a n s a r a t i o of 1 to 12 or 8 ?o. As the y ea rs w e n t by, t h r o u g h the wars, i n d u s t r i a l d e v e l o p m e n t and e n v i r o n m e n t a l p o l l u t i o n , we b u i l t up a s o c i e t y , w h i c h c r e a t e s d i s a b l e d and s e c l u d e d p e o p l e . M o r e o v e r the a g e d h a v e b e e n a d d e d to the c a t e g o r y of p e o p l e w i th s p e c i a l n e e d s due to l o n g e v i t y .

1. PO LI TI CS - SOCIAL EN V I RO NM EN T The i ma ge of the e n v i r o n m e n t is g i v e n t h r o u g h the c o m p l e x " E a m i l y - S o c i e t y - D i s a b l e d P e r s o n " , w h i c h is d e t e r m i n e d by the f o l l o w i n g four t y p e s of relations:

1.1.

Re la ti on Type 1 The M e d i t e r r a n e a n - m i n d e d and s u p e r - s e n s i t i v e G r e e k f a m i l y h i d e s the p e r s o n w i t h s p e c i a l n e e d s in the " b a c k room " , a w a y fr o m c o m m u n i t y ' s s i g h t , b e c a u s e it c a n n o t o v e r c o m e its g u i l t c o m p l e x . It o v e r p r o t e c t s its m e m b e r , d e p r i v i n g h i m of any s o r t of i n i t i a t i v e . It e x p l o i t s the m e m b e r for its own f i n a n c i a l and p r o f e s s i o n a l a s c e n t , by u s i n g his s p e c i a l p e r m i t to sell c i g a r e t t e s , N a t i o n a l L o t t e r y and S o c c e r Pool t i c k e t s . Societ y does and d oe s not

not see or o v e r l o o k s the b e c o m e s e n s i t i v e to it.

situation

The s ta t e c o n s i d e r s p e o p l e w i t h s p e c i a l n e e d s d e p e n d e n t m e m b e r s of the f a m i l y , who are e n t i t l e d to a p e n s i o n and w h o s e f a m i l i e s are e n t i t l e d to tax b e n e f i t s and h o u s i n g p l a n s and t h e n . . . . it w a s h e s its h a n d s of the i s s u e . It s h o u l d be noted; that the 1981 s t a t i s t i c a l r e p o r t s m e n t i o n e d n o t h i n g of the s e l f - s u f f i c i e n t d i s a b l e d p e r s o n . The d i s a b l e d p e r s o n d e v e l o p s his own q u i l t c o m plex, f i n d i n g it c o n v e n i e n t to e x p e c t e v e r y t h i n g f rom o t h e r s , t h u s not j o i n i n g s o c i e t y . In r a r e c as e s , he l i t e r a l l y escapes, e a c h in h is own way, 200

HEALTHY PUBLIC POLICY a c c o r d i n g to the p a r t i c u l a r c a s e and of c h a r a c t e r of the p e r s o n i n v o l v e d .

1.2.

201 the

strength

R e la ti on Type 2 The f am i l y t r i e s to get rid of the p r o b l e m , by s e n d i n g the d i s a b l e d m e m b e r to a f o u n d a t i o n u s u a l ly n a m e d " a s y l u m " . This s e e m s to be s o m e s o r t of s o l u t i o n to the p r o b l e m . The ve r y w o r d " a s y l u m " , in Gr e e k , m e a n s an i n t r e s p a s s a b l e p l a c e , a p l a c e o f f er in g p r o t e c t i o n from pe rs e cu t i o n . S o c i e t y has c r e a t e d p r i v a t e or c h u r c h - r u n ins ti tu ti o n s , which, apart from some b r i l l i a n t e x c e p t i o n s , t a k e a d v a n t a g e of the d i s a b l e d p e r s o n by p r o f i t i n g f r o m him. The st a t e , in o r d e r to s o l v e the p r o b l e m , e s t a b l i s h e s i n s t i t u t i o n s s i m i l a r to g h e t t o s . At the s a m e time, s o m e s t a t e - r u n i n s t i t u t i o n s a t t e m p t to r e h a b i l i t a t e t h e i r i n m a t e s both, p h y s i c a l l y and p r o f e s s i o n a l l y , b e i n g h o w e v e r , l i m i t e d to g u i t e a s m a ll n u m b e r of p r o f e s s i o n s . For i n s t a n c e : A p a r a p l e g i c b e c o m e s a w a t c h m ak e r , a b l i n d p e r s o n b e c o m e s a s w i t c h b o a r d o p e r a t o r , e v e n t h o u g h he may h a v e a Law d e g r e e , a d e a f p e r s o n may b e c o m e a p r i n t e r . T h i n g s l i k e t hat ........ The d i s a b l e d p e r s o n in t h i s ty p e of r e l a t i o n , r e a c t s in two way s : e i t h e r by p a s s i v e l y a c c e p t i n g his l i f e in the f o u n d a t i o n , th us c o m p l e t e l y w i t h d r a w i n g f r o m s o c i e t y , or by r e v o l t i n g and j o i n i n g g r o u p s and U n i o n s . In t h i s case, he l e a v e s the f o u n d a t i o n and is e n t i t l e d to a s p e c i a l g r a n t for t ho s e not in f o u n d a t i o n s . (The p e r c e n t a g e of d i s a b l e d p e o p l e in f o u n d a t i o n s and i n s t i t u t i o n s is g r a d u a l l y d e c r e a s i n g , b e c a u s e of t h i s s p e c i a l g r a n t .)

1.3.

Re la ti on Type 3 The f a m il y of t h i s t y p e o v e r e x a g g e r a t e s the a b l e d p e r s o n ' s p r o b l e m , u r g i n g h i m to b e c o m e b e g g a r in the s t r e e t , i n c r e a s i n g in t h i s way t o t al f am i l y i n c o m e .

disa the

S o c i e t y r e a c t s w i t h c o m p a s s i o n and a c t s p h i l a n t h r o p i c a l l y , a t t e m p t i n g in t h i s way to o v e r c o m e its g ui l t c o m p l e x . It b e c o m e s c l e a r at t h i s p o i n t , that S o c i e t y c o n s i d e r s a d i s a b l e d p e r s o n yet a n o th e r h e l p l e s s h u m a n b ei n g , l i v i n g as an o u t c a s t , for w h o m the o n l y -thing we c an do is to s h o w pi t y and o ff e r m o n e y .

202 MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS On the o t h e r h and, the d i s a b l e d p e r s o n b e c o m e s a c c u s t o m e d to b e g g i n g , w h i c h f i n a l l y d o e s b e c o m e his way of life. ( F o r t u n a t e l y , th i s p e r c e n t a g e is very l o w ).

1 -4. Re la ti on Type

4

Ihe fami l y , in th i s case, a c c e p t s the p r o b l e m , t a c k l e s it in e v e r y way, u r g i n g the d i s a b l e d m e m b e r to j o i n s o c i e t y . It b e a r s in m i n d the m e m b e r ' s p e c u l i a r i t i e s , w i t h o u t c o n s i d e r i n g him different. Society becomes disabled person respect towards him in s o c i e t y .

s e n s i t i v e , its m e m b e r s a c c e p t the as an e q u a l a m o n g them, and s h o w s t h a t p e r s o n , th u s i n c o r p o r a t i n g

Ihe d i s a b l e d p e r s o n o v e r c o m e s his p r o b l e m , l e a r n s to liv e w i t h o t h e r m e m b e r s of s o c i e t y , f u l l y p a r t i c i p a t e s in all s o c i a l a c t i v i t i e s , and c o n t r i b u t e s in p r o d u c t i o n , p r o v i n g in t h i s way, th a t he a c t u a l l y is c a p a b l e and w o r t h y . Ih i s is e x a c t l y w ha t h a p p e n s to e v e r y g r o u p of o u t c a s t s , no m a t t e r w h e t h e r i m m i g r a n t s or c o l o u r e d p e o p l e o r . . . . e v e n w o m e n (!) u n t i l r e c e n t l y , a n y w a y . The f o u r t h t y p e of r e l a t i o n is the one d e s i r e d by the c i v i l i z e d w or l d . H o w e v e r , G r e e c e s t i l l has a l o n g way to go b e f o r e a c c o m p l i s h i n g this, and, now is the t i m e t hat E u r o p e and I n t e r n a t i o n a l O r g a n i z a t i o n s m u s t s t a n d by and help. A r i s t o t e l e , the g r e a t G r e e k P h i l o s o p h e r and t e a c h e r who l i v e d 25 0 0 y e a r s ago, s t a t e d : MMan is by n a t u r e a s o c i a l b e i n g " C o n t r a r y to the p r e v i o u s a n a l y s i s , it is c l e a r t ha t in G r e e c e , the p e r s o n w i t h s p e c i a l n e e d s , in m o s t c a s e s w as a p p r o a c h e d up u n t i l r e c e n t l y , on a p e r s o n a l l e v e l , as a p s y c h o l o g i c a l c ase, and d e p r i v e d of his s o c i a b i l i t y . T hat is, the p o s s i b i l ity to d e v e l o p his p e r s o n a l i t y , his i n d i v i d u a l i t y and in s h o r t his d i g n i t y . The d i s a b l e d p e r s o n h a v i n g to c o u n t e r - b a l a n c e two f a c t o r s , the p h y s i cal or b i o l o g i c a l p r e s s u r e and a l s o the e m o t i o n a l or m en t a l , was a b l e to a c h i e v e s o m e s o r t of b a l a n c e , t h r o u g h his i n t e l l e c t . H o w e v e r , he remained u n t r a i n e d . At his s i d e the u n t r a i n . e d in s u c h m a t t e r s and o v e r - p r o t e c t i v e f a m i l y , s u f f e r e d a nd o f f e r e d all it c o u l d , in o r d e r to o v e r c o m e its c o n s c i o u s or s u b c o n s c i o u s q ui l t c o m p l e x , not b e i n g able, h o w e v e r , to ke e p a balance.

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203

s o c i e t y , and e v e n the s t a t e , The u n t r a i n e d f u n c t i o n e d as an e x t e n s i o n of the f a m i l y . T h r o u g h its f e e l i n g s of g u i l t for its d i s a b l e d m e m b e r s , it e s t a b l i s h e d f o u n d a t i o n s and i n s t i t u t i o n s or o nly g r a n t e d a d i s a b i l i t y a l l o w a n c e , w h i c h t u r n e d out to be a s t a n d i n g p o l i c y . In o t h e r w o r d s , it only g r a n t e d a l l o w a n c e s , p e n s i o n s and tax b e n e f i t s . T h r o u g h the yea r s , it has b e e n p r o v e d , t hat t h r o u g h t r a i n i n g , the i n d i v i d u a l , the fa m i l y , s o c i e t y and the st a t e , are led to a t h o r o u g h e r k n o w l e d g e of the p r o b l e m . T his r e s u l t s in the b a l a n c i n g , and f i n a l l y the s o l u t i o n of the p r o b l e m .

THE MO VE ME NT OE THE D I SA BL ED Onl y in the last d e c a d e , s i n c e 1977 and e s p e c i a l l y in 1981, w h i c h was d e c l a r e d the " Y e a r of The D i s a b l e d " did the d i s a b l e d i n d i v i d u a l s t a r t to s o c i a l i s e . In the F i r s t C o n g r e s s in 1982, The M o v e m e n t of the D i s a b l e d , in an a t t e m p t to free t h e m from the " s t i g m a " of the d i s a b l e d p e r s o n , w h i c h e x i s t e d up to that date, r e f u s e d to a c c e p t t e r m s s u c h as " d i s a b l e d " , or " h a n d i c a p p e d " etc. I n s t e a d , it i n t r o d u c e d the t e r m " p e r s o n w i t h s p e c i a l n e e d s " . I n f l u e n c e d , h o w e v e r , by the s o c i a l s t r u c t u r e s , a l r e a d y m e n t i o n e d , the M o v e m e n t i t s e l f set the w r o n g p r i o r i t i e s . It d e m a n d e d and g a i n e d the i m p l e m e n t a t ion of an a l l o w a n c e p o l i c y . That is : - non l o d g e g r a n t (for t h o s e not in f o u n d a t i o n s ) - tax free c a r s - i n o t h e r w o r d s b o u g h t at 1/5 of ru nn ing cost - tax free fuel - e x e m p t i o n s and d i s c o u n t s for all p u b l i c m e a n s of t r a n s p o r t a t i o n - education within foundations The r i g h t to be e d u c a t e d at all l e ve l s , o u t s i d e f o u n d a t i o n s , and the r ig h t of free e m p l o y m e n t w e r e d e m a n d e d m u c h l a t e r and on l y then, did t hey g a i n the r ig ht of 1 i v i n g ,m o v i n g and b e i n g t r a n s p o r t e d i n d e p e n d e n t l y , t hat is, the r e m o v a l of a r c h i t e c t u r a l b a r r i e r s , w h i c h is a c t u a l l y one of the m a i n r e a s o n s that d i s a b l e d p e o p l e are d r i v e n to i s o l a t i o n . U r b a n i s a t i o n set t h e s e b a r r i e r s in an a t t e m p t to use e v e n the la s t s q u a r e i n c h of s p a c e . As a r e s u l t , the d i s a b l e d and e l d e r l y p e o p l e are not a b l e to a s c e n d the s t e p s of a b u i l d i n g or to get a b o u t , as the p a v e m e n t s s e e m to be i n t e n d e d for cars, m o t o r bikes, b u i l d i n g m a t e r i a l s etc. C o n s e g u e n t u p o n t h i s s i t u a t i o n is the fact th a t t h e s e p e o p l e do not a p p e a r in p u b l i c a r e a s , th e y are not seen, so it is c o n c l u d e d th a t t hey do not

204 MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS exist. N a t u r a l l y , if th e y do not e x i s t the q u e s t i o n a r i s i n g is : "For w h o m s h o u l d r a m p s on p a v e m e n t s be c o n s t r u c t e d and for w h o m s h o u l d the s t e p s at b u i l d i n g e n t r a n c e s be a b o l i s h e d ? " Yet, in s u c h s o c i a l s t r u c t u r e s , the i g n o r a n c e of the p r o b l e m p r e v a i l e d t ill 1981 at all l e v e l s . M a s s m e d i a (pre s s , r a d i o , T/V ), on a l a r g e r s c a l e , r e f u s e d to put f or t h p r o b l e m s , c o n c e r n i n g the d i s a bl e d , so as not to a n n o y the p u b l i c ! A t y p i c a l e x a m p l e of the i g n o r a n c e of the p r o b l e m by the p o l i t i c a l p a r t i e s , is the m a n n e r , in w h i c h the fi r s t i m p o r t a n t m e a s u r e t a k e n , w as v o t e d by the P a r l i e m e n t in 1978 : P r i v a t e c a r s e x e m p t e d f r o m all t a xes, w e r e g r a n t e d to p a r a p l e g i c a nd t e t r a p l e g i c G r e e k c i t i z e n s (Act 8 2 7 / 7 8 ) . In o t h e r w o rd s , th e y we r e g i v e n the r i g h t to buy a car at 1/5 of the ru nni ng cost . Thi s m e a s u r e , as far as we k now, d o e s not e x i s t in any o t h e r c o u n t r y . It is an a l l o c a t i o n , w h i c h w as g r a n t e d , w i t h o u t the i s s u e h a v i n g b e e n c l o s e l y e x a mi n e d, and w i t h o u t h a v i n g t a k e n i n t o a c c o u n t the a c t u a l s t a t i s t i c a l f i g u r e s . It was s i m p l y b a s e d on the n u m b e r of m e m b e r s of an a s s o c i a t i o n of d i s a b l e d p e o p l e , ‘w h i c h at t h a t ti m e n u m b e r e d to 50 m e m b e r s , t h e r e f o r e r e f e r r e d to a p p r o x i m a t e l y 50 cars. Tod a y , tha t s a m e a s s o c i a t i o n has o v e r 4 . 0 0 0 m e m b e r s , w h i l e the c a rs of th a t c a t e g o r y e x c e e d the n u m b e r of 5000. In 1979, p u r s u a n t to Act 9 6 3 / 7 9 , for the f i r s t t i m e d i s a b l e d p e o p l e are p e r m i t t e d to w ork. In fact, it is p r o v i d e d th a t d i s a b l e d p e o p l e may be e n t i t l e d to e m p l o y m e n t by P u b l i c S e r v i c e s at a p e r c e n t a g e of 1?o. W h a t s m o r e , a s p e c i a l a l l o w a n c e is g r a n t e d to t h o s e not in f o u n d a t i o n s u n d e r Act 1 0 4 1 / 8 0 . H o w e v e r ,y e a r s p a s s e d and s o c i a l c h a n g e s had to be m a d e b e f o r e it c o u l d be g r a n t e d . That a l l o w a n c e is e q u a l to a p p r o x i m a t e l y 8 0 ?o of the l o w e s t w a g e s , w h i c h w as at fir s t g iv e n as an i n c e n t i v e , to u r g e p a r a p l e g i g p e o p l e to l e a v e the f o u n d a t i o n s . L a t e r on, an a l l o w a nce e q u a l to 5 0 ?o of the f ir s t one w as g r a n t e d to di sa b l e d persons, who were occupied. 1981 was a t u r n i n g p o i n t in the c o u r s e of the M o v e m e n t for the D i s a b l e d . The M o v e m e n t was e n f o r c e d and c am e out of o b s c u r i t y . By e x c h a n g i n g i n f o r m a t i o n w i t h d i s a b l e d p e o p l e fr o m o t h e r c o u n t r i e s the m e m b e r s of the M o v e m e n t b e g a n to l e a r n m ore, to b e c o m e t r a i n e d , to c l a i m t h e i r r ig h t s , to be s e e n in p u b l i c . T hey b e g a n to m o v e a b o u t and d e m a n d s o c i a l a c c e p t a n c e . The d i s a b l e d

HEALTHY PUBLIC POLICY now read, lear n , c l a i m , th e y are they c l a i m s o c i a l a c c e p t a n c e .

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An oth er s i g n i f i c a n t event which took place was the fact tha t G r e e c e j o i n e d the EEC on 1 . 1 . 8 1 and t hat the o b l i g a t i o n to a s s i m i l a t e l e g i s l a t i o n c o n c e r n i n g s o c i a l m a t t e r s b e c a m e a p p a r e n t . B e s i d e s this, G r e e c e i n a u g u r a t e d its p a r t i c i p a t i o n in s o c i a l p r o g r a m s and e x c h a n g e of i n f o r m a t i o n , K n o w l e d g e and v i e w p o i n t s . f u r t h e r m o r e t h e r e was a c h a n g e of p o l i t i c a l s c e n e . D u r i n g the s a m e y ear, for the f i rs t t i m e in its recent history, Greece elected a government, which a l s o i n c l u d e d in its p r o g r a m a s e r i e s of m e a s u r e s for the d i s a b l e d , r e g a r d i n g t h e i r i n c o r p o r a t i o n in s o c i e t y and t h e i r p r o f e s s i o n a l r e h a b i l i t a t i o n .

G A IN IN G SOCIAL AC CE PT AN CE Now, we e n t e r the m o s t s u b s t a n t i a l p h a s e of the s y s t e m a t i c a p p r o a c h to the b r o a d e r p r o b l e m of the d i s a b l e d , e x a m i n i n g the p r o b l e m w i t h i n the p o l i t i c a l p l a n of a ct i o n . In D e c e m b e r 1981, the M i n i s t r y of E n v i r o n m e n t , P h y s i c a l P l a n n i n g and P u b l i c W o r k s , a s s i g n e d a c o m m i t t e e to d r a f t the G e n e r a l B u i l d i n g R e g u l a t i o n s . One of the m e m b e r s of the c o m m i t t e e w as a d i s a b l e d technical - representative. In May 1982, for the f i r s t t i m e an o f f i c i a l s t a t e m e n t was g i v e n t h r o u g h the m a s s m e d i a s t a t i n g , t h a t r am p s w i l l be c o n s t r a c t e d at all b u i l d i n g e n t r a n c e s to e n a b l e p e o p l e w i t h s p e c i a l n e e d s to h a v e e a s y access. In 1982, the B o a r d of E m p l o y m e n t of W o r k i n g M a n p o w e r p r e p a r e d a c o m p l e t e p r o g r a m , a i m i n g at d i s a b l e d p e o p l e ' s p r o f e s s i o n a l r e i n s t a t e m e n t , in p r i v a t e s e c t o r s , by g i v i n g i n c e n t i v e s to p r i v a t e e m p l o y e r s . A l so in the s a m e y e a r the f i r s t E m p l o y m e n t A g e n c i e s for d i s a b l e d p e o p l e a p p e a r e d . In 1983, the R e g u l a t i o n s for R e m o v a l of A r c h i t e c t u ral B a r r i e r s w e r e i m p l e m e n t e d in r e g a r d to P u b l i c H e a l t h and C a r e B u i l d i n g s . A w h o l e c h a i n of new l a w s f o l l o w e d , w i t h r e g a r d to : - d i s a b l e d p e o p l e ' s e m p l o y m e n t by P u b l i c S e r v i c e s by 5?o of the t o t a l m a n p o w e r to be e m p l o y e d - t r a v e l l i n g by p u b l i c m e a n s of t r a n s p o r t at a free or r e d u c e d c ost

206

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS - sports - social

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C o n c i s e l y , at th i s s t a g e , the p o l i t i c a l p r o g r a m of a c t i on , the p o l i t i c a l wi l l and p l a n n i n g are m a d e clea r . B e h i n d all t h e s e , is the g r e a t p r e s s u r e , e x c e r c i s e d by the d i s a b l e d p e o p l e ' s a s s o c i a t i o n s , t he ir c o o p e r a t i o n , t h e i r p e r s o n a l p a r t i c i p a t i o n in d ec is io n making. In a d d i t i o n , the m a s s m e d i a b e c o m e s a c t i v e . All of the m ea n s , r a d i o , T/V, p r e s s s t a r t e d to p r e s e n t p e o p l e w i t h s p e c i a l n e e d s . The w a l l s of s e c l u s i o n fell. In t h i s way, s t o r i e s of h u m a n i n t e r e s t c a m e up. T/V s t a t i o n s s t a r t e d to p r e s e n t m o t i o n p i c t u r e s w i t h s t o r i e s a d a p t e d f rom d i s a b l e d p e o p l e s e x p e r ie n c e s . O f f i c i a l a n n o u n c e m e n t s of p r o g r a m s for p e o p l e w i t h s p e c i a l n e e d s w e r e made. In the to the

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Greek P a r l i e m e n t every s u g ge st io n, re l a t i n g p r o b l e m , is a p p r o v e d , w i t h o u t a r g u m e n t s .

POLICY D E VE L O P M E N T PR OCESS Now, we h a v e c o m e to a p o i n t , w h e r e both, the p u b l i c and the p u b l i c s e r v i c e s h a v e b e e n i n f o r m e d t hat t h e re are p e o p l e w i t h s p e c i a l n e e d s . F r o m t h i s p o i n t p r e p a r a t i o n for the i s s u e of a u t o n o m o u s l i vi n g , m ov i n g , t r a n s p o r t a t i o n s t a r t s , and the q u e s t i o n now a r i s i n g is : "How w i l l th i s p r o b l e m be s o l v e d ? " In J u n e 1985 the M i n i s t r y of E n v i r o n m e n t P h y s i c a l P l a n n i n g and P u b l i c W o r k s o p e n e d the O f f i c e of R e s e a r c h for D i s a b l e d P e r s o n s . The a i m of t his o f f i c e is to s t u d y , l e g i s l a t e la w s and to c o o r d i n a te all b o d i e s of t e c h n i c i a n s , w h o d e a l w i t h b u i l d i n g s , o p e n a r e a s , and t r a n s p o r t . In D e c e m b e r 1985, the new Act 1 5 7 7 / 8 5 re: G e n e r a l Bu il di ng Re gu l a t i o n s , takes a r e v o l u t i o n a r y step a h ead: It d i c t a t e s s p e c i f i c a t i o n s , s e c u r i n g free h o r i z o n t a l and v e r t i c a l m o v e m e n t to p e o p l e with s p e c i a l n e e d s , in e v e r y b u i l d i n g . In s p e c i f i c : - if b u i l d i n g s u s e d by the p u b l i c h a v e o ne s t o r e y a b o v e g r o u n d l e v e l , and - if d o m i c i l e b u i l d i n g s h a v e t h r e e s t o r e y s a b o v e g r o u n d l e v e l , t h e n it is m a n d a t o r y t h a t t h e s e b u i l d i n g s are e g u i p p e d w i t h r a m p s at t h e i r e n t r a n c e s and p r o v i d e d w i t h e l e v a t o r s w i t h s p e c i a l s pe c i f i c a t i o n s . The

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s t a t i s t i c s . T a k i n g i n t o a c c o u n t , the i n t e r n a t i o n a l e x p e r i e n c e , a 2 5 % at l e a s t of the p o p u l a t i o n r e f e r s to e l d e r l y p e o p l e and p e o p l e w i t h s p e c i a l n e e d s , s u f f e r i n g e i t h e r a p e r m a n e n t or a t e m p o r a r y d i s ability . That very Act was g i v e n a u n a n i m o u s a p p r o v a l by MP's. You see, e v e n t h o u g h one m ay not h a v e a d i s a b l e d p e r s o n in the f a m i l y , he may h a v e an e l d e r l y p e r s o n or he wil l p r o b a b l y h a v e one in f u t u r e , s i n c e e v e r y one get s old, and in a way, we can say t h a t e v e r y o n e by ag i n g , i n e v i t a b l y has a t e n d e n c y t o w a r d s b e c o m i n g a p e r s o n w i t h s p e c i a l n e e d s . T h e r e f o r e , the r e l a t i v e Bill c o n c e r n e d e a c h i n d i v i d u a l . N a t u r a l l y , t h e r e w e r e s o m e r e a c t i o n s fr o m the t e c h n i c i a n s ' s i d e but the M i n i s t e r ' s d e c i s i o n was final. S o c i a l and p o l i t i c a l b e n e f i t s a l s o w e i g h e d , but d i s a b l e d p e o p l e ' s c o o p e r a t i o n and p r e s s u r e w e r e not of m i n o r i m p o r t a n c e . The r e l a t i v e a r t i c l e of Act 1 5 7 7 / 8 5 was g i v e n w i d e p u b l i c i t y by the m e d i a , w h i l s t at the s a m e time, all t e c h n i c i a n s w e r e m a d e a w a r e of a r c h i t e c t u r a l b a r r i e r s , w h i c h p e o p l e w i t h s p e c i a l n e e d s had to face on a d a i l y b a s i s . The new m e a s u r e was a p p l a u d ed by the p u b l i c and n a t u r a l l y the d i s a b l e d . N e w h o r i z o n s o p e n e d for the M o v e m e n t . At last, a d r e a m had s t a r t e d to c o m e true.

I N TR OD UC TI ON AND I M PL EM EN TA TI ON B e s i d e s the fact t h a t the n ew law was m a d e k n o w n , it was a l s o m a d e k n o w n to the p u b l i c , t h a t t h e r e was a " R e s e a r c h O f f i c e for D i s a b l e d P e o p l e " at the M i n i s t r y of E n v i r o n m e n t , P h y s i c a l P l a n n i n g and P u b l i c W or k s . This, r e s u l t e d in an i n t e r - o f f i c e c o o p e r a t i o n . I n d e e d , the b e l i e f th a t o n l y P u b l i c H e a l t h and C a r e s e r v i c e s d e a l t w i t h the p r o b l e m , now s e e m e d o u t - d a t e d . E v e r y b o d y e i t h e r as an o f f i c e r or as an i n d i v i d u a l b e c a m e a w a r e of the fact t hat in the f r a m e w o r k of t h e ir a c t i v i t i e s and a u t h o r i t i e s , t h e y h a v e to e x a m i n e and see h ow t h e y can be of b e t t e r s e r v i c e to this c a t e g o r y of f e l l o w - h u m a n b e i n g s , w h i c h is the c a t e g o r y of p e o p l e w i t h s p e c i a l n e e d s . W h a t was of g r e a t e r i m p o r t a n c e was the e s t a b l i s h m e n t of a p e r m a n e n t l e v e l of c o m m u n i c a t i o n , c o n n e c t i n g G r e e c e w i th o r g a n i s a t i o n s l i k e the U n i t e d N a t i o n s , the E u r o p e a n C o m m u n i t y , the E u r o p e a n C o m m i t t e e of M i n i s t e r s of T r a n s p o r t , as w ell as w i t h t h e i r r e s p e c t i v e d e p a r t m e n t s , o f f i c e s and w o r k s h o p s ,d e a l i n g

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MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS w i t h the s p e c i f i c i s s u e of a u t o n o m o u s l i vi n g , m o v i n g and t r a n s p o r t a t i o n . F r o m 1987 thi s i s s u e was i n c l u d ed in the p l a n of a c t i o n set f o rt h by the r e l e v a n t EEC o f f i ce , in c o o p e r a t i o n w i t h the E u r o p e a n P a r ii e m e n t . Some of the s i g n i f i c a n t a r g u m e n t s , w h i c h a r o s e fr o m this c o o p e r a t i o n and in fact fr om a m o r e t h o r o u g h s tu d y of the i s s u e are g i v e n b e l o w : - s o c i a l b e n e f i t s w h i c h a r i s e f rom b e t t e r p l a n n i n g , that is : by p l a n n i n g and p r o g r a m i n g for p e r s o n s w i t h s p e c i a l n e e d s , in fact we p l a n a nd p r o g r a m for e v e r y b o d y ' s own good, s i n c e e v e r y b o d y ' s g u a l i t y of li f e is i m p r o v e d . - c r o s s - s e c t o r be n e f i t s which arise from these m e a s u r e s in mid t e r m s by t r a n s f e r r i n g f u n d s fr o m H e a l t h and C a r e to t e c h n i c a l p l a n n i n g and t r a n sp o r t , and in l o n g t e r m s , by i n t r o d u c i n g t h e s e p e o p l e to the p r o d u c t i v e p r o c e s s . On the b a s i s of the t a c t i c s set, a 3 0 - m e m b e r w o r k s h o p was f o r m e d in the s e c o n d h a l f of 1987. The m e m b e r s w e r e t e c h n i c a l r e p r e s e n t a t i v e s of v a r i o u s m i n i s t r i e s , o r g a n i s a t i o n s , f o u n d a t i o n s and i n s t i t u t i o ns for the d i s a b l e d , and t e c h n i c a l a s s o c i a t i o n s . The w o r k s h o p d r e w up a s p e c i a l b u i l d i n g r e g u l a t i o n , w h i c h s u p p l e m e n t e d the G e n e r a l B u i l d i n g R e g u l a t i o n s . They a l s o d e a l t w i t h the i s s u e of a s p e c i a l b u l l e t i n c o n t a i n i n g s p e c i f i c a t i o n s , l e g i s l a t e d or not, w h i c h w e r e to c o v e r the w h o l e s p e c t r u m of s p e c i a l f a c i l i t i e s , s e r v i n g as a g e n e r a l g u i d e l i n e to t e c h n i c i a n s in the f ie l d of s t u d y and p l a n n i n g of any b u i l d i n g u s e d by the p u b l i c , d o m i c i l e or e q u i p m e n t . An i m m e d i a t e r e s u l t was that e a c h m e m b e r ' s a w a r e n e s s of the m a t t e r , was t r a n s f e r r e d to his s u p e r i o r s and in this way the r e l a t i v e i n t e r n a t i o n a l s p e c i f i c a t io n s w e r e t a k e n i n t o a c c o u n t for w o r k s , w h i c h w e r e e i t h e r at the s t a g e of p l a n n i n g or e v e n at the s t a g e of c o n s t r u c t i o n . H o w e v e r , one of the b e s t r e s u l t s of thi s c o o p e r a t i o n w e r e the n ew s p e c i f i c a t i o n s of the G r e e k T o u r i s t A s s o c i a t i o n (EOT), w h i c h c a m e in t o e f f e c t in M a r c h 1988. T hey p r o v i d e t h a t 1 0 % of the h ot el r oo m s in e a c h h o t e l s h a l l be s p e c i a l l y d e s i g n e d and e q u i p p e d to r e c e i v e g u e s t s w i t h s p e c i a l n eed s . The m i n i m u m r e q u i r e m e n t p r o v i d e d is 2 r o o m s , and the m a x i m u m 30. A s i m i l a r p o l i c y w as a p p l i e d in the f i e l d of t r a n s p o r t . A w o r k s h o p was f o r m e d w i t h m e m b e r s c o m i n g from e ve r y p a r t y c o n c e r n e d . The a im w as to p l a n m e t h o d s and d e s i g n e q u i p m e n t in m e a n s of p u b l i c t r a n s p o r t in o r d e r to s e r v e p a s s e n g e r s w i t h s p e c i a l

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n ee d s .

6 . IMPACT I n t e r m e d i a t e i m p a c t s on p a r t i e s c o n c e r n e d are a l r ea dy e v i d e n t . The i s o l a t e d d i s a b l e d of 1977, who b e l i e v e d t h e y w e r e the o n l y o n e s w i t h t h i s s o r t of p r o b l e m in the w h o l e w o r l d , and t h o s e s p e e c h l e s s c r e a t u r e s l i v i n g in the v a r i o u s " a s y l a " , w e r e c o n v e r t e d to the w o r k i n g c i t i z e n s of 1988, w i t h t h e ir own p r i v a t e c a r s and a b e t t e r q u a l i t y of life. In o t h er w or d s , t hey a c h i e v e d to s o l v e the p r o b l e m of a u t o n o m y in l iv i n g , m o v i n g , and t r a n s p o r t a t i o n . H o w e v e r , t e c h n i c a l w o r k s t ake s o me t i m e to be t r a n s f e r r e d f rom d r a f t s to m a t e r i a l and th e n to be d e l i v e r e d to the u s e r s . As for the m e d i a , a g r e a t t u r n was mad e . R e c e n t l y , the s u b j e c t c o n c e r n i n g a u t o n o m o u s l i v i n g , m o v i n g and t r a n s p o r t a t i o n s u d d e n l y b e c a m e v er y f a s h i o n a b l e . Q u i te r e c e n t l y , c o o p e r a t i o n w i t h m u n i c i p a l and c o m m u n a l a u t h o r i t i e s f o l l o w e d . In the l i g h t of the n ew l y f or m e d c i r c u m s t a n c e s , l e c t u r e s w e r e g i v e n and a t t e m p t s of t e c h n i c a l i n t e r v e n t i o n s w e r e m a d e to s e c u r e a c c e s s i b i l i t y to b u i l d i n g s and s i d e w a l k s . C i t i z e n s are n ow w e l l i n f o r m e d . T hey n o w k n o w the p r o b l e m . T h e r e f o r e , t h e i r a t t i t u d e t o w a r d s the d i s a b l e d has c h a n g e d to the b e t t e r , and s o c i a l r a c i s m c o n c e r n i n g t h i s g r o u p of p e o p l e is n o w f a d i n g steadily. I n t e r - o f f i c e and i n t e r - m i n i s t r i a l c o o r d i n a t i o n has now i m p r o v e d s i g n i f i c a n t l y , t h a n k s to the c o o p e r a t ion of the M o v e m e n t w i t h r e s e a r c h o r g a n i s a t i o n s . In the f i e l d of the t e c h n i c i a n s , two t e n d e n c i e s appeared : - one r e f e r s to the m o r e s e n s i t i v e t e c h n i c i a n s , who i m p l e m e n t e d the new s p e c i f i c a t i o n s , b e f o r e t hey were even legi sl at ed . - the o th e r r e f e r s to a s m a l l n u m b e r of p r o f i t o r i e n t e d c o n t r a c t o r s , who s aw n o t h i n g e l s e in the new s p e c i f i c a t i o n but a lo s t c h a n c e of p r o f i t and an i n c r e a s e in c o s t s , d e s p i t e the fact t hat t h i s i n c r e a s e was on l y one of 0,5%. T h e r e f o r e , t hey t r i e d to a c h i e v e s o m e f a v o u r a b l e a m e n d m e n t s in the law, but t h e y w e r e p r e v e n t e d by the M o v e m e n t of the D i s a b l e d .

7. S I G NI F IC AN T F A C I L I T A T O R S AND BA RR IE RS

210 MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS 7*1.

W h a t is of m a j o r i m p o r t a n c e in l e g i s l a t i n g a new m e a s u r e are the P o l i t i c a l c h o i c e s of the G o v e r n m e n t . G r e a t i n f l u e n c e , in m a k i n g t h e s e c h o i c e s , is e x e r t e d by i n t e r n a t i o n a l o r g a n i s a t i o n s , w h i c h o b j e c t i v e l y can e x e r c i s e p r e s s u r e on any c o u n t r y , e s p e c i a l l y in m a t t e r s of s o c i a l i n t e r e s t . Ihe E u r o p e a n C o m m u n i t y t h r o u g h c o m p r e h e n s i v e t i c a l and c o m m u n a l p r o g r a m m e s p l a y s the m o s t i m p o r t a n t r o l e in t h i s s u b j e c t .

poli-

I n t e r n a t i o n a l e x p e r i e n c e and p r a c t i c e a p p l i e d so far, g a v e us the o p p o r t u n i t y to p r o c e e d f a s t e r , a v o i d i n g m i s t a k e s , e l s e w h e r e m a d e , a nd s u i t i n g o t h e r s ' e x p e r i e n c e to the G r e e k r e a l i t y . that is w hy one can see n o w d a y s , th a t G r e e c e is far m or e a d v a n c e d in the f ie l d of l e g i s l a t i o n c o n c e r n i n g d i s a b l e d p e o p l e e v e n in c o m p a r i s o n w i t h c o u n t r i e s h a v i n g ov e r 15 y e a r s of e x p e r i e n c e in this i s sue. In s p e c i f i c : - the G e n e r a l B u i l d i n g R e g u l a t i o n s - the N a t i o n a l T o u r i s t A s s o c i a t i o n s p e c i f i c a t i o n s - l e g i s l a t i o n , r e g a r d i n g e m p l o y m e n t of d i s a b l e d p e r s o n s by P u b l i c S e r v i c e s . - the low cost, tax free c a r s (at 1/5 of the run nin g cost ) . f u r t h e r m o r e , e a c h ti m e a new m e a s u r e is b r o u g h t into P a r l i e m e n t for d i s c u s s i o n it is u n a m i m o u s l y a p p r o v e d of w i t h no a r g u m e n t s at all. Yet, the m o s t i m p o r t a n t f a c t o r was the p a r t i c i p a tion of p e o p l e w i t h s p e c i a l n e e d s in the d e c i s i o n maki ng centers. Behin d every program, behind every law, t h e r e are u s e r s t h e m s e l v e s , at l e a s t in the p h a se of p l a n n i n g . The r e a s o n for th i s a c h i e v e m e n t is th a t the d i s a b l ed h a v e the v e r y a r g u m e n t s , b e c a u s e t hey h a v e l i v ed w i t h and w i t h i n the p r o b l e m . T h e r e f o r e , r e l y i n g on the e x p e r i e n c e g a i n e d , th e y k n o w e x a c t l y w h a t t hey are a i m i n g at. I m p o s i n g a new m e a s u r e on c i t i z e n s ' a n d s t a t e o f f i c i a l s ' c o n s c i e n c e s , r e m i n d s one of h u m i d i t y . N o r m a l l y , it c l i m b s up s l o w l y , e x c e p t w h e r e it m e e t s w i t h m o r e s e n s i t i v e a r e as . Then, it c l i m b s up f as te r and e a s i e r . In o t h e r w o r d s , p r o v i d e d that one f i n d s the r i g h t p a s s a g e , the r e s u l t s c ome soorier . 7-2. The m o st s i g n i f i c a n t b a r r i e r s w e r e : 7.2.1. Social racism T h e r e w e r e a n u m b e r of i n s t a n c e s , w h e r e the p u b l i c a p p e a r e d to be n e g a t i v e or r e j e c t i v e

at

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the i de a of a p p r o a c h i n g p e o p l e w i t h s p e c i a l need s . M o r e o v e r t h e r e w e r e i n s t a n c e s , w h e r e p u b l i c s e r v a n t s r e f u s e d to c o m p l y w i t h l e g i s l a tion, r e g a r d i n g p e o p l e w i t h s p e c i a l n e e d s . For e x a m p l e : r e f u s a l to e m p l o y p e o p l e w i t h s p e c i a l n e eds, n a m e l y b e c a u s e of m o b i l i t y p r o b l e m s . Ihe m a s s m e d i a , on the o t h e r hand, did not do its bes t or at l e a s t at the d e s i r e d d e g r e e , so as to s e r v e as a b r i d g e b e t w e e n the p u b l i c and the d i s a b l e d , in o r d e r to b r i n g the two c l o s e r to e ach o t h e r . 7 . 2 . 2 . Lack of s t a t i s t i c s E v e n t o d a y , we s ti l l use i n t e r n a t i o n a l statistics. 7 . 2 . 3 . Lack of a r e c o r d , i l l u s t r a t i n g the a c t u a l s i z e of the p r o b l e m in both, the s o c i a l f i e l d and the b a c k g r o u n d f o u n d a t i o n . O t h e r w i s e , the real c o n t r a d i c t i o n s w o u l d h a v e a p p e a r e d and the r eal p ro b l e m , f a c e d by the d i s a b l e d , w o u l d h a v e b e e n il lu st r a t e d more precisely. 7.2.4. Lac k of i m a g i n a t i o n of p e o p l e h o l d i n g key positions 7. 2 . 3 . And last but not l ea s t b u r e a u c r a c y I'm c l o s i n g w i t h the a s s u r a n c e , th a t the r e a l i t y of t o d a y g i v e s us e v e r y r i g h t to h o p e for a f u t ur e w h e r e , w h e n r e f e r r i n g to " p e r s o n s w i t h s p e c i a l n e e d s " we w ill not s t r e s s the w o r d s " s p e c i a l n e e d s " but the w o r d " p e r s o n " . I t is a fact that in the c i v i l i z e d w o r l d the p e r s o n , the h u m a n b e i n g will be the s u r v i v e r and not the p h y s i c a l l y s t r o n g ones. In G r e e c e , the c r a d l e of c i v i l i z a t i o n , t h e r e are s e v e r a l d e s c e d a n t s , w o r t h y e n o u g h to b ear d e s e r v i n g l y on t h e i r s h o u l d e r s the h e a v y h e r i t a g e and r e s p o n s i b i l i t y and who s t r u g g l e for c i v i l i s a t i o n , w h i c h a ft e r all is LI F E i t s e l f .

KENYA SOCIETY OF THE PHYSICALLY HANDICAPPED PERSON

SUBMISSION OF MY PAPER ON THE FIFTY INTERNATIONAL CONFERENCE ON MOBILITITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

MY PROFESSION IS LEATHER WORK TECHNICIAN TITLE:

"PLANNING, DISABLED TO ENJOY FACILITIES AND

HOW TO FUND ORGANISATION PROJECTS PRESENTATION BY MR. WYCLIFFE KEPHA ANYANZWA AMATEKWA CHAIRMAN OF THE ABOVE NAMED SOCIETY IN STOCKHOLM SWEDEN 21-24 MAY 1989." CHAPTER 1

INTRODUCTION His Worship the Conference Chairman, Conference Cordinator, the Secretriat Conference meeting committee, Guest of Honour, My Disabled Friends and all participants. It is my greatest pleasure to get this opportunity first to be with you here in Stockholm Sweden for this historic meeting.

I like this country

very much and I present this paper now. As the old age says "its the wearer who knows where the shoes pinches" and the owner of the house is supposed to know all the corners of his house better than a stranger, so I think time has come who we must IDENTIFY TACKLE and OVERCOME our problems ourselves with minimum outside assistance if not only from our respective Government.

By our condition as disabled 212

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of money and a area tl v increased support for the organisation. 2.

The other form o^ fundraising concerns programme aid where a grant or occasionally is in Britain. Europe or the U.S.A. It is this second type of income geheration that we will discuss first in this chapter.

GETTING THE IDEA: It is essential that the group in question gets ideas right before starting any significant fundraising operation. It is astonishing how many groups send off letters or even fully budgetted astonishing how many groups send off letters or even fully budgetted reports about ideas which have not been thought th throughly and Which may not even be supported by all the membership of a particular association or a group of disabled people. HOW TO DEVELOP YOUR IDEA IN TO A CONCEPT:* 1 In order to have a concept to discuss with a potential funder, it is important first of all to develop the idea full. So as to allow the idea time to mature the following approach can be helpful in following: 1.

If idea is that of an individual or a small group, give them encouragement and make it clear that they have support in principle to take the idea forward. Encourage them to be open and set a time limit on when they should report back.

2.

A group will take time to develop its ideas at this stage. If the individual or small group report back and appear not to have made much progress. A sympathetic approach should at first be taken. Too much ereticim at an early stage can be damaging.

CHAPTER 4 3.

The group may need a resource person of some kind. In such a case it may be necessary to point out that further information is required. Always set a time limit by which the development of an idea should reach its next stage. Ask those with responsibility for developing the idea to came back and make further report.

4.

if the idea is ready for initial examination,

214 MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

CHAPTER 2 1.

BASIS OF ASSOCIATION'S OR' SOCIETY1S PROGRAMES. The Association's plans are based on its objectives, on the national policy and programmes for disabled and on United Nations policy etc. Different implemantation committees at the Headquarters ought to find out the existing programmes and give their suggestion on those which can be implemented or developed. These have to make efforts on creating new programmes as many as they could think of including those proposed by the association and helpful individuals who advocate for the association's development. Regional implementation committees have the responsibility of creating new development programmes for their own regions. The must however bear in mind that they are the source of the association's general programmes. Therefore there must be some coordination between the regions and the headquarters in preparing the programmes. Copies of all regional programmes should be sent to the Headquarters so that a national programme could be produced? Because Association of Disabled programmes are a total of all the regional programmes plus a few national programmes.

2.

ASSOCIATION'S OBJECTIVES. Basically, the main objectives of the association are, first to understand the burdens/problems facing the disabled, and second to create and implement ways and programmes of solvina them in order to improve their social welfare and enable them to achieve self reliance. The Association aims at enabling the disabled people to actively participate inthe social life of working according to their abilities. And they should never be disregarded or oppressed. Many of them can participate in productive activities or hold leadership position if they could obtain the opportunity. The attitude, that the disabled individuals are "INCAPABLES" is wrong and misleading. Because an incipable person is the one who is in a coma. Before reaching such a discouraging stage, many people are able to do things, includina the givine of ideas and advice. The fact is that disabled people are not inferior, they can do a lot and many of them have bia untapped talents. The

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bigger problem they face is to secure an opportunity and equipment which woule enable them to awaken and enhance their individual creativity. UNITED NATIONS POLICY According to the UN Declaration on the rights of the Disabled anounced by the General Assembly, the policy of this organisation is that disabled people have equal rights with the physically fit individuals on civil and political. In addition, they have the right to be helped so that they become self reliant and feel happy with their daily lives. The aim of the United Nations declaration No. 31/123 of December 1900 is to awaken the international community to reorgnize the problems which disableds face and accept its responsibility in offering the necessary social service they require. CHAPTER 3 HON' TO FUND ORGANISATION'S PROJECTS AND PROGRAMMES As Disabled people, members must themselves have stern targets in becomming more professional in whatever endeavour that they are involved in. Yet it has been noted that organisations of disabled people in Africa sometimes misunderstand how an organisation can be funded particularly from within the country or overseas. lie write the wrong information to the wrong people at the wrong time. As a consequence of this, we often achieve a negative reaction when in fact they deserved better. The purpose of this chapter is therefore to examine how organisations can be funded. Perhaps equally important the chapter will give guidance as to what preparation must be undertaken, what questions have to be asked and when it is appropriate not to request funding. TYPES OF FUND RAISING:1 1. One from of income generation relates to activities carried out by organisation in their own locality. Organisations can run lotteries, flag days house to house collections aponsorship events and special local appeals. These are not the subject of this chapter but are very worthwhile and can often raise a considerable amont

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factor and the responsibility of the community in helping the disabled individuals. There has been different periods of human history - concerning the disabled. Some attitudes were misleading and ignored the problems of the disabled and their rights to the extent of oppresasing them. The aim of both United Nations and our Nations policy is to end such negative negative attitudes, and give disableds their rights, and to foster acceptance and implementation of the society Is responsibility in helping their disabled. Seminars should be organized and conducted aiming at improving the awareness of the disabled people and that of the general public. (f)

Technical aids to help disableds on the affected parts of their body, transport facilities, and equipment for association's projects etc. These include, crutches, shoes, calipres, artificial limbs, motor cars, chairs, bicycles, motorcycles/ scooters, fishing boats etc. The needs of the disabled of short and long term v/ill be listed in the development programmes and in the estimates/budget of the association, depending on its financial position.

10.

Development Programmes : The association's objective is mainly to improve the lives of the disabled. The will be reached through better planning and implementation of development programmes set forth for the disableds. APPEAL At regional level or at headquarters, every member of the association without hesitation, is free to give his ideas on new programmes and a committee or the association in general will edit it if necessary.

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(b) (c) (d) (e) 8.

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Government Institutions and Parastatal, Organisations. Private Institutions and Companies inside and outside the country. Individuals. International Agencies.

appeal

GENERAL

TO DIFFERENT COMMITTEES AND MEMBERS IN

It is an obligation of every committee member to think of, research on, and create development programmes for the disableds. They should think on, do research and create such programmes without any hesitation, so that the association gets many and good programmes for implementation or for giving suggestions. 9.

Needs of the Disabled: The needs of the Disabled are varied. However, they could be categorised as follows:(a) (b) (c) (d) (e)

Offices for their activities and places of work. Disabled centres and recreation centres. Institutions/Schools to provide knowledge and skills which would benefit the disabled in their effort for self suport. Technical education to enable them acquire skills of doing jobs wich they are capable of. Education to help cquire self esteen instead of looking upon themselves as outcasts in the society. And this kind of Education should reach the masses too through the mass media. This is because besides getting syspathy from the pulic and their acceptance that we have equal rights with them, there is a need to educate the pulic to be aware of the rights of the disabled, understand their problems, and the society's responsibility to this segment of the community. And it is true that a lot of people do not understand prombles disabled people are facing, their rights, and their responsibility in helping them. Either people are less informed or they just ignore the human

218 MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS 5.

S ta tis tic s

o f D is a b le d s

Statistics showing the number of the disabled in your country are important in an attempt to understand the degree of their disability, problems and needs. The total number of the disabled in the world is presently 500,000,000. The number of disabled is 10% of the whole world population. 6.

Care Centres for the Disableds: Statistics for the Disableds care centres are important in an effort to understand their problems and needs. Names of such Rehabilitation Centres, Schools and Institutions will be listed and kept on files of the association's programmes (refer to Table a,b,c, and d. in the Handouts papers. (a)

Existing Programmes: Implementation committees have the duty to collect some statistics on the existing programmes so that they could be listed in the association's file concerning programmes .

(b)

New Programmes: Nes Programmes will be of many types: However, they will fall under the following proupings:Schools, Institutions Technical Institutions, etc. Special Centres. Projects such as poultry farming fishing, kiosks, selling of clothes, tailorings, shoe making, carpentry etc. Sports such as football and the like, choir, Jazz band etc. New programmes will be listed in the files.

7.

Donations : Our big hope is to receive donations from our nation.' However, there is a possibility of getting aid from outside the country. The association should expects to receive help from: (a)

The local central Government

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involved with aid are this category of large international organisation. 4.

Medium and small Welfare organisation: There exists considerable number of nationally based welfare organisations concerned with benefiting mankind. A large number may be found and they are also to be found in some parts of Europe, for example, Germany. Ghey are often called Charitable Trusts and may have a specific interest in overseas disability or in helping with development work or in the general promotion of welfare. Many of these organisations may not be insterested in overseas matters but some are.

HOW TO MAKE CONTACT WITH YOUR FUTUTE FUNDER: Whother your future funder has a representative in your own country or whether they are abroad, initial contact must be made. The method of contact unfortunately, has often got to be by mail. There is a difficult problem when many people in the development process still cannot write or read. It emphasises the need for everyone to work as a team and it is very important that those who cannot read should not be made to feel that they are second rate in any way at all. It is often wiser to attempt some preliminary contact rather than spending many hours on a fully bledged proposal together with complete budget. Often funders abroad and elsewhere find they have substant ial documents sitting on their desks sent to the unsolicited. Often they cannot respond effectively to these documents since those who have sent the documentshave not studied the criteria of the agency concerned correctly. Thus, the most important thing is to establish what criteria are and on what basis the funder might be prepared to support your concept. CHAPTER 64

4.

Programmes : Efforts in establishing programmes for the disableds will start by making a research on the type and degree of the problems facing them and their needs. Also research should be undertaken on the existing programmes, to determine whch ones should be implemented/developed. Thus efforts in creating new programmes should go hand in hand with these research.

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HOW TO FUND THE PROGRAMME; If the money is not to come from the membership or from fundraising schemes run by the membership, then it will have to come from an organisation of one kind or another, These organisations may be in the country, African based or may be abroad, Some International Organisations have representation in your own country. Although it following way: 1.

The United Nations system: The UN is currently involved in a Decade for Disabled People. It, or its specialised agencies ought to be interested in projects suggested by disabled people.

CHAPTER 5 Normally the on system will have formal representtion in the Capital city of most African countri ies. There may be one UN agency represented or more. If there is only one agency represented, it will probably have means of telling you about the other agencies that exist within the UN system. 2. Government Agencies: Many foreign governments have representation in the capital city. Normally these are Embassy ought to be equipped to tell you about how it can facilitate aid from its country of origin to your programme. It may well be that the Embassy will need to make a link with the relevant Goverment Department in your own country. This is because much aid handled by Embassies is "Government to Goverment" aid may Embassies however also carry small project funds which can be dispersed directly and which help to support small projects.3 3.

International Agencies (non-Governmental): British, European and American agencies exist with substantial budgets to assist the right programme in a developing country. Many of these agencies have staff based in African countries. There is little point in contacting the international agency at its headquarters if it does have a member of staff in your country. Your letter will simpley be sent back to the relevant official belonging to that agency in your country. Church organisations, some of whom are directly

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invite the group or person to speak about the idea to the Executive Committee of the Association. Give appropriate time. Don't forget that many do nat know how to write and also others are not used to addressing a committee or formal gathering. 5.

Test the idea. You may need to ask members of the Association what they feel particulary if it involves money or a contribution from individual members. Consider c a r e f u l l y how the concept, if it wereto be turned into a programme of work, would effect the overall runnina of the association. Very small associations of disabled people could easily be overwhelmed by choosing you great a programme to begin with.

HOW TO DEVELOPS THE CONCEPT Those with literacy and numeracy skills will need to help thsoe who ao not have them. If certain task are to be carried out by individuals employed on new programme it is important not to fall into the trap of deciding who will do the job when the money ftas been found. It is much better to think of the tasks as functions with an appropriate functions with an appropriate function title. An example of this might be a "Development or SocialTJUorker" . This is an important point because often those who at first appear to be most appropriate for a task actually are not all what useful when the functions have been properly defined. At this juncture it is probably was to prepare a very simple document for use by members of the association. This will just describe what the problem is that needs help and how the solution can be found by the introduction of the proposed programme. A approximate budget should be added. This should show reasonable items of expenditure and also should note where any income might be expected. Any contributions in kind, for example, land, office space or human resources such as expert should also be noted either in a financial estimate or as an appendix to the budget. Ensure that as much agreement as possible is achieved about the stated objectives of the programme, its budget and how it effects your association. Do not forget that programmes can cause disagreement in associations of disabled people and this in turn can lead to a considerable amount of bad feeling among members.

9

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persons and by communicating with other worldwide organization, individuals, etc. We

v e r y

very strongly come up with a fea

suggestions that we hope and trust that if given consideration and implemented than the disabled attending these conference will have matual co-operation in future with a sound base.

INNOVATIVE PRIVATE SECTOR ROLES IN TRANSPORTATION Erling Johnson Chairman, AARP Board of Directors Stephen Stiles Assistant Manager, AARP Tax-Aide & Transportation INTRODUCTION Transportation is primary to the mobility and independence of all persons, and public responsibility for transportation options is established to a degree at least. Less defined but equally important are private sector roles within transportation issues. This paper addresses five recommendations that involve major private sector roles within transportation. The procedures within represent significant departure from current practices; all hold potential for systemwide improvement in mobility for older Americans. Discussions within each recommendation reinforce the reality that public and private roles are inseparable. The conclusion of this paper is that a more involved private sector results in improved service delivery, and increased mobility for older persons. Transportation issues change for those who drive and those who do not. Factors of aging, which affect individual skills and needs, also create a distinct client population to be served. This paper focuses exclusively on transportation for older persons, with recommendations divided between non-driver and driver interests. DEVELOPMENT OF ALTERNATIVES FOR NON-DRIVERS Transportation systems for non-drivers are generally less developed than those for drivers, although mobility needs are equally essential. This is especially true for the frail, low-income elderly and those older persons living in isolated and rural areas. Paratransit is a shorthand term for transport systems that serve these special populations, as distinct from mass transit/commuter systems. Private sector business principles conceptually aid paratransit planning, design, and operations. The most efficient use of resources allows for the greatest degree of service provision. Efficiency concepts also serve the public interest in equal access to service. True understanding of costs compared to benefits allows for equitable matching of 223

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resources to needs. RECOMMENDATION 1: Comprehensive private sector market research should be conducted nationwide to assess the need for and feasibility of additional paratransit service development.

PRIVATE SECTOR ROLE: Identify data collection networks. National public and private networks have the capability to identify paratransit service at the local level. Private sector research entities can coordinate comprehensive collection efforts that adequately define parameters of paratransit and account for all specific service deliverers. The private sector is well established in its research of social service issues — this expertise can be better focused on paratransit. Provide data collection networks. Private sector membership associations are resources to tap in the collection process. Networks are already established for information links between communities and centralized research efforts. The American Association of Retired Persons (AARP) is one such network, with over 30 million members nationwide. Analyze nationwide paratransit information. Data collected from communities, agencies, and known service providers must be collated and analyzed. From this comes the determination of relative paratransit coverage, as well as a resource data base available for dissemination back to the local level. Recommend appropriate public/service provider responses. Existing services can be adjusted, and new services provided as needed, to provide more comprehensive paratransit coverage. Updating the resource data base, as changes in service occur, also provides an on-going analysis tool. Ample precedence exists of public/private commissions as forums for developing service responses. JUSTIFICATION: Widespread speculative needs assessments. The needs of non-driving populations are widely discussed within public service circles as a serious problem. Along with the public in general, the consensus is that the mobility needs of non-drivers are not being adequately met. As likely as such a consensus may be, an objective basis is required before any remedies can be attempted. Specific populations in specific locales

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must first be identified as underserved. Paratransit resources are limited. Considerable public monies are already being spent on the operation or subsidy of paratransit service (over one billion dollars in federal funding alone, per year, in the United States for special transportation operations). The political undesirability of public sector growth will likely require service improvement within existing resources. In such an environment, the waste of underutilized/duplicative service is at the cost of other underserved populations. REQUIREMENTS: Public sector commitment to comprehensive paratransit Serviced Social service agencies must feel public support for the provision of service to those in need, as much as is practical, in order to finance a service identification process. Such commitment is also required for the response mechanisms, at all government levels, to unmet needs. Public sector cooperation in data collection and dissemination" Public agencies are definate sources of paratransit information, through funding and direct service provision activities. Much of the data collected will come through such networks. Similarly, public networks are the most likely conduits for information dissemination back to local-level client populations. The area agency on aging network in the United States, for example, is an ideal repository of information on available paratransit service. Keeping the resource data base current is the largest requirement attached to such dissemination. RECOMMENDATION 2: Private/public sector oversight processes should be established for all local—level paratransit service delivery, and at each level of public funding.

PRIVATE SECTOR ROLE: Oversee public funding of paratransit. Public funding for paratransit in the United States comes about at the federal, regional, state, sub-state, and local levels. At each level, a public/private oversight mechanism is needed for more coordinated distribution of all devoted resources. The mechanism would include social service agencies, service providers (public and private), and user groups such as can be represented.

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At the federal level, an oversight mechanism would coordinate the paratransit funding currently provided by 1) the Department of Health and Human Services (HHS) and 2) the Department of Transportation (DoT). Similar coordinating efforts are needed at all other levels of public agency operation. JUSTIFICATION: Public agencies' responsibilities and jurisdictions currently overlap. A single paratransit service provider may receive funds from any number of agencies operating among varying geographic jurisdictions. This same service provider often faces fragmented and sometimes conflicting operational requirements. Uncoordinated resource distribution fosters duplication of service at the local level. Duplicate service in one locale is at the expense of any service at all in another. The shuttle service operated exclusively for and by one public health facility (and funded by HHS) may be duplicating the services provided by the community-wide senior shuttle already in operation (and funded by DoT). HHS is currently estimated to fund one-half of the paratransit operations in the United States, most of them for very specialized purposes of transporation to and from one social service facility. Such equipment and personnel allocations clearly beg for coordination. DoT funding of paratransit is estimated to account for one-tenth of available services nationwide. This funding may or may not be coordinated with other state and local transportation contributions; it is unlikely to be coordinated with any HHS funding at all. Independent oversight crosses territorial concerns. Bureaucratic infrastructures tend to be encumbered with jealousies, turf battles, and empire building — social service networks are no exception. These obstacles to coordination can be overcome by an independent body that is invested with appropriate oversight authority, which can also foster greater public agency accountability. REQUIREMENTS: Public consensus on the need for oversight. There is no single entity, short of Congress, with clear responsibility for understanding the total paratransit situation in the United States. Without such

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understanding, public consensus on remedial efforts is unlikely. Congressional focus on current problems and future possibilities is key to generating any federal-level response. From there would come similar efforts at other levels of government. Identification of all agencies of jurisdiction. Paratransit funding and operation comes from a myriad of public agencies — any coordinating efforts must account for all participants. Procedural mechanisms to be developed would necessarily apply to all entities at all levels of government. Identification of suitable oversight representatives and guidelines. Selecting representatives from the public and private sectors is clearly subjective, and likely to vary among jurisdictions. Establishing a federal model that includes procedural guidelines and reporting requirements would help replication at other government levels. RECOMMENDATION 3: Public subsidy of transportation should be channeled through users as opposed to direct system funding. Transportation vouchers for those in need should be created, and direct transport system subsidies abolished.

PRIVATE SECTOR ROLE: Design a transportation voucher system. The massive requirements attached to a voucher concept require comprehensive research and design. Implementation must be structured as a long-term phase-in of changes, to avoid the collapse of current operations. Promote efficiency concepts in paratransit service delivery. Public understanding of the reasons for systemic changes is a prerequisite to improvement. Educational campaigns must be planned to bring about understanding and commitment. Provide more paratransit service. The abolition of system subsides increases privatization of the delivery process, and creates more entrepreneurial opportunity. Rising market demand that results from an empowered clientele also requires the expansion of existing services. JUSTIFICATION: Rider subsidies better distribute public resources to individuals in need. More resources are available to those who actually need them if they are not spent on

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those who actually do not. This is controlled by subsidizing riders based upon their specific economic circumstances. User subsidies within private markets are more effective than direct public sector service provision. A classic example of the difference is found in comparing food and housing subsidy in the United States. Persons unable to adequately pay for food are given stamps (vouchers), which are presented as cash for the purchase of food. The cash value of stamps is then redeemed by the efficiencies of the food industry are maintained, and people are being fed. Persons unable to adequately pay for housing are supported very differently. Public housing projects are built and run by the government, with pitiful results. Living conditions and crime are intolerably bad and per-client costs are exorbitant. Projects are being demolished as uninhabitable, while the homeless population is growing into the millions. Fairbox dependency better matches services to needs. Paratransit service is provided to meet a market demand. The demand for such service is best measured by the collection of fares — are there adequate numbers of riders for the service as designed? Are more riders accomodated by route or vehicle changes? From the perspective of service providers dependent upon the farebox, successful operation (income) depends upon ridership. Economic incentives best determine routes, vehicles, and fares. Strengthening the purchasing power of the market population breeds competition, and creates more options for service provision. Administrative overhead is also checked as a cost saving measure, and less needed with the elimination of government reporting requirements. Traditional public service administration grows disproportionate to operations, in that overhead costs are easily passed on to taxpayers. Public subsidy of paratransit service becomes more manageable. Costs of service provided are defined on a per-rider basis, allowing for informed decisions on the degree of public support for individual mobility needs. Paratransit service maintains itself as a constant — subsidy of individual circumstances

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becomes a controlled variable. Increased efficiency potentially yields increased service delivery. As duplicative and underutilized systems are corrected within the evolving paratransit service network, freed resources become available for the development of new services that may be needed. It is entirely possible that existing public resources devoted to paratransit in the United States would very adequately meet all transportation needs. REQUIREMENTSs Public understanding of market principles. Current total levels of paratransit funding need to be determined and brought to public attention, along with understanding of the consequences of public sector intervention into the marketplace. From this can come the impetus to change an ingrained service delivery network. Revamped public funding mechanisms. Available paratransit monies would be shifted from system grants into voucher pools. Persons applying for vouchers would document their economic situation, and receive vouchers commensurate with their need. Service providers' would redeem used vouchers for payment by the government. Means testing of individuals. Criteria must be established to sufficiently identify relative economic needs. Testing must comprehensively evaluate individuals' financial circumstances in order to be effective, and include verification of reported data. Such a test can (and should) then be standardly: applied against all social service provision. Public consensus on degree of transportation subsidy. Consideration of circumstances such as (means-tested) economic need and proximity to services (affecting cost of tranport) would establish scales of subsidy. These scales are also more adaptable over the long term to ever-changing available public resources. Service providers operating within established business practices. Cost-effect analysis, financial accounting, actuarial projections, cost recovery mechanisms, and fare scheduling must be applied to all paratransit systems. Much technical assistance from the business community will be needed to help bring this about. ASSISTANCE TO OLDER DRIVERS

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Maintaining the mobility of older drivers is a public responsibility and a private sector interest, given the large (and growing) percentage of older drivers. The driver, vehicle, and roadway are inseparably tied within a comprehensive safety environment — safety itself is an integral compenent of mobility. Private sector representatives involved with driving assistance include medical personnel, researchers, engineers, driver educators, and vehicle manufacturers. The applied expertise of these specialists can greatly increase roadway safety. RECOMMENDATION 4: Driver sensory and cognitive capabilities should be tested by private sector vision specialists, using state-certified standards as part of the licensing process.

PRIVATE SECTOR ROLE: Develop validated standards of driver performance within viable testing mechanisms. Performance criteria sufficiently sensitive to driving functions are needed. Sensory and cognitive capabilities are measureable, and are undeniably tied to the process of driving. It remains for the research community to link quantitative measurement with behind-the-wheel experience. Validated laboratory driver testing replicable on a nationwide basis in useful. Testing designs are needed drivers, with minimal investment of money.

must also be order to be that encompass all their time and

Produce new or modify existing equipment that adequately measures predictive performance skills. The actual equipment that measures performance remains to be developed. Cost considerations point development toward a modification of existing vision testing equipment with cognitive measures added. Conduct actual driver testing and provide state-recognized certification. As part of or in addition to routine eye examinations, vision specialists can conduct the state-certified sensory and cognitive testing battery. Tested drivers would then present the certification to the state for relicensing. JUSTIFICATION:

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Testing expertise already exists with vision specialists. Regardless of which visual skills are determined to be critically related to driving, vision specialists can understand them and test accordingly. Training would be needed to use modified equipment that includes cognitive measures — this pales in comparison to using non-expert state personnel within a sophisticated testing process. Vision testing equipment already exists. Vision specialists generally have sophisticated vision testing equipment, whereas departments of motor vehicles do not. Existing resources can be efficiently applied to a more comprehensive testing process. More precise diagnoses can be made. The expertise and additional equipment of vision specialists makes more precise diagnoses possible within the testing process. As licensing moves more and more toward recognizing special needs (often referred to as "restricted licenses"), precision testing can provide the basis for making such decisions. Working models of private-sector certification for state licensing already exist. Israel uses such a practice now in licensing drivers. The state provides criteria, and vision specialists conduct the testing. In the United States, a parallel example exists with vehicle safety inspections. In many states, vehicles must be inspected yearly prior to being relicensed (although the worth of these inspections is questioned in some quarters, the process is at issue here). In most of those states, private vehicle repair shops conduct the inspection for a small, state-regulated fee (usually less than $10). A certification sticker is placed on satisfactory vehicles by the mechanic. The state does not try to replicate the technologies necessary to carry out such testing, and sufficient stations are available for motorists to conveniently select from. Public resources are better spent. A major public investment is currently made in personnel, training, and equipment to conduct vision tests of questionable worth. Improved testing standards within such a design will add considerably to public costs — this can be avoided by changing the design. State personnel can very appropriately issue drivers licenses, based upon the certification provided by the private sector. The expensive replication of already available private sector expertise is avoided.

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Drivers are more conveniently served. A window of time can be established within which drivers must become certified. This allows for coincidence with already planned eye exams, etc. This also avoids the stultifying lines always found at departments of motor vehicles. REQUIREMENTS: Validated sensory and cognitive performance standards. Standards must incorporate ability levels met by the majority of drivers in order to be feasible. Extreme cases must be highlighted for remedial action, such as special or revoked licenses. Public acceptance of private-sector screening. State testing of vision is well-established in the United States, and public comfort levels must be addressed. Understanding the futility of current processes is a key component of educational efforts. Vision specialist community willingness to carry out testing. Compensation structures must be established for the involvement of vision specialists. Given the brevity of actual testing, volume of trade, and marketing opportunities, fees should be reasonably low (and set by the state). Procedural design for drivers, vision specialists, and public personnel. Such a radical departure in procedure for the public requires major educational efforts. Additionally, roles for specialists and public personnel must be spelled out and training provided. RECOMMENDATION 5: Roadway design, lighting, signs, signals, and markings should be improved, through private sector research and development efforts, to better meet the needs of older drivers.

PRIVATE SECTOR ROLE: Develop recommended roadway standards. Research that fully considers the sensory and cognitive capabilities of older drivers within roadway features can be built from the considerable efforts already made. There is a large body of knowledge regarding the various sensory/cognitive aspects — it requires validated application to specific standards. Build public understanding of older driver needs related to the driving environment? Modification of

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established road networks, and the requirements for new ones, is a significant investment of public resources. As such, it requires strong public commitment to safe driving environments. Commitment is generated through educational and advocacy efforts. JUSTIFICATION: Older drivers are a significant percentage of the driving population. Approximately thirty percent of the United States driving'population is currently fifty years of age or older, and the percentage is increasing yearly. Roadways must accomodate the needs of such a sizeable population. Many current roadway standards date back twenty years or more. Nearly all were founded on crieria developed for the average twenty year old. The major public investment in surface networks demands maximum utilization of the resources provided. Upgraded roadways benefit all drivers. Signs more easily seen by older drivers are also more visible to everyone else. Design and cue placement along roadways, to build greater reaction-time distance cushions, do so for all drivers. The private sector is equipped to carry out needed research. The existing body of knowledge regarding sensory/cognitive skills of older drivers was primarily built by the private sector. Laboratories and providing grounds are available to validate the findings of research that is developed. REQUIREMENTS: Policy adaptation to implement improved standards within available resources. Funds must be earmarked for pilot demonstrations of new designs, and requirements applied to signs/signals/marking/lighting that are scheduled for replacement. Inexpensive retrofitting should be phased-in as well.

Mobility Assistance for Disabled People in the UK Adrian V. Stokes

Chairman, Executive Committee, Royal Association for Disability and Rehabilitation 25 Mortimer Street, LONDON, W1N 8AB,U.K.

INTRODUCTION The provision of assistance in the United Kingdom towards the mobility of locomotor-disabled people has changed greatly over the years and has improved substantially over the last ten to fifteen years. This paper reviews and analyses the changes that have taken place in the provision of mobility assistance over the years and, in particular, it pays attention to the introduction of the Mobility Allowance and to the functions of a charity, known as Motability, which was set up ten years ago by the Government in order to assist Mobility Allowance beneficiaries.

EARLY MOBILITY ASSISTANCE Following the 1914-18 War, there was a considerable need to improve the mobility of people injured during that war and the Red Cross made various provisions, including the fitting of motors to "bath chairs". Such provision, by charitable organisations, was little altered until the introduction of the National Health Service. It is perhaps of relevance that an organisation to protect the interests of disabled war pensioners who were able to drive a motor vehicle was set up in 1922. This organisation, the Disabled Drivers’ Motor Club, is still in existence with some 16,000 members. With the inception of the National Health Service, the UK Government accepted responsibility for the provision of mobility assistance to certain groups of disabled people. In the case of war pensioners, provision for their mobility was made by Royal Warrant and this provision was generally appreciably more favourable than that provided for civilian disabled people. This position has continued to this day, although the difference in provision has reduced in recent years. In the case of civilian disabled people, mobility provision usually took the form of a lowpowered, three-wheeled vehicle (the "trike") which was a direct descendant of the Red Cross’ motorised vehicles. This vehicle was regarded, in law, as a prosthesis (albeit a rather sophisticated one) and it was provided, in the terms of the National Health Service Act, as "medical nursing and other services required at or for the purposes of hospitals". It was not until the 1968 Health Service and Public Health Act (Sec. 33) that the Secretary of State was specifically authorised to issue vehicles to civilians. Although, in most cases, the trike was the only vehicle available, there were a few small groups of people who were issued with a four-wheeled car. These groups were disabled parents in sole charge of children or a disabled person who lived with a relative who was either eligible for a trike or was blind. In 1972, an additional group, certain haemophiliacs, was added to this list. 234

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The criteria for issue of an invalid tricycle were that the disabled person was: • A double leg amputee (one above or through the knee); or • A person suffering from another disability whose walking ability was similar to that of the previous category; or • A person who was less severely disabled but who needed a vehicle to get to and from full time employment (but NOT full time education) A cash allowance was introduced in the 1960s for people who chose to waive their right to a trike and buy their own car. This allowance was paid towards the cost of converting a vehicle’s controls and was payable every five years. A further financial benefit was that drivers in receipt of one of the above provisions was exempt from payment of the annual Vehicle Excise Duty. In 1972, the Government introduced the "Private Car Allowance" (PCA) of £ 100 per year, tax free, in place of the conversion grant. At the same time, various other, relatively small, changes were introduced to the scheme. From the earliest days, provision of mobility assistance to civilian disabled people (but not to war pensioners) was restricted to those people able to drive themselves and, with one small exception, the more severely disabled (those who were unable to drive themselves) were eligible for no benefit. The minor exception, introduced in 1972, was that a car which was registered in the name of a disabled person who needed constant attendance and the car was "co n sp icu o u sly a n d p e rm a n en tly a d a p te d " for that person’s use was exempted from Vehicle Excise Duty.

THE BARONESS SHARP ENQUIRY In the late 1960s and the beginning of the 1970s, mounting pressure was put on the Government from two different sources to modify the Vehicle Service. The first was from people who were excluded from help because their disability was too severe to allow them to drive (the disabled passengers), a totally anomalous situation. The second was from trike drivers themselves who were concerned at many aspects of the trike - the cost, the safety record and the lack of provision for a passenger. These pressures led, in April 1972, to the Secretary of State inviting Baroness Sharp GBE: "to re-exam in e the lim ita tio n s im p o s e d u p o n p e rs o n s w h o se m o b ility is red u ce d b y severe p h y s ic a l d is a b le m e n t, n o t o c c a s io n e d by o ld age, a n d the m e a n s by w hich th o se lim ita tio n s can be m itigated, h avin g regard to the n eed s a n d circu m stan ces o f the d is a b le d p e o p le a n d to the h e lp in cash o r k in d w hich th e a va ila b le resources p e rm it o r c o u ld p e r m it fr o m th e variou s agen cies w ith resp o n sib ilities f o r su ch persons".

Lady Sharp invited a number of organisations to submit evidence and over two hundred organisations and individuals gave written or oral evidence. Her report was completed in October 1973 but was not published until the middle of 1974. A number of major organisations concerned with mobility of disabled people proposed that a cash allowance should be introduced but the report rejected these suggestions in favour of the principle of supplying vehicles, mainly on the grounds of possible abuse of a cash scheme. The possible introduction of a system of grants was suggested, provided they were means tested, although the concept of means testing for the provision of vehicles was excluded on grounds of administrative complexity. Perhaps the most important recommendation of the report was that cars and not trikes should be issued. In order to overcome the problems of extra overall cost, Lady Sharp

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MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

proposed that"severe p h y s ic a l d is a b le m en t sh o u ld n o t in its e lf en title a n y N H S (i.e. civilian) a p p lic a n t to a car. This sh o u ld d e p e n d , in a d d itio n on the N E E D o f the d is a b le d p e rs o n f o r a ca r in order, broadly, to m a in ta in h im o r h erself a n d the fa m ily o r to con tribu te to th eir su pport. A l l the circu m sta n ces o f the h o u se h o ld sh o u ld b e taken in to account."

MOBILITY ALLOWANCE After much deliberation on the Sharp report, in September 1974, the Government issued a statement called "M obility f o r D is a b le d P eo p le: the G overn m en t's Intentions" which proposed a new allowance, the Mobility Allowance. In their own words, "the G o v ern m e n t therefore

p r o p o s e s to in trodu ce a w eekly m o b ility a llo w a n ce o f £ 4 - eq u iva len t to roughly £ 2 0 0 a year. This w ill rep la ce the existing p riva te car a llo w a n ce o f £ 100 a year, b u t u n like th e p r iva te ca r a llow an ce, p a y m e n t w ill n o t d e p e n d on the ow n ersh ip of, o r a bility to drive, a car. T o give the m o s t ben efit to th o se in grea test n e e d the a llo w a n ce w ill be m a d e taxable. The m e d ic a l criteria u s e d to defin e eligibility w ill b e the s a m e as a t presen t, b u t the extension o f eligibility to n o n -d rivers w ill m a k e c o n sid era b le d e m a n d s on m e d ic a l a n d a d m in istra tive m a n p o w er. F o r th is reason, a n d to lim it th e cost, the a llo w a n ce w ill be e xten ded to the n ew categories b y sta g es beginning in 1975/6. The G o v ern m e n t in ten ds th a t coverage sh o u ld be ex ten d ed o v er the fo llo w in g 3 yea rs to in clu d e n on -drivers o f w orkin g age a n d children betw een the ages o f 5 a n d 16. In th e la tter case, th e a llo w a n c e w ill b e p a id to p a r e n ts ."In addition to the allowance, the Government said that "the th ree-w h eeler w ill be reta in ed f o r th o se w h o p refer it to the m o b ility a llo w a n c e ". Also, anyone in

receipt of PCA could retain it in preference to Mobility Allowance.

This statement at long last established the principle that eligibility for benefit should be based on degree of disability and not some arbitrary criterion such as the ability to drive or ownership of a vehicle. The scheme started in January 1976, with payment at the increased rate of £ 5 per week. Although the Government had stated that the medical criteria for eligibility would be unaltered from the previous arrangements, when the actual criteria were published, it was clear that they were noticeably more rigorous. They were that "his p h y s ic a l co n d itio n a s a w h o le is such that, w ith o u t h avin g regard to circu m stan ces p e c u lia r to th a t p e rs o n a s to p la c e o f resid en ce o r as to p la c e of, o r n atu re of, e m p lo y m en t {a) h e is u n a b le o r virtually u n a b le to walk; or (b) the exertion requ ired to w a lk w o u ld con stitu te a dan ger to h is life o r w o u ld b e likely to le a d to a serio u s deterioration in h is health"

Also, it was stated that the criteria would not apply if the person could walk with the aid of a prosthesis. Due to a well publicised case regarding the payment of Mobility Allowance to a child suffer-

ing from Downs Syndrome, the Regulations were modified in March 1979 by changing the vague "virtually u n able to w a lk "phrase to the, arguably less vague, "his a b ility to w a lk o u t o f

d o o rs is s o lim ited, as regards the dista n ce o v er w hich o r th e s p e e d a t w h ich o r th e length o f tim e f o r w hich o r th e m a n n er in w hich h e can m a k e progress on f o o t w ith o u t severe d isco m fo rt, th a t h e is virtually u n able to walk".

Clearly a major problem with the Mobility Allowance was the fact that, however large a weekly allowance, it would not be possible for the majority of people to afford the capital payment required for a vehicle and a scheme whereby the weekly allowance could be commuted into a capital sum was required (and this was one of the recommendations made by a Working Party set up by the Government to examine the introduction of Mobility Allowance). Nevertheless, it appeared that the situation at the beginning of 1976, namely that a disabled person had a choice between a cash benefit and a vehicle (including free maintenance), was right in principle, although some changes in implementation were required.

DISABLED PEOPLE IN THE UK

237

However, in July 1976, the Secretary of State for Social Services announced (in contradiction to the statement two years previously) that the trike would be "phased out" and that no new applicants would be able to choose a trike rather than Mobility Allowance, unless the applicant were outside the age groups which had been phased into Mobility Allowance, in which case the trike would be issued on the same terms as Mobility Allowance, namely it would be removed at retirement age. Needless to say, this led to serious problems of mobility for such recipients and, within a relatively short time, this scheme was modified so that people receiving trikes under this arrangement could retain them after retirement age until they became unserviceable but, at the same time, the Minister announced that the "concession" was to be removed from new applicants. Thus the situation had deteriorated significantly and, while Mobility Allowance was uprated to £ 7 in November 1977, the absence of a commutation scheme or provision of some vehicle left many people immobile. The Central Council for the Disabled (later the Royal Association for Disability and Rehabilitation) had investigated a scheme but it would have proved to have problems in implementation and would have required a significant injection of funds. However, during 1977, the Government asked Lord Goodman CH to investigate ways in which Mobility Allowance could be put to best advantage and, in December 1977, a new organisation, Motability, was announced.

MOTABILITY The basic purpose of Motability was to maximise the use of the Mobility Allowance. In order to do this, Motability negotiated discounts with car manufacturers, arranged a special insurance scheme and, most important, arranged for four major clearing banks to set up a company, Motability Finance Ltd., with initial funds of £ 100 million. The initial scheme was a leasing scheme. The funds from Motability Finance Ltd. were used to buy vehicles which were then leased to disabled people on preferential terms (a survey in 1980 indicated a saving of about one third compared to commercial schemes). The deal included all maintenance charges but excluded insurance, petrol and oil. In exchange for the vehicle, the disabled person paid over the full amount of his Mobility Allowance for the period of the lease (originally three or four years, depending on the manufacturer but later fixed at three years), together with a fixed sum at the beginning of the lease, representing the difference between the value of the Mobility Allowance over the lease period and the price of the vehicle including maintenance. This initial sum varied from zero to about £ 1000, depending on the vehicle. However, it is dependent on many factors including the price of the vehicles (less discount), the estimated value of the vehicle at the end of the lease, interest rates and taxation. As a result, this initial sum has varied quite substantially over the ten years since Motability was formed. At best, one or two cars have been available from each manufacturer in the scheme with no initial down payment and a contribution has been made to the insurance premium. For a number of people, a leasing scheme was unsatisfactory - for example, because heavy

conversion was needed and the cost of re-conversion at the end of the lease would be too high. Therefore, in 1979, Motability also launched a hire-purchase scheme which had the additional advantage of not restricting the disabled person to the relatively limited range of cars available at that time on the leasing scheme. The major differences between the two schemes were that, under the leasing scheme, the disabled person had to return the car at the end of the lease and obtain another one; under the hire purchase scheme, the disabled person owned the car at the end of the period (four and a half years) but was responsible for the maintenance of the car during the hire purchase period. Although these two schemes were the original ones introduced and remain the principal ones, additional schemes have been introduced. The next scheme was the hire-purchase of secondhand vehicles (over a two or three-year period). The vehicles had to fulfil certain criteria,

238

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

such as being under four years old and having covered less than 40,000 miles and the dealer had to hold a franchise from a vehicle manufacturer or be a member of an approved trade association. For a number of people, their mobility needs could be met by a vehicle other than a car. Although the Government supplied hand- propelled wheelchairs (or electrically powered chairs for indoor use), they only provided outdoor powered wheelchairs in exceptional cases. The next scheme to be introduced by Motability was the hire-purchase of such wheelchairs. Because of the costs of these vehicles, the scheme had a large number of options, permitting the use of only part of the Mobility Allowance over a number of different periods. In addition, the Motability schemes were extended to war pensioners, with somewhat different criteria (for example, adaptations costs were met by the Government). Improvements have been made to all the schemes as circumstances permitted. For example, an insurance based scheme has been introduced whereby, if a Motability vehicle is off the road for more than a week, a sum equivalent to the person’s Mobility Allowance is paid to enable other transport to be used. By the end of 1979, Motability had over five thousand cars on the road under the two schemes. This figure has consistently risen and, by the middle of 1988, one hundred thousand vehicles had been provided. This achievement was recognised by the award of a Royal Charter to Motability and to HM The Queen (who is Motability’s Chief Patron) performing a ceremony on 19 May 1988 to mark the handing over of the hundred thousandth vehicle. At the beginning of 1989, the total number of vehicles supplied was over 127,000 of which 122,000 were cars and the remainder wheelchairs. Of these vehicles supplied, over half (69,000) were still the subject of live agreements. These figures should be contrasted with those of a year before which were 98,000 and 54,000 respectively. These figures mirror, to some extent, the large increase in recipients of Mobility Allowance. At the end of 1988, the number of recipients was nearly 600,000. The value of the vehicles supplied by Motability is significant - of the order of £ 400 million and the original funds available to Motability Finance Ltd. have been increased on a number of occasions.

MOTABILITY’S CHARITABLE FUNDS Of course, many people were unable to afford the front-loading on the car or the conversion Ycosts and so Motability set up a charitable fund to pay these costs in some cases. Within eighteen months, this fund had exceeded the half-million pound mark and about a quarter of a million pounds a year is currently being provided from this fund. Towards the end of 1988, the Government announced that it was setting up a special fund to mark Motability’s tenth anniversary. The Government proposed to allocated £ 5 million for this fund with a similar sum being provided by the major banks. This fund’s sole purpose would be to provide assistance to Motability’s charitable fund. Although, at the time of writing this paper, the fund is not yet in operation, it is expected to be so during the early part of 1989 and it is expected that it will enable Motability to provide mobility for many more disabled people, particularly those with more severe disabilities where the cost of conversion is extremely high.

OTHER FORMS OF MOBILITY ASSISTANCE This paper has so far concentrated on the provision of vehicles or cash to improve the mobility of disabled people. But in addition to the problems of mobility caused by lack of a

DISABLED PEOPLE IN THE UK

239

vehicle, there are also serious problems of parking and these problems have increased very noticeably over the last few years. As parking meters and other parking restrictions spread during the 1960s, a "yellow badge" scheme was introduced. This scheme was a means of identifying disabled drivers (N.B. once again, the disparity between drivers and passengers). It had no statutory significance and the significance paid to it by local authorities varied from authority to authority. In many cases, the benefit gained from displaying the badge was restricted to the area in which the badge was issued. Towards the end of the sixties, more authorities recognised the Yellow Badge, whether issued by themselves or not, but the facilities available still varied significantly and, except in very rare cases, no facilities were available for "disabled passengers". This unsatisfactory situation was corrected in 1970 by the universal recognition of a "badge of a prescribed form". Although the badge (later to become the "Orange Badge") was still to be issued by local authorities, it was to be recognised throughout the country (but different Regulations were applied in Scotland). The Act stated that the badge should be issued "for m o to r veh icles driven by, o r u se d f o r th e carriage of, d is a b le d p e r s o n s ". The scheme was introduced in 1971 but there were still a number of problems. First, five inner London boroughs (who had consistently refused to recognise Yellow Badges) were exempted from the Orange Badge scheme on the grounds of their alleged special traffic problems. One of these Boroughs has since accepted the national scheme. The scheme has been reviewed a number of times (and, at the time of writing, a further revision is in progress). In July 1973, a major revision took place. The major changes were that blind people were to be included in the scheme (this change was for an experimental period of a year but was made permanent when reviewed); parking on yellow lines (in England and Wales) would be permitted, provided that there was no ban on loading or unloading, for a period of up to two hours; the inclusion of Islington in the national scheme (mentioned above); and a large badge including the international "wheelchair" symbol would be issued for display at the rear of the car.

SUMMARY Since the introduction of mobility assistance by the Government for disabled people a number of years ago, a significant number of improvements have been made. In particular, there is a cash allowance which is intended to assist with a disabled person’s mobility and a major scheme, Motability, has been set up to permit the Mobility Allowance to be exchanged for a vehicle. In addition to the ordinary Motability scheme, its charitable arm has provided a significant amount of money to people who cannot afford the sums required to enable them to become mobile, because of their disability. The introduction of the Charitable Trust should assist many more disabled people become mobile.

REFERENCES 1. Sharp, "Mobility of Physically Disabled People", HMSO, 1974. 2. —, "Mobility for Disabled People: The Government’s Intentions", Department of Health and Social Security, September 1974.3 3. ~, "Report of the Working Party on Mobility Allowance", Central Council for the Disabled, June 1976.

TRANSPORTATION FOR DISABLED PERSONS IN ONTARIO: TOWARDS A STRATEGY FOR THE 1990’s David L. Lewis, Brian M. Guthrie, Peter Friedrichs James F. Hickling Management Consultants Practice in Disability and Aging Ottawa, Ontario, Canada

1.0 Introduction This paper is a summary of the policy-oriented discussions of a study prepared by James F. Hickling Management Consultants Ltd. on behalf of the Ontario Ministry of Transportation, entitled Transportation for Disabled Persons in Ontario: Towards a Strategy for the 1990’s. The overall Study is presented in four volumes, including (i) a Summary Report; (ii) the Main Report; (iii) Appendices to the Main Report; and (iv) Detailed Options Studies. The study was commissioned by the Ministry of Transportation of Ontario to provide a basis for long term policy development and strategic planning in the provision of transport services for disabled people. Although the study is intended to provide a basis for program planning and budgeting, further analysis will be required in order to implement any of the policy initiatives discussed. Any study of this scope and nature involves assumptions, forecasts and estimates that are inevitably uncertain. Tests conducted by the study team indicate, however, that the study’s fundamental strategic conclusions remain the same under a wide range of variation in the underlying assumptions. To aid in the development of detailed implementation programs, the study provides a framework within which further operational assumptions and forecasts can be tested in order to study the implications of alternative approaches. This research would not have been possible without the help and participation of a number of individuals and organizations in Ontario, including user groups, service providers and governments. The authors are particularly grateful to the Steering Committee: Richard Puccini, Kevin Pask, Rob Barnes, Chris Poon, Bob Boyle, Glenn Johnston, Dave Hanes, Kathy Moore, Joan Cappa, Pentti Suokas, Larry Smith, Dave Winkworth, Nino Campitelli and Hau-Chi Pang for their review and comment on the report. The work reflects the views and conclusions of the authors and not necessarily those of the government of Ontario. 2.0 The Score-Card on Current Policy Based upon a wide-ranging review and analysis of the availability, distribution and use of transportation services for disabled persons in Ontario, this study draws two principal conclusions regarding current policy. 240

DISABLED PERSONS IN ONTARIO

241

First, provincial objectives underlying transport for disabled persons focus exclusively on enhancing the travel opportunities of disabled persons. Transportation is regarded as a means of gaining access to other activities and not as an end in itself. In the context of this objective, the focus of existing policy on door-to-door transportation is well conceived in light of the apparent preferences of the majority of disabled persons. The analysis presented in the body of this report indicates that, like other members of the general public, disabled persons prefer the convenience and comfort of door-to-door transportation. Specialized service has come closer to satisfying the preference for door-to-door transportation than a program of adapting fixed-route vehicles and facilities for those physically unable to use these services today. In the provision of door-to-door specialized service, the gradual development of public-private partnerships is also well conceived from the viewpoint of improved efficiency and effectiveness. Provincial eligibility policy, though highly constrained compared with most other specialized service systems in North America, also appears well conceived given the existing budgetary commitment to specialized service. By constraining eligibility to persons unable to board fixed-route transit, the current approach allows municipalities to target specialized resources to those with the greatest need. Steps to expand eligibility to those unable to get to a nearby transit stop would extend the service to a number of individuals without meaningful alternatives; as indicated below, however, a standard of eligibility that is open to too wide an interpretation could quickly lead to excessive demand at the expense of service quality. The current policy of channeling the major share of available provincial resources to door-to-door service rather than fostering a mix of accessible fixed-route and specialized service (the so called "integrated" approach) tends to focus resources on services that maximize trip making for a given transport budget. The subsidy of design modifications to public transit vehicles, for the ambulatory disabled, is also a well-founded policy. It serves many travellers, for comparatively low cost. However, current budgets and schedules are not fixed or mandatory. More could be done. The second conclusion regarding provincial policy is that despite the reasonably effective use of existing budgetary resources, scope exists for substantially improving the availability and distribution of travel opportunities for disabled residents of Ontario. In the longer run, scope also exists for improving the efficiency with which existing programs are delivered and for using the savings to improve service availability and quality. To improve travel opportunities for disabled persons in Ontario, the existing provincial budget for disability-related transport programs - - about $14 million in 1986 — would need to expand. Measures to improve efficiency would help mitigate budgetary growth but additional spending would nevertheless be required. The most significant problems under current policy may be summarized as follows:

242 MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS o

o o

Personal Mobility. In focusing almost exclusively on the provision of public transportation, current policy fails to address the preference of many disabled persons for personal transportation. Ubiquitous and important as it is in North American society, lack of access to an appropriately adapted car can sharply curtail the mobility of a disabled person, Rural Transportation. In areas without transit service, provincial policy is weak in its efforts to promote mobility for disabled persons, Urban Transportation. Current policy is weak in facilitating interjurisdictional mobility among disabled persons. The problem is particularly acute in the greater Toronto region where commuter services offered by GO Transit operations have virtually no equivalent service for disabled persons who cannot negotiate steps and overcome other architectural barriers. Intermunicipal specialized services are also inadequate. Current policy could also be strengthened by aligning provincial eligibility guidelines for specialized service subsidies more closely with the needs of individuals who cannot use existing fixed-route services. As well, there is considerable scope in the medium to longer term to promote efficiency through further public-private partnerships in the provision of specialized transportation. Finally, minor fixed-route transit design failings inhibit travel opportunities for those mildly and moderately disabled persons for whom buses and trains are difficult and inconvenient to use.

This review also examined the intercity transportation problems of disabled persons and a number of issues are identified below along with options for a provincial role. 3.0

Future Directions: A Comprehensive Strategy for the 1990’s

Given the broad array of objectives, needs and opportunities outlined above, no single initiative can be expected to respond to them all. Based upon the review and analysis of a wide array of possible responses to the problems that exist under current policy, Summary Table 4 presents the costs and benefits of those initiatives that form a regionally balanced, effective and economic basis for guiding provincial planning over the decade ahead. As a basis for strategic planning, the initiatives outlined in the Summary Table do not require immediate or simultaneous implementation. Nor do they require implementation in precisely the form indicated in the Table. Indeed, for each initiative there exist many possible variants, each with higher or lower costs and benefits than those shown, depending upon their relative scope. It is this flexibility that characterizes the Summary Table as a basis for long-term strategic policy rather than a prescriptive basis for immediate change. Using the strategy as a guide, policy planners and decision makers should be able to forge specific plans and budgets for the phasing and scope of individual initiatives. The strategy is aimed at maximizing mobility for those disabled persons with the greatest transport problems for any given endowment of budgetary resources (an approach sometimes known as "optimization"). For this reason, the strategy places relatively little emphasis on large scale investments in making fixed-route transit systems accessible to wheelchair users and others unable to use steps. The analysis finds that such investments tend to draw very heavily on resources while resulting in relatively little additional trip making.

DISABLED PERSONS IN ONTARIO S U M M A R Y T A B L E 4:

IN IT IA T IV E S

C U R R E N T P O L IC Y

P R IN C IP A L E L E M E N T S O F A S T R A T E G IC T R A N S P O R T A T IO N P O L IC Y F O R D IS A B L E D P E R S O N S IN O N T A R IO

G EN ER A L N A TU R E O F PR O G RA M

Operating and capital assistance to municipalities in the provision of specialized transit

PERSONAL M OBILITY Enhanced Training

Added funds for disabled driver training centres; mobile training unit for remote communities.

Subsidy for Adaptive Auto Equipment

90 percent first-time and SO percent subsequent sudsidy to wheelchair users.

Subsidy for Auto Purchase or Lease

90 percent first-time and 50 percent subsequent subsidy for wheelchair users who drive.

RURAL TRANSPORTATION Block Grants

Block grants to small or rural municipalities for allocation according to locally developed, provincially approved Local Transportation Plans (LTPs).

Accessible Vehicle Subsidies

50% subsidy to operators for purchase of accessible vehicles.

URBAN TR A N SPO R T M unicipal Specialized Service Expand Eligibility and Audit

Expand eligibility to persons unable to access bus stops.

Accessible Taxi Subsidies

50 percent subsidy to taxi operators for accessible vehicle purchase.

Private Sector Paratransit (T «is)

Expanded private-public partnerships in provision of par »transit: use of taxis user-side subsidies.

Cross-Boundary Service Enhancements Public T ra n sit

243

Funds and planning grants to facilitate cross-boundary specialized transit without transfer.

Added Training (Blind & Mentally Disabled Persons)

Added funds for training in the use of public transit.

Design Improvements for Ambulatory Passengers

Small scale design and operational improvements, for ambulatory passengers.

IN TER -R EG IO N A L SER V ICE Specialized InterJurisdictional Service

Public-private partnership in provision of specialized inter-regional door-to-door transportation in GO Transit service area.

Design Improvements for Ambulatory Passengers

Small scale design and operational improvements for ambulatory passengers.

Research and Demonstration for OnCall Accessible Bus Service

Demand-activated buses for long-distance recurring commuter trips.

INTERCITY SER V IC ES Accessible Intercity Buses

Provincial financial incentives to coach operators to equip buses with wheelchair lifts.

Design Improvements for Ambulatory Passengers

Small scale design and operational improvements for ambulatory passengers.

244 MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS S U M M A R Y T A B L E 4 (c o o 't)

IN IT IA T IV E

N um ber of Persona Potentially Benefiting (1986)

Percentage of Disabled Population Served

Num ber of T rips (1986) (000's of trip s/y ear)

A verage Annual Total Cost Annual Cost Per Budgetary (Present Budgetary T rip (1986) Outlays Value over Outlays ( (/trip ) 5 (1986) 3d years) 12345 (1996)7 ((m illio n s) ($M/annum) ($M/annum] Total

C U R R E N T P O L IC Y

53.000

5.2

1,800

270

5

Province Total

26

14

51

5

Province 27

14.50

PERSONAL M OBILITY Enhanced Training

12,000

1.2

1.900

8

0.86

0.8

1.6

1.6

0.42

Subsidy for Adaptive Auto Equipment

15,000

1.5

2,400

57

8.0

8.0

8.7

8.7

3.30

Subsidy for Auto Purchase or Lease

12,000

1.2

1,900

134

19

19

21

21

10.0

26,000

2.6

820

62

6.0

3.3

12

6.5

7.30

1,400

0.1

40

3

0.3

0.3

0.6

0.6

7.50

3 77,000

7.6

2,400

310

30

16

59

31

1250

4 5,000

0.5

140

2

0.2

0.2

0.4

0.4

1.40

Private Sector Paratransit (Taxis)

19,000

1.8

610

(50)2

(4.8)

(2.7)

[9.5)

(5.1)

(6/40)

Cross-Boundary Service Enhancements

77,000*

7.6

195

29

2.8

1.5

55

29

14.40

20,000

2.0

3,000

2

0.2

0.2

0.4

0.4

0.07

134,000

13.2

20,400

26

2.5

2.3

4.9

4.5

0.12

Specialized InterJurisdictional Service

29,000

28

157

39

3.8

2.5

7.4

4.8

24.0

Design Improvements for Ambulatory Passengers

59,000

3.8

1,800

1

0.1

0.1

0.2

0.2

0.06

4,000

0.4

12

7

0.6

0.6

1.2

1.2

54

4,400

0.4

33

13

1.3

0.8

25

1.6

39

16,000

1.6

240

1

0.1

0.2

-

RURAL TRANSPORTATION Block Grants Accessible Vehicle Subsidies URBAN TR ANSPOR T M unicipal Specialized Service Expand Eligibility and Audit Accessible Taxi Subsidies

Public T ra n sit Added Training (Blind & Mentally Disabled Persons) Design Improvements for Ambulatory Passengers IN TER -R EG lO N A L SER V ICE

Research and Demonstration for OnCall Accessible Bus Service INTERCITY SERVICES Accessible Intercity Buses

Design Improvements for Ambulatory Passengers

1) Number of Registrants. 2) Brackets denote co6t savings. 3) Includes those registered currently. 4) Assumes that only additional registrants (from expanded eligibiltiy) benefit from taxis. 5) Excludes cost to user (i.e. fare). 6) Over-and-above that spent by training centres and trainees already. 7) From 1986 figures using a factor of 1.96 (projects 20% increase in target population and assumes 3% inflation per year).

0.40

DISABLED PERSONS IN ONTARIO

245

The strategy does, however, see the need for research into a possible role for limited lift-equipped service in the provision of long-distance, line-haul bus transportation, the area in which fixed-route accessible service has the greatest potential effectiveness and efficiency. As well, the strategy includes provision for limited modifications to all existing fixed-route transit infrastructure to make it more effective and efficient for mildly and moderately disabled persons to use. These are individuals who can already use the fixed-route systems but find doing so relatively difficult due to design shortcomings. The approach displayed in the Summary Table contains five principal components, mirroring the problems under current policy discussed earlier. In selecting initiatives for inclusion under each component, the full range of possible approaches was explored. The final selection reflects the optimization objective outlined above. The five components correspond to the major problem areas under current policy but they do not stand as independent planning elements. Indeed, while each contains the basis for initiatives that serve a particular sector, a number of the initiatives benefit other sectors as well. The accelerated development of crossboundary specialized transit in small municipalities, for example, would benefit residents of such areas’ rural hinterland as well. The discussion below summarizes the strategy for each component in turn. The final section discusses implementation issues. Personal Mobility. A wide range of alternatives exist for improving the personal mobility of disabled individuals, but all revolve in one way or another around improving access to private cars. As shown in the Summary Table, a program of subsidized acquisition of adaptive equipment (hand controls and other accessibility features) would require a provincial budgetary commitment of an estimated $8 million annually and would benefit about 15,000 individuals living in both urban and rural areas. Extended to both disabled drivers and households of disabled persons, the program would improve the personal mobility and safety of these disabled persons. A program of assistance to wheelchair users for the lease or purchase of automobiles would cost substantially more — an estimated $19 million annually in provincial resources if a high share of the cost of the car (90 percent in this example) were covered and if only drivers were to be eligible. More than 12,000 urban and rural severely disabled Ontario residents would benefit from the program, many of whom do not drive today because of the prohibitive cost of lease or purchase. A number of methods could be employed to implement this program, including costreducing schemes such as the provision of a loan component to discourage frivolous demand and encourage recipients to use the car to find and engage in productive work. This is the basis of Britain’s highly successful "Motability" program. Alternatively, the share of total cost to be covered by provincial subsidy could be reduced, again to preserve incentives and to hold down provincial expenditures. Rural Transportation. As indicated earlier, the analysis presented in the body of this report finds a wide array of transport available to disabled persons in rural areas, including autos, volunteer services and taxis. The principal problem appears to be insufficient supply. Rather than target particular services for provincial

246 MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS attention, however, the strategy presented here draws on the mechanism of provincial block grants. Under this approach, the provincial government would make grants of about $3 million annually to small municipalities and rural authorities for subsequent allocation to various transportation initiatives, such as volunteer programs, service clubs, the establishment of taxi-oriented user-side subsidies, the acquisition of accessible vehicles or for other transportation approaches, at the discretion of the municipality. The rationale behind this approach is that existing rural transport for disabled persons varies greatly among localities; moreover, each locality displays a diversified web of individual and group efforts, efforts of local service organizations and of commercial operators that are organized in a wide variety of different ways. Only the localities themselves are fully aware of these arrangements and are thus in the best position to allocate augmented funds effectively. Accountability for the effectiveness of provincial expenditures would nevertheless require an element of provincial control. This could be achieved through the creation of rural transportation advisory boards, organized for the purpose of advising rural authorities in drawing up Local Transportation Plans (LTP’s) for provincial approval prior to receiving the funds. The establishment of such boards would be consistent with recommendations of the Ontario Advisory Council on Senior Citizens and the Ontario Advisory Council on the Physically Disabled. LTP’s would be up-dated and re-submitted annually. It should also be noted that initiatives discussed earlier involving the private automobile would be of relatively greater benefit to residents of rural areas that are not served by regular or specialized transit service. Urban Transportation. The strategy for urban areas focuses on improvements in the effectiveness and efficiency of existing specialized transportation systems; the strategy also includes modifications to fixed-route transit as a means of improving its effectiveness for ambulatory disabled persons. The strategy outlined here does not, however, include the adaptation of fixed-route systems to make them accessible to those unable to use steps — an approach often called full accessibility. In the case of municipal bus systems, full access was found to offer less mobility than the existing specialized service approach. In very small bus systems, equipping the vehicles with lifts can cost less than the operation of a specialized service. At the same time, however, the likely draw on provincial and municipal budgets would likely claim resources that would otherwise flow to specialized service, thereby diminishing the quality of the more effective option. As shown below, the strategy calls for enhanced eligibility for specialized service, a step that requires additional resources. It would not be possible to adopt a strategy of full access as well without putting the more effective option at risk. Full access with regard to the Toronto Transit Commission’s (TTC) subway system was explored and found to offer the prospect of very little mobility at very high cost. Although the marginal cost of making stations accessible in the construction of a new subway system is only about one percent of total cost, all existing key stations (about half the stations in the TTC system) would need to be re-fitted with elevators and other modifications at an estimated cost of $180 million. Moreover, if

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the use of these stations by disabled persons were to mirror the use of U.S. accessible systems the cost per trip could be as high as $8,000. What about a gradual strategy of full access, making only new stations and buses accessible? This study concludes that in relation to provincial objectives for mobility, economy and efficiency this approach would, in many instances, defer resources from their most effective and efficient use. In particular, while the marginal cost of making new facilities accessible is relatively low, additional resources would have to be deployed to make key portions of existing systems accessible as well — otherwise the network as a whole would not be useful to disabled persons. This in turn would create the high additional costs outlined above and dampen the availability of budget dollars for programs that promise greater mobility. On the other hand, where wholly new and self-contained accessible networks are considered, the low marginal cost of full accessibility would not necessarily be prohibitive. If full access were to limit door-to-door service, however, the travel opportunities of many severely disabled persons would be constrained. These cases, however, will need to be considered on their individual merits. Under the strategy presented here, improvements in the effectiveness of specialized, door-to-door systems in municipal areas would be brought about through a somewhat broader provincial eligibility standard and the accelerated development of crossboundary transportation. The analysis indicates that the number of disabled persons who require specialized service — about 61,000 persons who cannot board or gain independent access to transit stops - - is substantially greater than the 27,000 who qualify under the existing "unable to board" eligibility guidelines. On the other hand, the analysis also finds that municipalities actually extend eligibility well beyond the strict interpretation of municipal guidelines. More than 53,000 disabled persons are registered to use municipal specialized services (1986), only about 20 per cent fewer than the estimated 61,000 enumerated above. The strategy thus makes allowance for a revision to the provincial eligibility guidelines without risking an unmanageable increase in demand and cost. The strategy also calls for an eligibility audit system to ensure that municipalities do not use provincial funds to subsidize trips by ineligible individuals. The analysis also finds that about one-third of all legally blind persons and as many as 45 per cent of mentally disabled persons have difficulty using regular fixed-route transit and could thus benefit from specialized transit. A number of these individuals have physical disabilities that already qualify them for specialized transit; moreover, many municipalities accept those with the greatest problems even in cases where they do not strictly qualify under existing provincial guidelines. It appears however that some mentally disabled and blind persons who cannot use fixed-route transit are not eligible at present. The strategic issue is whether to extend the official provincial eligibility guidelines to include mentally disabled and blind persons who have difficulty using fixed-route transit. The strategy outlined in the Summary Table rests on the premise that such an extension ought not be implemented due to the sizeable budgetary risks and risks to service quality that such an extension would entail. The reason for these risks

248 MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS is that it is extremely difficult, and often impossible, to distinguish objectively among mentally disabled and blind persons on the basis of functional ability. Extended eligibility is thus very likely to result in virtually all such persons obtaining registration rights for specialized service, including those who can, with training, use existing fixed-route transit. Under such circumstances, the specialized transit budget would either have to expand substantially, or service quality would need to be sharply reduced as existing vehicles are used to serve a considerably greater number of persons. It is noteworthy that with even limited expanded eligibility, the average cost-pertrip of specialized services in Ontario could be expected to decline by about 15 percent (see the Summary Table). This means that the additional cost to the province of expanding program eligibility is likely to be less than proportional to the increase in the number of eligible users. Cost-per-trip can be expected to decline because newly eligible persons have disabilities that enable them, on average, to get in and out of vehicles more quickly than existing passengers, many of who use a wheelchair and thus require additional boarding time. With faster average boardings, system productivity (trips per vehicle-hour) would increase and cost-per-trip would thus decline (cost-per-trip being simply cost per vehicle-hour divided by trips per vehicle-hour). The remaining strategic question is how to approach the problems of mentally disabled and blind persons who are ineligible for specialized transit. The plan outlined in the Summary Table provides additional funds for training these individuals in the use of fixed-route transit. This approach, together with the fact that those with the most serious problems are being admitted to the system anyway, would allocate resources to these individuals with due regard for effectiveness and efficiency. A number of municipalities already serve cross-boundary demand. Improvements in cross-boundary travel would stem from enhanced provincial resources for this activity. The cross-boundary problem is particularly acute in the Toronto metropolitan region; under the strategy presented here, these demands would be served through door-to-door initiatives in the GO Transit service region, as outlined later. Measures designed to improve municipal specialized transit’s efficiency would also lead to greater cross-boundary effectiveness. By creating the incentives to encourage more public-private partnerships in the provision of specialized transit, unit operating costs for specialized transit overall would decline. This is because the taxi industry operates with lower labour costs than the public transportation industry generally. Effectiveness would improve because taxi operations can typically operate with shorter advance request and en-route travel times and serve a greater number of cross-boundary trips, the cost of which are reflected in the Summary Table. As well, savings could be used to improve the quality of existing publicly operated specialized service. Over time, accessible taxis can be brought into the system. All this assumes, however, that the use of subsidized taxi services as a component of specialized transit could be successfully implemented without impeding the efficiency of commercial operators and that commercial operators would be willing to participate. Experience in the United States indicates that neither assumption

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can be taken for granted. Some cities have contracted with a single operator only to find that in the absence of competition price and service are no better than publicly operated public transit. Where competition among taxi operators has been retained (Phoenix, for example), true efficiencies have been achieved. And while some cities report positive experiences with private partnerships, others (such as South Portland, Maine) have been unable to attract the taxi industry to participate at all. For these reasons, this element of the strategy must be implemented carefully and cannot be expected to develop quickly. It should be viewed as a medium to longer term initiative - - one that is well worthwhile but one that would take shape gradually. Inter-Jurisdictional Service — The GO Transit Situation. The analysis presented in the main report spans a wide spectrum of options for providing commuter services in the GO Transit region that disabled persons can use. As in the urban case, full access to the fixed-route modes (commuter rail and inter-jurisdictional buses) was found to offer the prospect of little additional mobility and high cost. The analysis also revealed technical barriers associated with extended dwell times at rail stations. The inter-jurisdictional strategy outlined in the Summary Table features three components. The first would accelerate the implementation of improvements to existing GO Transit stations, bus stop environments and vehicles in order to improve the effectiveness of the system for ambulatory disabled persons. These improvements would benefit fully 59,000 disabled residents of the GO Transit service area and would likely aid a great many others who, though technically not classified as disabled, endure minor arthritis and other conditions that make the existing system less than fully effective. The second initiative involves the introduction of specialized, door-to-door service for in ter-jurisdictional journeys in the GO Region. The service envisaged here would be contracted by GO Transit to commercial taxi operators and coordinated by a central dispatching function operated either by GO Transit or contracted to a commercial firm. It is important to note that the service would not be tendered to a single taxi firm but rather be open to several firms. This approach retains an element of competition among providers so as to ensure the lowest possible fares; competition would also helps maintain high service quality; as well, the use of several firms would allow the dispatcher to optimize productivity and thus diminish costs by drawing on many vehicles and thereby minimize deadheading. The approach would also involve financial assistance to commercial taxi operators for the purchase of accessible vehicles in sufficient quantities to handle the demand among wheelchair users. The approach envisaged in the Summary Table foresees half the cost of these vehicles being covered by the provincial government and half shared between municipalities and the commercial operator. Finally, the strategy addresses the question of access to fixed-route services operated by GO Transit. In developing the strategy, the possibility of making the commuter rail service and the commuter bus service accessible to wheelchair users (and those with similar functional disabilities) was explored in terms of effectiveness

250 MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS and cost. On both counts, these options scored very poorly, with forecasts indicating low trip making, high capital and operating outlays and cost-per-trip often in the hundreds of dollars. One option, however, does suggest a possible role for accessible fixed-route service, though more research and development is needed. The option is called On-Call Accessible Bus Service, or OCAB. Under this initiative, a GO Transit bus route would operate an accessible bus if requested to do so by a disabled person. If the disabled person demonstrates that the vehicle would be used regularly, then the bus could become a permanent feature of the route. In this way, the OCAB system would activate the need for accessible buses only in the event that demand is revealed, thereby diminishing financial risk. Accessible fixed-route service in a line-haul, long distance commuter environment is found to be more effective than in an urban network environment due to the absence of transfer and other network requirements that increase the number of accessible vehicles needed. As well, long-distance, line-haul service could more easily compete with door-to-door service when trip lengths are very long. Interregional door-to-door trips in the GO Transit region would cost, on average, some $30.00 per trip (including fares) - - f a r higher than the $16.00 associated with municipal specialized service. Longer than average inter-regional trips would cost even more. A taxi journey from Barrie to Toronto, for example, would likely exceed the estimated $54.00 per-trip cost of OCAB. It is in this long-distance environment where, at first blush, it seems that OCAB could prove cost-effective. On the other hand, if door-to-door feeder service were required at either end of the line-haul journey, any relative cost-effectiveness advantages of OCAB could quickly evaporate. The OCAB concept should thus be viewed as a possible subject for further research and development, not as a ready-to-go element of the strategy presented here. Intercity Services. This part of the strategy involves the province in providing financial incentives to the intercity bus industry to equip their vehicles with lifts. As the public transport mode covering the largest intercity network, this approach is found to be potentially more effective than accessible rail services or other forms of accessible bus transportation (such as station-based lifts). At hundreds of dollars per-trip, door-to-door services over long intercity distances are found to be cost ineffective. Air services (including both airport and airline aspects) are found to be improving steadily but in need of further encouragement. From the provincial standpoint, travel to and from the airport appears to be the most relevant problem. It would be dealt with most effectively through the urban and rural programs that foster door-to-door service. Beyond this, an active provincial liaison with the federal government and with airlines is appropriate in order to stay abreast of — and influence — their efforts to enhance airport (including airport parking) architectural improvements and airline procedures regarding disabled passengers. Here again, it is noteworthy that initiatives in the personal mobility section of the strategy, designed to extend the availability of private cars, would be of particular

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significance. Given a choice, most disabled persons choose the car over the bus or the plane and many cannot afford to travel by air. 4.0

Strategic Policy and the Planning Process

A number of general conclusions emerge from the strategy summarized in this report. First, while a large number of disabled persons gain substantial benefits from provincial transport policies, they represent a small proportion of the disabled population generally. This results from the fact that not all disabled persons have disabilities that result in transportation problems. As well, most disabled persons have access to private cars and elect not to avail themselves of publicly sponsored transport programs. Moreover, among those who do use such programs, many regard them as a "back-up" to the auto and thus do not use them on a regular basis. At present, about five percent of the disabled population gain from provincially sponsored transport programs at a provincial cost of about $14 million annually (in 1986). Under the broader eligibility strategy presented here, this proportion could rise to about 25 percent while the provincial budgetary commitment could eventually increase four-fold. Among these, about 13 percent are mildly or moderately disabled persons who would gain from design improvements to existing fixed-route transit services. And about 12 percent are severely disabled individuals. Among these, just under eight percent are urban residents who would gain from expanded specialized services; almost three percent are rural residents; and between one and two percent are persons who would gain from greater access to private autos. As discussed earlier, the strategy presented here is just that, a strategy. It provides broad direction with regard to transport modes, methods of subsidy, private sector participation, expected costs and expected benefits. It does not indicate when a particular initiative should be implemented nor does it prescribe the exact scope of a given initiative or indicate in what combination various actions should be taken. Indeed, it is clear from Summary Table 4 that implementing all the initiatives, in their full scope, simultaneously could require a four-fold increase in the provincial transport budget for disabled persons. Although this report does not recommend against such an increase, the point here is that the strategy presented in Summary Table 4 does not confine the province to any one approach. The specific approaches taken will depend upon the budgetary resources available and the priorities of decision makers. In other words, the decisions to be made are planning and programming decisions that should follow the adoption of a strategic policy. The strategy presented here is intended to provide sufficient information to guide the process of shaping priorities in consultation with providers and user groups and to steer the adoption of a rational and effective plan for the decade ahead.

IMPROVING OPPORTUNITIES FOR STATEWIDE TRAVEL IN M A S S A C H U S E T T S

Ms. Denise Karuth Chairperson Governor's Commission on Accessible Transportation 1.

Mr. Russell H. Thatcher Transportation Planner

INTRODUCTION

This paper describes efforts undertaken by the Commonwealth of Massachusetts to improve options available to persons with disabilities for travel between cities and regions of the state. Key elements of this effort, described in this paper, include: (1) the purchase of the first wheelchair-lift equipped intercity coaches operated in the United States; (2) the development of a "reciprocity" agreement between all of the state's public transit operators so as to provide local service at either end of a trip; (3) the development of a standard identification card to allow reduced fares on public transit services to be extended to all disabled residents of the state; (4) the expansion of hours of operation of local paratransit services to better meet the time requirements of extended travel; (5) statewide public information and marketing efforts to provide disabled persons with information about services in all regions; and (6) local consumer participation in the development of the program. The Commonwealth of Massachusetts is the 12th most populous state in the United States. Its 5,832,000 residents (1986) live in an area of 21,303 square kilometers. Over 83% of its residents live in urban areas with the vast majority living in the Boston metropolitan area which is home to some 4,051,400 persons (1985). From Boston, the state's capital and largest city, in the east to the City of Pittsfield in the west, is a distance of 146 miles (235 kilometers). Travel to Cape Cod, the resort community located on a peninsula jutting out into the Atlantic Ocean can add from 70-120 additional miles from Boston. Massachusetts contains 351 cities and towns and is noted for a centuries-old tradition of strong locallycontrolled governments. In many communities, citizen participation in annual town meetings still determines local policy. Local, publicly-subsidized transportation in Massachusetts is provided by fifteen (15) regional public transportation agencies (PTAs). These agencies act as semi-autonomous public authorities and are guided in 252

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their system design and expenditures by those communities that have voted to join a PTA and pay for services. Collectively, these 15 agencies serve 268 of the state's 351 cities and towns. All urbanized areas of the state (defined as regions around a city with a population of at least 50,000 persons) are included in this network of local service. Figure 2 shows the areas of the statethat are included in this network.

The type of service provided locally varies from area to area. All of the PTAs, however, provide a combination of both fixed-route service and paratransit service. The Massachusetts Bay Transportation Authority (MBTA), which is by far the largest transportation agency, serves the metropolitan Boston area and provides bus, commuter rail, rapid rail, light rail, and commuter boat services as well as a paratransit service which provides approximately 4,000 one-way trips per week to disabled persons. The remaining PTAs vary in size. The Pioneer Valley Regional Transit Authority, which serves the Greater Springfield Area, operates 224 fixed-route buses and a paratransit service that provides 5,400 trips per week to elderly and disabled residents. The Martha's Vineyard Transit Authority provides seasonal fixed-route bus service and a five vehicle paratransit service for the resort island of Martha's Vineyard. Service provided by these 15 PTAs prior to the initiation of the state's inter-regional transportation program was largely confined to the cities and towns within each region. A few PTAs did provide paratransit service outside of their region but this was almost exclusively for specific purposes such as specialized medical care. Accessible, regularly-scheduled public transportation between cities and between PTA regions was not available.

Local paratransit service in all but one of the PTA areas was also provided exclusively to residents of communities which were members of the PTA. Each PTA established its own guidelines for paratransit eligibility and issued its own form of identification for reduced fare benefits. Even if an individual was able to travel from one region to another, local paratransit service and reduced fare benefits were not available in that other region. It is also important to note that local paratransit services were not available to individuals who lived in one of the 83 communities outside of the PTA network.

Public transportation between cities and between regions of the state is provided by a network of private, for-profit bus companies. Figure 1 is a schematic of the private bus routes throughout the state. There were seventeen (17) Massachusetts-based companies

10

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225 buses as of January, 1986. Most of this operating service is commuter-oriented and radiates out from the City of Boston. A number of out-of-state companies including national companies such as Greyhound also serve the state. Unlike many of the PTA bus systems, however, this private network was not accessible to persons with disabilities - particularly those persons who use wheelchairs. None of the privately-owned intercity buses were equipped with wheelchair-lifts.

These factors combined made it extremely difficult and costly - if not impossible - for persons with disabilities to use public transportation to travel outside of the region in which they lived. In general, the following three options were the only alternatives for interregional travel: (1) the use of a private vehicle, if available; (2) the hiring of a private ambulance or van service; or (3) the use of inaccessible private bus or taxi services. Private ambulance and van services are prohibitively expensive. For example, a round trip from Boston to Springfield and back, which is a trip of 180 miles (290 kilometers) costs approximately $500. Use of inaccessible bus and taxi services necessitates carrying or otherwise assisting passengers who use wheelchairs onto the vehicles - an unacceptable alternative for many wheelchair users and a physical impossibility for at least one-third of this population.

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ADVOCACY FOR AN IMPROVEMENT IN INTER-REGIONAL TRAVEL OPTIONS

Improving inter-regional travel options for persons with disabilities was identified in 1984 as the priority issue of the state's largest coalition of disabled persons - the Massachusetts Coalition of Citizens with Disabilities (MCCD). The leadership of this organization began discussing alternatives with the state's Office of Transportation and local chapters began soliciting input and support from members. MCCD's advocacy was bolstered by findings of the Governor's Commission on Accessible Transportation (GCAT)(1), which was formed in 1984 to investigate shortcomings in the public transportation system and to make recommendations for change to the Governor.

As originally envisioned by consumer advocates, eligibility guidelines for paratransit services and reduced fare benefits would be standardized and a single identification card would be issued which would make these programs available to persons statewide. 3.

THE INTERCITY BUS CAPITAL ASSISTANCE PROGRAM(2) (IBCAP)

The first opportunity to begin addressing interregional travel needs arose with the passage of legislation which created the Intercity Bus Capital Assistance Program (IBCAP). This program was developed to provide public support for the private bus industry which was operating an aging fleet and losing ridership. Under the program, the state allocated $10 million for the purchase of intercity coaches that would be owned by the Commonwealth and then leased to the bus operators at rates 50% lower than commercial lease rates. Public involvement in the purchase of these buses provided an opportunity to investigate alternatives for making these vehicles accessible to wheelchair-users and other persons with disabilities. (1)

The Governor's Commission on Accessible Transportation was composed of twelve persons with disabilities, eight state legislators and representatives of three state human service and transportation agencies. Seven public hearings and several additional issue-specific hearings were held across the state at which the full range of accessible transportation issues were discussed including policy and regulation, private vehicle ownership, and fixed route and paratransit services provided by state PTAs. The Commission's three hundred findings and recommendations are contained in eight position papers which total over three hundred pages.

(2)

Much of this section is taken from Lebeaux, Sharff, "Wheelchair Access to Intercity Bus Service: The Massachusetts Experience", Community Transportation, Oct/Nov, 1987.

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The state*s Office of Transportation learned that the Canadian government was concurrently working with Motor Coach Industries (MCI), a major bus manufacturer, to develop wheelchair-lift technology that could be fitted onto an intercity coach. A prototype vehicle had been placed in service in Newfoundland by Transport Canada in January of 1985. It was learned that this vehicle was operating successfully. An agreement was negotiated with MCI in July of 1985 to equip six of the state*s first order of twenty-eight (28) coaches with this prototype lift. One bus was leased to each of the six companies that received this first order of IBCAP vehicles. Figure 2 shows the routes on which the first order of buses were placed.

As shown in Figure 3, the prototype lift mechanism is located in one of the vehicle's luggage compartments at approximately the midpoint of the bus. It is an "elevator-style'* device that utilizes a section of the bus* floor as a lift platform. This floor section is lowered, on four "screw posts" that operate off of the vehicle's hydraulic system. As originally designed, the lift was activated using a hand-held microprocessor that controlled numerous safety interlocks. The cost of each lift was 30,000 U.S. dollars.

Each bus is designed to accommodate two wheelchair users. The first securement position is located immediately in front of the lift and the passenger is secured ' in a rear-facing position. The second wheelchair user can be secured in a forward-facing orientation on the lift platform when it is raised to floor height. If only one wheelchair passenger is being transported, a quick-release seat can be added in front of the lift to minimize seat loss.

All twenty-eight buses purchased in early 1986 were also equipped with an extra retractable front step, with extra handrails, and with public address systems. The retractable step divides the vehicle's 16 inch first step height into two 8 inch steps. The step is activated by the driver and retracts automatically when the front door is closed.

While the lift mechanism performed fairly well during the initial months of operation, two recurring technical problems were identified which affected its reliability. The microprocessors on three of the buses occasionally malfunctioned which necessitated use of the manual back-up system. Problems were also experienced with the "shroud" that surrounded the lift platform as it was lowered through the baggage compartment. A decision was made in consultation with MCI and the lift manufacturer - TES Ltd - to eliminate the microprocessor and to rewire the lifts for direct electrical operation. Safety features and interlocks

c u rre n tly a c c e s s ib le b u s ro u te s

b u s ro u te s p la n n e d fo r 1 9 8 8

1 R TA S e rv ic e A re a s

2

Source: Executive Office of Transportation and Construction

C _ 5 ..

Legend

FIGURE

Intercity Bus Routes and Regional Transit Authorities Service Areas

'C

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during this redesign. Problems with were maintained the shroud were also corrected. Since the end of 1986, the lifts have performed reliably. Weather has had little effect on the lift's reliability because all working parts are located inside the bus. Two operational issues also had to be addressed. Intercity bus loading areas are ordinarily arranged in a >"saw-toothed" pattern with the buses parked at an angle to the terminal and separated by low concrete platforms about 4 feet wide. The use of the prototype lifts requires a platform dimension about 6 feet wide. Wider platforms at the ends of the terminal had to be utilized until facilities could be redesigned. The placement of only one bus with each carrier also raised the issue of how to most efficiently allocate and schedule this limited resource. Local consumer

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input was sought by the state and the bus operators on this issue. Four carriers chose to assign their buses to specific routes identified by local consumer advisory groups. The other two carriers, with more extensive systems, chose to require 24 hour advance notice and to assign the accessible bus as needed.

Schedule adherence has not been an operational concern. Carriers typically schedule sufficient layover time for baggage checking, ticket inspection, and boarding announcements. Occasional lift operation has not added materially to the time required for these routine operations. The major impact on carrier operation has been the loss of six to eight ambulatory seating positions. This becomes a problem for companies operating at or near capacity during peak hours. A second order of buses, due to be delivered in May of 1989 will address this problem by utilizing a more compact lift design and seats which can be folded and slid onto and off of the lift platform. This new design (illustrated in Figure 4) will provide a "zero seat loss'1 interior arrangement. FIGURE 4: NEW "ZERO SEAT LOSS" SEATING PLAN

4.

STATEWIDE PASS AND RECIPROCITY AGREEMENT

As noted above, a major limitation to inter-regional travel was the inability to use local paratransit services in other areas of the state. To make travel on the new accessible intercity buses a real alternative, this problem had to be addressed. In anticipation of the IBCAP program, the state Office of Transportation began working on this issue with the 15 PTAs in late 1984.

Initially, two local concerns hampered efforts to negotiate a "reciprocity" agreement. A standard criteria for paratransit eligibility could not be agreed upon. Rural PTAs tended to have more liberal criteria. PTAs in urbanized areas, which had more extensive fixed-

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route service, had eligibility criteria which were more restrictive in order to promote maximum use of mainline services. The MBTA, which was expected to receive the greatest number of additional trip requests, also expressed concern about the impact that the program might have on its existing paratransit service.

The final agreement negotiated by the state Office of Transportation addressed the first of these concerns by creating statewide eligibility standards which were general in nature. Each PTA retained the right to establish its own specific criteria within this basic statewide framework. All 15 PTAs agreed to accept paratransit service requests from individuals determined eligible by other public transit agencies despite the fact that minor differences in eligibility criteria existed. To address the MBTA's concern, a limited "core" area was identified in downtown Boston within which paratransit service would be provided to nonresidents. This area included the city's major ground transportation terminals, several medical facilities, the downtown shopping and employment centers, and the airport. While paratransit was limited, all other MBTA services including accessible fixed-route buses, rapid transit, and rail services were made available. Other important provisions of the agreement included: (1)

The designation of a single, central telephone number within each PTA area for trip requests made by non-residents. This provision was important because many regions utilized several paratransit programs and operators. Under the agreement, one designated operator was responsible for making the necessary local arrangements;

(2)

A requirement that each PTA maintain a current, easily accessible list of persons determined eligible to use paratransit services. This permitted spot verification of eligibility by other PTAs?

(3)

The inclusion of all of the state's 351 cities and towns in the program. Non-member communities were assigned to one of the 15 PTAs. Eligibility determinations were performed for residents of those cities and towns by the designated PTAs. Although service was not extended to these nonmember communities, this provision made it possible for residents from these areas to receive paratransit service when they travelled to regions which were within the public transit network.

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In addition to paratransit reciprocity, the agreement signed by the PTAs established a statewide photo identification card - the "Transportation Access Pass" which entitled holders to reduced fares on mainline services (buses, subways, railroads) throughout the state. It is hoped that this pass (shown in Figure 5) will eventually replace the fifteen different forms of identification used by the PTAs.

FIGURE 5: STATEWIDE TRANSPORTATION ACCESS PASS

4.

EXPANDING LOCAL PARATRANSIT SERVICE

Another statewide initiative which was being pursued concurrently and which was important to inter-regional travel options was the expansion of local paratransit service hours. Many local programs were designed around the needs of elderly persons (local shopping, medical trips, noon meal programs, etc.) and had limited hours of operation. Given the fact that travel across the state involved several hours and that there were limited numbers of buses running between certain regions, trips often could not be completed between 9:00 a.m. and 5:00 p.m. when local paratransit was typically available. Beginning in 1986, the state's Office of Transportation offered additional operating assistance to PTAs as an incentive to expand local services. The goal of this program was to have paratransit service operating from at least 7:00 a.m. to 7:00 p.m., Monday through Friday, as well as on weekends and during the evenings. As of December, 1988, fourteen of the fifteen PTA regions provide service from 7:00 a.m. to 7:00 p.m., nine offer weekend services, and seven p rovide limited paratransit service during evening hours.

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MARKETING AND CONSUMER PARTICIPATION

Local MCCD chapters assisted with the inter-regional initiative throughout its design and implementation. This involvement was particularly helpful in the development of driver training programs, the selection of routes to which buses were dedicated, and in the development and distribution of public information. A brochure entitled "Removing Roadblocks to Opportunity: A User's Guide to State Transportation Services for Disabled Persons in Massachusetts" was jointly developed by the MCCD and the state Office of Transportation (see Figure 6). The brochure provided information about the IBCAP program, a map showing the state's 15 transit regions, and the telephone numbers needed to request service from bus carriers and RTA's. Also included was information about airport travel and accessible ferry s ervice. FIGURE 6:

6.

BROCHURE DESCRIBING SERVICES STATEWIDE

OUTCOMES, FUTURE DIRECTIONS

Implementation of the above described programs has removed a number of barriers to statewide travel for persons with disabilities. With only six accessible intercity coaches in operation, however, the benefit of these programs is yet to be fully realized. Demand for the service, which has been low to date, can be expected to increase as more of the state's 225 intercity

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buses are made accessible and as the program becomes better known. Demand should also increase as the overall transportation system in Massachusetts becomes more accessible.(3)

Another twenty-two (22) accessible coaches have been ordered by the state's Office of Transportation. Delivery is expected in June of 1989. This second order of buses will be equipped with a modified lift and interior package that will be less obtrusive and will eliminate ambulatory seat loss.

The program had at least one unexpected outcome. Mr. John Winske, a wheelchair user and MCCD member, took one of the lift-equipped coaches to attend the MCCD Annual Meeting and advance his candidacy for Chairperson of the Coalition. As he was working the crowd, he noticed "a really beautiful woman" who turned out to be Joy Bevan, a former classmate of his at the Massachusetts Hospital School. Soon Joy was commuting from Fitchburg to Boston each weekend on the accessible bus operated by Englander Coach. Their courtship continued in this fashion for a year until their wedding on June 18, 1988. Now they use the accessible coach to visit their families. 7.

IMPLICATIONS FOR NATIONAL AND INTERNATIONAL TRAVEL

Wheelchair-lift equipment for intercity buses is now a proven technology. Motor Coach Industries, the builder of the buses used in Massachusetts, now offers this lift as an optional item to its customers. At least one other manufacturer is also developing a similar lift. (3)

By direction of Secretary of Transportation Frederick P. Salvucci, all future bus, heavy rail (subway) and commuter rail vehicles purchased by the state and local transit authorities will be accessible. These vehicles will be used in an increasing number of new and rehabilitated accessible rail stations. At the MBTA, for example, 10 subway and 2 commuter rail stations were accessible to persons using wheelchairs in 1984. As of January 1, 1989, 22 subway and 28 commuter rail stations are accessible. Twenty million dollars (US) have been set aside in the 1988 Massachusetts Transportation Bond Issue to make an additional 15 subway stations accessible and a feasibility study is under way to make recommendations for access on the MBTA's antiquated light rail system. An accessible docking system has also been implemented on some Massachusetts ferry lines and an accessible interterminal shuttle has been put in service at Logan International Airport, which serves the metropolitan Boston area, by the Massachusetts Port Authority.

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Intercity bus operators in other states and countries should consider making a portion of their fleets accessible to wheelchair users. Regulators should not consider technology an obstacle to requiring access in this industry.

The "reciprocity" agreement, statewide pass program, and public information efforts developed in Massachusetts could also serve as a model for national and international application. Reciprocity between states and between countries should be pursued even if the eligibility criteria used by each varies. A standardized form of identification should also be considered to make national and international travel easier. Information about services available in each country should be maintained by the federal ministries and departments and this information should be shared, possibly through existing airline and travel agency computer systems. As discovered in Massachusetts, these efforts can be implemented at a reasonable cost and with minimal change to existing services and can greatly expand travel opportunities for persons with disabilities.

COMMUNITY TRANSPORT MARKETING AND ITS EFFECT ON ELDERLY PERSONS; POLICIES, STRATEGIES AND IMPLICATIONS Mr Mr Dr Mr 1.

John Abbiss, Senior Lecturer, Trent Polytechnic, Nottingham Steve Cassidy, Research Asst, Trent Polytechnic, Nottingham David Gillingwater, Senior Lecturer, Loughborough University Stuart Swift, Senior Lecturer, Trent Polytechnic, Nottingham INTRODUCTION

Since the beginning of the century, there has been a significant increase in the numbers of elderly people (aged 65 or over) in the UK. From a total of 2.4 million in 1901, the number increased to 8.8 million by 1987 and is expected to reach 11.3 million in 2025 due to the post World War 2 baby boom. As Figure 1 shows, the greatest increases are in the numbers of 'frail elderly' comprising those aged 75-84 and 85 or over. The latter are expected to comprise 12.4% of the total elderly population in 2025 compared to 9.1% in 1987. The consequences of this for demands on health care and personal social services are clear to see. This paper examines the underlying influences affecting the response of voluntary sector transport organisations in meeting these changing demands.

Figure

2.

1

Change« in the Elderly Population in the UK (Source: Social Trends

CHANGING SERVICES

1S51 - 2021

19, HMSO, London, 1989)

The U.K. public transport sector has recently undergone significant changes. The 1985 Transport Act heralded a shift to a free market approach to transport provision. The results of this shift have varied throughout the country. However, specific problems for rural communities have emerged due to low and diffused demand for transport in these areas. Due to the nature of this demand, neither the free market, nor even the publically (subsidised) tendered bus service, has always been able to meet 265

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travel needs. One approach to overcoming some of these problems was the establishment of the Rural Transport Development Fund by central government. This provides grants to promote innovative services to meet the needs of rural areas, and is also used to employ Rural Transport Advisers, to aid in the innovation process. These Advisers encourage commercial and voluntary sector transport operators to fill the transport gaps in rural areas (1) However with limited resources and manpower there are still large gaps in rural transport provision. Thus, the transport services, which will have to cope with the increased demand from the elderly, are in a state of flux.

3.

CHANGING POLICIES

Transport: services are also affected by the policy shifts in health and social services. Central government is playing a decreasing role in the provision of welfare services, leading to a rationalisation of the services it provides, and decreased expenditure on them. This can be seen as a shift to welfare pluralism (2) with an increased role for the voluntary, commercial and informal sectors. Symptomatic of this are the pressures on health and social service facilities and associated transport. The move to 'care in the community' began in the early 1970's and has intensified over the last decade. This movement away from residential care has increased the demand for transport to health facilities from patients now located in the community. Added to this, the 1989 White Paper on 'The Future of the National Health Service' is predicted to reduce the number of welfare facilities, and increasingly centralise those remaining. Due to these policies, demand for public sector health and social services transport is already high and could rapidly increase. Coupled with these pressures on facilities has been the reduction in the availability of public sector transport to these facilities provided by Health Authorities and Social Services Departments. Past "abuse" of Ambulance Services (by patients who could have travelled by other means), and reduced funding of them has often led to tighter eligibility criteria. Social Services transport has also been under increasing financial pressure. Hence, not only are there increasing demands for public sector transport, but public sector transport services are less able to meet them.

4.

THE GAP IN RURAL TRANSPORT PROVISION

Consequently, the situation facing the elderly in the UK is one in which public sector transport is under pressure in meeting the demands placed upon it because of the reduced role of the state in welfare services. This shift towards a free market philosophy

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has reduced the level of transport services in rural areas. Together these create a 'gap' in transport provision, as discussed by Sutton (3). This is created by the restriction in Health and Social Services transport and the inaccessibility and scarcity of public transport. This raises the question as to the relative roles, of the voluntary sector and the state, in filling this transport gap. Should the voluntary sector be a complementary, a supplementary, or even a primary provider of transport services? (4) The strategies of voluntary transport providers in filling the gap are particularly important. Whereas operators of commercial transport services are concerned primarily with maximising revenue and therefore profit, voluntary transport operators are the ’servants of many masters'. Various factors come together to produce a potential 'demand' for their services; also the organisation's income comes from sources other than just the 'farebox'. These include local authority grants and subsidies, charities and even fund-raising. Hence, in managing their organisation, voluntary transport operators have to satisfy not only the local transport needs of potential customers, but also the sometimes different objectives of other bodies to whom they are accountable. This situation can also be found in the commercial sector as Bly (5) noted when considering subsidised bus services: "the operator has to deal with customers and various layers of government whose objectives go far beyond transport". He argued that this complexity leads to inefficiency and undermines the operator's management of the service. With the voluntary transport sector being even more complex, this may have a significant effect upon the management of the service and the way that it meets needs. Do the services change to meet local need or respond to the other pressures upon the organisation? It will be interesting to see whether such organisations use a traditional marketing strategy as used by commercial organisations to fill the increasing gap in transport provision. 5.

BACKGROUND TO THE CASE STUDIES

In order to examine the ways in which the voluntary sector makes these decisions about service provision, three case studies are being undertaken. Because of the particular problems facing rural areas, it was decided to look specifically at rural organisations and in particular voluntary car schemes, a form of organised lift-giving. These schemes are non-profit making and rely on an unpaid scheme coordinator to recruit volunteer drivers. These drivers, who give lifts in their own vehicle are matched up by the coordinator with people requiring lifts. Drivers receive a payment, usually on a mileage basis. This cost

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is met wholly or partly by the passenger, the balance coming from various public agencies.Voluntary car schemes are emerging as an important form of transport for meeting needs in rural (and urban) areas (6). This paper presents the initial results from the first of the three case studies being carried out in Nottinghamshire in the East Midlands region of England. Voluntary car schemes can be classified (7): a) b) c)

village-based; agency-based such as those organised by a Council for Voluntary Service or Volunteer Bureau; centrally-based in conjunction with a public agency, such as those organised by the Women's Royal Voluntary Service.

Our three case studies cover only the village and agency-based car schemes. Because of their different organisation and objectives, the centrally-based schemes may be regarded as almost part of public sector transport and therefore of less relevance to a study of decision-making in voluntary sector rural transport. In Nottinghamshire there are currently (1989) 8 village-based and 9 agency-based voluntary car schemes. Two village-based and one agency-based schemes were chosen for the case studies: 1) 2) 3)

Thorney, a village-based scheme serving a small village in East Nottinghamshire on the border with Lincolnshire. Tuxford, another village-based scheme serving a larger village in NE Nottinghamshire; Newark, a Volunteer Bureau scheme serving the Newark and Sherwood District of SE Nottinghamshire.

This sampling strategy provides typical cases of rural car schemes, yet they vary in size, location and organisation. will permit replication and cross-analysis of results.

This

A case study approach was chosen because of the nature of the research, and the questions being posed: 1) 2) 3)

How are voluntary transport organisations "managed" to meet transport needs in the complex environment in which they operate? What are the important considerations in doing this, and why? How and why is change in the service/organisation instigated, if at all, to meet these transport needs?

These 'how1 and 'why' questions explore contemporary operational events and linkages which are constantly changing and cannot be controlled by the researcher; this is the domain of the case study methodology. (8) The case studies involve various research

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techniques being applied at the case study site, including observation, participant observation, interviews and statistical data collection. A great deal of the data is qualitative in nature, consisting of descriptions of events, situations and behaviours, and documentation of people's experiences, attitudes and thoughts. The advantage of qualitative data is that it is open-ended, and collected without prior commitment to theoretical models. This is essential as it allows those involved with the scheme to describe "in their own words" (9) the complex events affecting the scheme. When all the research techniques are complete, they allow key issues and themes to emerge in response to the initial research questions. It is these issues and themes which are discussed below. 6.

THE THORNEY VOLUNTARY CAR SCHEME CASE STUDY

Thorney, Broadholme and Harby Voluntary Car Scheme, to give it its full name, was established in 1983 with money raised by local fund-raising and a large sum donated by "Opportunities for Volunteers". The car scheme was initiated in Thorney though almost immediately Harby, a larger village 5 km away, joined the scheme. This provided more drivers and users. Broadholme, being in the same parish as Thorney, was naturally also included in the scheme. Recent figures show that in 1987 the scheme undertook 214 return trips, and in 1988, 160 trips; these 160 trips were completed by twelve drivers. 87% of trips were provided by four drivers, including the coordinator herself. Presently the number of drivers without severe constraints on their availability has fallen to two, one each in Harby and Thorney. The coordinator notes that this lack of drivers is the greatest pressure on the scheme's continuing to operate. Of 125 trips in 1988 for which the destination was recorded, 34% were to the local doctors’ surgery at Saxilby, Lincolnshire, and 16% to an old persons' social club held fortnightly in Harby. The rest of the trips were to medical facilities in Lincolnshire, mainly the County Hospital in Lincoln. Of the 27 users during 1988, 20 were female; 18 of the 27 lived in Harby, 6 in Thorney, and 3 in the villages of North Clifton and Wigsley. Five users made 48% of the trips in 1988; of these, it is known that three need regular medical attention. Both the car scheme's operating area and criteria for use are loosely defined. The former is defined as "sort of locally" by the coordinator, the latter in effect being those unable to arrange lifts to medical facilities, or to the local old peoples' social club. A prescription pickup service from Saxilby Health Centre is also provided. The organisation and the scheme has not changed over the years and is run by one coordinator from her home in Thorney. Her next door neighbour (at the village post office) takes messages when

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the coordinator is out, and takes over when the coordinator is on holiday. The only others directly involved in providing the service are the two main drivers, the Thorney-based driver in fact being the coordinators other next door neighbour.

7.

IMPORTANT ISSUES IN MANAGING THE THORNEY CAR SCHEME

The recurring issues and themes which emerge in addressing the research questions posed provide the context of the scheme, the 'modus operandi', and all therefore have a bearing on the "marketing strategy" of the scheme. These are discussed below. A)

PHYSICAL AND SOCIAL CONTEXT

Physically the population in the catchment area is dispersed and small in number which reduces the probability of various influences affecting the scheme. For example, in discussion with the coordinator it appears that (sometimes hard) decisions are avoided as the situation "has not cropped up" for instance rationing of services due to increased demands for specific services, from Social Services. A related point limiting influences on the scheme is the fact that interaction between the villages is very low, as is interaction between those involved in the scheme. This can be accredited to the distribution of population and indeed the 'parochial' nature of the area, as one driver described it. If interaction is low it limits change in the scheme as the scheme is seldom discussed and, if dissatisfaction occurs, it is not expressed widely. (In the field the researcher noted that users/drivers often mentioned that they had "never thought about it (the scheme) before"). Indeed, because of the need to reduce 'dead mileage' the coordinator organises lifts on a village basis so that the Thorney driver does trips originating in Thorney and usually takes the same passengers. Opportunities for cross-fertilisation of ideas concerning the scheme are thereby thwarted and the scheme therefore never changes at least in the eyes of users and drivers.Thus the physical and social context can b6 seen as the "arena", in which the scheme operates: a very 'local' arena, in which influences for change are "nipped in the bud" or simply do not occur. B)

ORGANISATION

This may be considered in two parts:

1. Scale and concentration The organisation of the scheme is very concentrated. As noted previously, two-thirds of those directly involved in the scheme live in three adjoining houses in Thorney. Decision-making is even more concentrated, and lies solely with the coordinator herself. As such, the scheme has become, to users and drivers alike, the coordinator's scheme : she IS the scheme. The implication of this is that she can be seen as a buffer to change. Thus, when asked about the scheme users' replies such as

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"she couldn't try any harder" and "I know it's difficult, but she does a good job" are actually about the coordinator and not about the scheme. 2. Philosophy The scheme started initially because of the almost complete lack of transport. With only two local bus services per week some residents are now totally dependent on the scheme. This dependence and self-help philosophy may have implications for the management of the scheme in the face of increased demand. The coordinator has compared the scheme to a 1taxi1. This contrasts with other schemes which compare themselves to 'ambulances'. Indeed, literature concerning the Thorney scheme outlines destinations it serves rather than the general needs it aims to meet. In looking at strategies adopted, the coordinator notes that no major decisions have been taken or plans made for the scheme. In discussing her role rather than stressing strategic issues, the coordinator emphasises the day-to-day concerns which keep the scheme "ticking over". This shows that the management of the organisation is small scale, and that the philosophy of the organisation is self-help. Both must affect how the scheme reacts to influences upon it, and raises the issue of what would happen if its philosophy was challenged (this is discussed in Section (D)). These organisational considerations can be seen as the "orientation" of the scheme which is localised due to the scheme's philosophy. They determine how the scheme reacts to influences to change that are not filtered out in the arena. C)

RESOURCES

Over the past year the most critical change in resources has been the dwindling driver numbers due partly to driver demotivation. In discussing this, current and ex-drivers cited isolated incidents of 'abuse', some of which occurred long ago. Examples included passengers being discourteous or not turning up for lifts, and problems with parking at hospitals. Barriers to recruiting new drivers also included the regular commitment and the paperwork involved. These 'de-motivators' are important in the situation at Thorney, where the coordinator is very concerned about the decline in driver numbers. Clearly, drivers are the critical resource and, because they are motivated by more than just money, an increased mileage rate would not necessarily lead to increased numbers. Indeed, some of the existing volunteers would still drive if the rate were reduced.

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D)

FORMALITY

As the scheme has evolved from its self-help origins, the perceived increase in formality has affected drivers availability. Formality here means the degree to which the scheme is (or is perceived to be) part of a broader, more formal service be that public transport, health authority, or social service transport. Many now seem to view the scheme as part of the ’public service arena', perhaps limiting driver goodwill. Some symptoms of unwelcome formality are in the areas of driver administration, criteria of use, and user administration. Potential drivers have been put off volunteering because of "all that form-filling” . Indeed, current drivers do not want to-fully utilise the booking forms provided by the Rural Community Council; for most trips drivers have not completed starting and finishing mileometer readings, or used the tear-off claims slip. Ex-drivers have indicated that they would prefer to drive for a scheme with wider criteria of use which include social trips as well as the more ’formal’ medical trips. Users have also refused formal receipts from the drivers. It is this perception of the scheme's formality which is important, not only to drivers, but also to everyone involved with the scheme, whether directly or indirectly. A good example of perceived formality, and the frictions it can produce, occurred at the- County Hospital, Lincoln. One ex-Thorney driver mentioned that he was reprimanded by a hospital official because he had allegedly parked in the way of ambulances (something the driver refuted). The driver was very annoyed; "... and I thought 'well I'm doing their job'... and you've got to park right down in the car park!... It narked me!" The driver was annoyed as he had to park further away from the hospital (in the car park) while the outpatient ambulances received special parking.The official, from the very formal organisation (the hospital), says the car is not allowed to park there; he perceives the car scheme as informal vis a vis the ambulance service. The driver, from the relatively informal organisation (the village car scheme) parks the car there because in his eyes he's entitled to as he's doing the same job as the ambulance; he perceives the scheme as formal. This kind of anomaly in perceptions of the car scheme, and its role appear to be demotivating existing drivers (this sort of 'abuse' of his goodwill was give as part of the reason he stopped driving), reducing their number, and so possibly influencing use of the scheme. Perhaps the emphasis on medical trips, the financial support of the County Council and the scheme's trappings of formality have 'shot' the car scheme into another 'arena1, an arena in which it is not really comfortable and which challenge its self-help philosophy. This leads to dissatisfaction amongst potential, current and, sadly, former drivers.

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8.

IMPLICATIONS FOR VOLUNTARY TRANSPORT SCHEMES, USERS OF THE SCHEMES AND A COHERENT TRANSPORT STRATEGY FOR THE MOBILITY HANDICAPPED

(a)

VOLUNTARY TRANSPORT SCHEMES

This brief overview has shown what issues are important in organising voluntary transport in an area such as Thorney. These issues have implications for 'how they meet demand' (their ’marketing strategies'), and show the important influences on providing the service. We have shown that the marketing strategy of this voluntary transport scheme is not geared to change so as to meet demand. Rather it is limited in its capacity to change due to its context, organisation, and formalisation issues. Because of the local arena in which it operates, influences are often 'nipped in the bud' or do not occur, and the localised orientation of the organisation determines the way it reacts to these influences. This is not meant to be critical of the scheme. Instead it is meant to illustrate a potential future problem. The scheme is a good response to local transport needs in the area. It is however being asked increasingly to enter another transport arena which is very different from its own and may, even now, be causing operational problems. These problems occur because the 'raison d'etre’ and philosophy of the organisation (and those involved with it) may be being challenged. It is neither geared to operating in this new arena nor orientated to the influences occurring in it. Hence traditional marketing approaches to meeting demand may not be applicable here because of the complex context in which the scheme operates. The example of resources is important. The critical resource at the Thorney Car Scheme is volunteer drivers, the place of cash in the scheme being somewhat unsure. We have now started the case study at the Newark and Sherwwod Car-Scheme organised by the Volunteer Bureau. Very early analysis shows that the critical resource here appears much more to be finance. This does not seem at odds with the Newark 'modus operandi', though, as it can be seen to be in a different 'arena' : Newark takes referrals only from third parties such as doctors, social workers and hospitals. It obtains funds from them and also has Social Services origins. Drivers do not appear as easily demotivated by 'abuse' and define it somewhat differently. In all, the Newark scheme seems happy to be a public service in the wider public arena. Hence, different issues seem to be important in operating a voluntary car scheme. A blanket approach to their organisation, funding and support may be wrong as some schemes may be better equipped to meet the future demands outlined earlier.

274 b)

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS USERS OF THE SCHEMES

The major implication for the users of the Thorney Car Scheme is the fact that the service may not be able to serve transport needs fully. At present the schemes strategy is reactive and short-term. It is having difficulties meeting today's needs due to the problems outlined above. With demand predicted to remain high and/or increase, its potential in meeting new needs can be seen to be limited. As regards formality problems, a certain degree can be seen to be a good thing for users. Users mention that paying for a trip reduces the feeling of charity. (It must be noted that with this car scheme payment is however made in the car, which does seem to increase the charity/dependence feel to the scheme/for the user). However, the problems formality brings, especially to driver recruitment and therefore the future of the scheme, may outweigh any benefits. (c)

FOR A COHERENT TRANSPORT STRATEGY

From the above, it is not felt possible for the voluntary sector to simply substitute for transport provided by the state. The complexity of the issues which have arisen from this one case study show perhaps, that it is not possible to rely on the voluntary sector's goodwill in the future. In this case at least, the philosophy of the scheme, and therefore its 'marketing strategy' (or non-strategy), means that it is not able, or even willing, to increase its role any further. The discussion of resources at the scheme shows that cash cannot solve the problem of volunteer availability. Indeed this may have made it worse by putting the scheme into an arena which the scheme and the volunteers may not be able to come to terms with. The limited cross-analysis with the Newark scheme so far shows that different issues are important to different schemes. Hence, a blanket strategy towards transport for elderly persons, which includes voluntary car schemes, may not be possible - they are too different. Rural Transport Advisers have put effort into developing and supporting car schemes as a response to rural transport needs. This paper shows that Advisers, and indeed others concerned with transport planning, must approach car schemes carefully in aiming to maximise their role in the transport market. If a scheme such as Thorney was expected in the future to have an increased role, could it fulfil it? Is there a threshold beyond which growth and change is difficult? The discussion in this paper suggests there may be.

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CONCLUSIONS

The issues outlined above have emerged from tape-recorded interviews over many months with those involved in the Thorney car scheme. Much of the supporting evidence is qualitative and space limits its inclusion here. The results so far are drawn from only the first of the three case studies. Inevitably then, they must be regarded as tentative until the other two case studies are complete. Cross-analysis of the results from all three studies will further elucidate the importance of various factors in providing a voluntary car service and how and why change occurs in the service, and what this change is in response to. This paper shows some of the important issues emerging in answer to these questions. Influences upon the provision of a transport service vary within and between voluntary transport organisations. The influences on the organisation studied are determined by the "arena" in which it operates, and the "orientation" of the scheme. The availability of resources and the level of formality in the scheme are complex issues, and affect schemes, and 'actors' within schemes differently. These insights must be noted if it is intended to harness the voluntary sector's potential contribution to transport provision. The 'marketing strategies' of voluntary transport organisations are not as 'linear as commercial services', which aim to meet demand to maximise revenue and profits. The effects of the resulting complexity has implications for the organisations themselves, for the users, and indeed for a coherent transport strategy for the mobility handicapped.

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References 1.

Sutton, J. and Cassidy, S (forthcoming) The Role of the Rural Transport Adviser C.T.S.R.U. Working Paper, Trent Polytechnic, Nottingham.

2.

Hatch, S. and Moorcroft, I. (1983) Components of Welfare Bedford Square Press, London.

3.

Sutton, J. (1988) Transport Coordination and Social Policy. Avebury, Aldershot (p23).

4.

Kramer, R.M. (1981) Voluntary Agencies in the Welfare State. University of California Press, USA.

5.

Bly, P.H. (1987) 'Managing Public Transport : Commercial Profitability and Social Service', Transportation Research A Vol. 21A, No 2, pp 102-125.

6.

Sutton, J. (1986) 'Guide to Community Transport Services in Nottinghamshire', Nottinghamshire County Council, Nottingham.

7.

Sutton, J. (1988) op. cit. p26.

8.

Yin, R.K. (1984) Case Study Research : Design and Methods Sage, Beverley Hills, USA.9

9.

Patton, M.Q. (1980) Qualitative Evaluation Methods. Beverley Hills, USA.

Sage,

Transport for Mobility Handicapped People THE SCOTTISH EXPERIENCE Alan R ees, Assistant D irector, Edinburgh Council o f Social Service and Chairman, C om m ittee on Mobility for Scotland, Scottish Council on D isability. Hilary Howatt, Planning O fficer, Strathclyde Passenger Transport Executive

Having sketched in some of the necessary background, this paper highlights some recent developments in different parts of Scotland - its rural areas, its major conurbation in Strathclyde and around its capital city, Edinburgh. [It has not been possible to cover developments in all areas.] The paper concludes with a summary of the main issues to be faced and proposals for progress through the next decade. 1.

INTRODUCTION

Scotland forms the most northerly part of the UK, lying between latitudes 55° and 60° north (latitudes sim ilar to the southern half of Sweden). It has an area of 78,772 sq kms including numerous islands off the west coast and Orkney and Shetland to the far north. The mainland itself extends 540 kms from south to north and some 200 kms from east to west, although the ’central b elt’ between Edinburgh on the Forth estuary and Glasgow on the Clyde extends only some 50 kms. Half Scotland’s population of 5,121,000 live in this central belt so that the average density figures of 65 persons per sq km (compared with 234 persons for the UK as a whole) hides a most uneven distribution, the Highland Region to the north having 7.9 and Lothian Region having 422 persons per sq km. [1] Prior to the Act of Union in 1707, Scotland was an independent country and subsequently it has retained many of its national institutions of church and sta te . Whilst Parliam ent in London legislates, many laws relate (in whole or in part) to Scotland only, and there is a large elem ent of devolved adm inistration through five departm ents of the Scottish Office in Edinburgh under the Secretary of State for Scotland and his Scottish Ministers. The Scottish Development D epartm ent, for example, has responsibilities for roads and transportation which it adm inisters under the oversight of the D epartm ent of Transport in London. Scottish local authorities, of which there are 9 Regional Councils, 53 D istrict Councils and 3 Island Councils, are accountable to the Scottish Office for their various statu to ry functions. However, they have much local discretion, for example under the Social Work (Scotland) Act of 1968, the Concessionary Travel for Handicapped Persons (Scotland) Act of 1980 and the various Transport Acts, notably the 1985 Act. Calculations of the number of disabled people in Scotland have hitherto been based on the 1969 survey by Emelia Harris [2] but have recently been revised by the surveys [3] between 1985 and 1988. These give 277

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an estim ated 611,000 disabled adults (16+) in Scotland which is about 5% of the adult population. The rate of disability, however, rises with age, accelerating a fte r 50 and rising very steeply after 70. Almost 70% of disabled adults are 60 or over and near half are 70 or over, giving figures of 427,000 and 305,500 respectively. The elderly population generally over 65 is expected to grow by 4.7% over the next 12 years rising from 757,000 (15%) to 792,000. The increase in the 85+ age group will be markedly g reater (rising from 63,000 now to 95,000 by 2001 - virtually 50%). [4] As far as ’mobility handicap’ amongst disabled and elderly people in the community is concerned, i.e. difficulties posed by inappropriate or inaccessible transportation, the to ta l number in Scotland can be placed at about 350,000, although the trav el needs of the different age groups has particularly to be borne in mind. For instance there is a growing number of dem entia sufferers mainly amongst the very elderly population. The response to these needs will be illustrated in the pages that follow. The roles of central and local government in the public sector have been referred to although a significant part has been played by community based ’voluntary’ or consumer organisations acting as both service providers and lobbyists, notably through the Scottish Council on Disability's Com m ittee on Mobility, the Scottish Community Transport Group and the Scottish Consumer Council. Commercial and quasi-com m ercial bodies have responded in various ways to political, special interest and market pressures. 2.

RURAL EXPERIENCE

As has been noted, outside the ’central belt' Scotland has large areas of thinly populated country both to the south down to the border with England and to the north up the eastern seaboard and across the Highlands through to the Western Isles. Scotland has a third of Britain’s agricultural land but 68% of it is hill grazing for cattle and sheep. 2.1

BORDERS

The Borders Region to the southeast covers 1,800 sq miles and has a population of 100,000 of whom 32,000 live on farm s. It has only 11 settlem ents with a population of over 1,500. As Paul Gregory pointed out in his paper to the Second International Conference on Mobility and Transport of the Elderly and Handicapped in 1978 [5] the population contains a very high percentage of elderly people (over 21%) and the main problem they have is isolation. There being no railway station in the region (the nearest being thirty miles from the main centres of population) the principle public transport mode is the bus. A survey in 1975 showed th at 12.5% of bus passengers were in the pensionable age group (60 for women, 65 for men). In 1977 the Borders Regional Council introduced an concessionary fare scheme for elderly and disabled people fare travel card - the first of its kind in Scotland. Other since have included the carrying of fare paying passengers

improved - a half measures on school

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buses, on mail collection and delivery vehicles (postbuses) and on a special service, the Border Courier (started in 1979) which is routed also to transport medical supplies between rural surgeries and hospitals. These were all designed to reduce and share costs between public and private sector interests eg the Regional Council acting as both transport and education authority, the Post Office and the Health Board. These and other m easures have halted the decline in passenger journeys and produced a 5-6% annual increase since 1982. By 1984 pensioners were making 16% of all trips, though the percentage increase was partly due to a reduction in use by other groups. In addition there have been community based initiatives such as social car and car sharing schemes. The Federation of Borders Council of Social Service has recently been funded by the Scottish Office to study the scope for expansion in this area. Noel Charlton, who was appointed in October 1988 to undertake this study, also carried out a similar exercise in the Machars district of Wigtownshire to the southwest in 1985. [6] C harlton’s conclusions in Machars were that commercial operations were unlikely to provide solutions for rem ote rural areas. ’Watered down versions of town services’ would not succeed. Locally devised and delivered, small scale, low cost responses were needed but should be m ulti-functional and properly co-ordinated. He advocated management by non-profit-m aking community co-operatives, the use of small vehicles (a car and minibus mix) and a sta ff of part-tim e paid or volunteer drivers. He stressed the need to plan transport in the context of social and economic development for the area. 2.2

HIGHLANDS AND ISLANDS

The even g reater distances and more scattered communities in the Highlands and Islands of Scotland pose additional challenges for such ’unconventional’ responses to rural transport needs, as indeed they do for ’conventional’ services. Highland Regional Council is responsible for an area of 25,000 sq kms (roughly the size of Belgium) with a population of 200,000. As in Borders Region, a half-fare travel card scheme is in operation on most local bus, train, postbus and ferry services within the Region and for journeys starting or finishing within Highland Region on selected routes beyond Aberdeen, Edinburgh and Glasgow. Eligibility extends to women over 60, men over 65 and younger people with physical and m ental disabilities who satisfy certain eligibility criteria established through the Social Work D epartm ent. A Companion Card may also be issued to those requiring assistance when travelling. Registered blind people may travel free on all such services within the Region. During the financial year 1986-87 13,837 people took advantage of the scheme at a cost to the Council of £356,560. Out of a to ta l of 26,000 passengers annually carried on postbuses in the Highlands and Islands some 2,000 are concessionary pass holders. Fifty services are in operation using 68 vehicles, a mix of vans, landrovers, minibuses and esta te cars. (There are over 130 services in Scotland carrying 125,000 passengers a year and covering some 2.5 million miles.) Although they offer a very basic service, in th at they typically run only tw ice daily (often starting very early in the

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morning) and may not offer a high degree of passenger com fort, they have proved a reliable and relatively cheap complement to other bus services. As long as the requirem ent on the Postal Service to deliver and collect mail rem ains, the potential for maintaining and indeed developing the system (now nearing its third decade) will continue. For elderly and disabled travellers to the Highlands and Islands from outwith the area (as well as for residents), fare concessions are available on the railways (ScotRail - British Rail’s Scottish Region) and car and passenger ferries (Caledonian MacBrayne to 23 Clyde and Hebridean Islands; P and O Ferries to Orkney and Shetland; Orkney Islands Shipping Company within Orkney; Sealink to Ireland). All these services receive heavy Government subsidies to keep standard fares down as well as provide concessions - shipping subsidies amounted to over £12 million in 1987. Additional capital sums are also provided for new trains and ferries, stations and harbours. Where new developments take place improved access and facilities for disabled people are generally being incorporated, such as at Oban rail-harbour term inal, starting point for ferries to Mull and beyond, the ’Isle of Mull’ vessel being the newest and largest in the 31 strong CalMac fleet and lift equipped from car to passenger deck. The next generation of ’’Sprinter” trains between Glasgow and Oban, Fort William and Mallaig, and between Inverness and Aberdeen, Kyle and Caithness can carry passengers seated in wheelchairs and have a fully accessible to ilet. The pace of such developments, however, is slow and provision uneven. For the more severely disabled person affordability is of little consequence without physical access to the services provided and this is still a major problem over most of rural Scotland. One way of avoiding environm ental and man-made barriers on the ground - at least over larger distances - is to fly. Loganair, together with the Highland Division of British Airways, serve the western and northern isles. Half-price fare is offered to pensioners but it is still expensive for anyone on a low income to undertake journeys with any regularity and the choice of destination on the mainland is lim ited. 3.

STRATHCLYDE EXPERIENCE

This section outlines the experience and provisions made by Strathclyde Regional Council and Strathclyde Passenger Transport Executive (SPTE) to improve access to public transport services for mobility handicapped people. It includes bus, train and underground services, vehicle design and infrastructure developments. Strathclyde Region is the largest Regional Authority in Scotland and has a population of 2.34m (47% of Scotland’s population). The Region covers 13,851 sq kms (about one-sixth of the to tal area of Scotland). The Glasgow conurbation, which is the main urban centre has a population of 1.75m and includes 11 D istrict Councils out of the Regional to tal of 19. In 1980/81, the Regional Council established an Officer/M ember Group to examine key issues concerning disabled people across the spectrum

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o f responsibilities o f the Council and produced a report "The Cost

of Living in a Hostile Environment" in 1981 which drew together recom m endations for improving service delivery. [7] It is Regional Council policy to provide access and mobility to meet personal needs. It is also the Council’s policy to pay attention to the needs of disabled people in the design and implem entation of roads and public transport schemes and traffic management measures. 3.1

BUS SERVICES

Demonstration Projects undertaken during the early 1980s sought to te st the operating opportunities and passenger use of both fixed route services and demand-responsive "Dial-a-Bus" services. "Chauffeur Care" double-deck accessible buses were introduced in 1983 as local services on six routes in the Glasgow area. (i)

Chauffeur Care (September 1983 - January 1988)

Fixed route accessible bus services were operated by Strathclyde’s Buses, Monday to Saturday during the off-peak, 0900-2200 hrs. The cost of the services was £289,333 per annum in 1986/87 and about 21 disabled people travelled weekly. These services operated for the public at large as local bus services but certain journeys were run with accessible vehicles, i.e. double-deck Citybuses equipped with ram ps/lifts. Escorts travelled on these services. In 1984 a "M etroliner" was introduced at the same tim e as the doorto-door Dial-a-Bus service. It was a single-deck vehicle specially designed to carry up to 12 wheelchairs, 30 seated passengers, or a combination of both. It was equipped with a hydraulic lift. The M etroliner connected with the Dial-a-Bus services to take passengers into Glasgow City C entre from the local operating area. Experience showed th at disabled people were reluctant to change between vehicles to com plete journeys and the Metroliner was subsequently withdrawn. (ii)

Dial-a-Bus (Decem ber 1983 - January 1988)

Dial-a-Bus was operated by Strathclyde’s Buses in Pollok/Paisley and Easterhouse/Baillieston, Services M l5 and M l6, Monday to Saturday, between 0900-1530 hrs. The services were only available to people with a mobility handicap but they could be accompanied by a companion if necessary. Able-bodied people could not use Dial-a-Bus. Service M l5 operated into Glasgow City Centre on Saturdays on request. The vehicles operating these services were Renault Masters and Bedford Dodges, each had ramped access at the rear. From December 1983, Stokes operated a sem i-fixed route service in Clydesdale D istrict, a rural area to the South East of Glasgow. Dial-a-Bus carried about 325 people a week at a cost of £131,308 in 1986/87. The subsidy per passenger was £8.86. The Highways and Transportation C om m ittee agreed in October 1986 to continue with the provision of Chauffeur Care services in the Glasgow area following bus service deregulation on 26 October 1986. To perm it

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the effectiveness of the Chauffeur Care services to be assessed in the deregulated environment, contracts were awarded until the end of July 1987, a 9 month period. C ontracts were also awarded in October 1986 for the two Dial-a-Bus services in the Pollok/Paisley and Easterhouse/Baillieston areas in 1986/87. The to tal cost of Chauffeur Care and Dial-a-Bus was £420,641 p.a. In April 1987, SPTE became concerned about the low passenger demand for the subsidised Chauffeur Care services. In April/May 1987, SPTE reassessed the provision and style of bus service provision for the mobility handicapped. The outcome of the review recommended an extension to the concept of door-to-door Dial-a-Bus services and term ination of fixed route accessible Chauffeur Care services. It was agreed in August 1987 to award the Dial-a-Bus contracts to Strathclyde’s Buses for the operation of six Dial-a-Bus services in the Glasgow conurbation. The new service network was introduced on 1 February 1988. A contract was awarded to a private operator in August 1987, for a Dial-a-Bus service in the rural area of Clydesdale D istrict at an annual cost of £17,600. This service, which replaced a previous service, operates between 0900-1700 hours, Monday to Thursday, on a semifixed route and to a tim etable. There are other services operated by voluntary organisations. They include Clyde Dial-a-Bus in North West Glasgow, Motherwell Community Transport in Motherwell D istrict, Monklands Community Transport in Monklands D istrict and Trans-port in Port Glasgow. SPTE have no control or financial responsibility over the operation of these services. Dial-a-Bus continues to operate as a demand-responsive service. It is available only to those who have a mobility handicap which prevents them from using local public transport services. To be eligible to use Dial-a-Bus, passengers should be holders of Strathclyde Region's Concessionary Travel Card for the elderly, handicapped or blind. Ablebodied people cannot use the service, but a companion can travel with a registered Dial-a-Bus user if necessary. The service operates MondaySaturdays, between 0900-1800 hrs. The flat fares charged are 15p for a Concessionary Travel Card holder and 5 Op for an adult and 25p for a juvenile companion or tem porary disabled person. The service operates with driver/escorts. There is a service into Glasgow City C entre once a week on request from four of the operating areas. Strathclyde’s Buses Ltd operate Metro Cammell Weymann M etrorider vehicles. They have a seating capacity of 13, can carry two wheelchair passengers, have lift access at the rear and space is provided for luggage. The cost of Dial-a-Bus is £0.7m per annum. The original Dial-a-Bus services were adm inistered by the Social Work D epartm ent in Glasgow and this principle was retained under the expanded network. The Dial-a-Bus Unit takes passenger bookings and relays this inform ation to the bus operator to enable vehicle scheduling for the following day. However the Unit was transferred to SPTE in January 1989 to improve its function as an integral elem ent of SPTE’s responsibility for m eeting the travel needs of the elderly and handicapped.

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Within the first few weeks of operation in February 1988, the demand for the 7 Dial-a-Bus services exceeded 1,200 passengers per week. This was higher than anticipated and was a 90% increase on previous weekly patronage of accessible bus services. It was agreed in September 1988 th at additional Dial-a-Bus services would be introduced in 7 new areas in 1989 to cover all the remaining urban centres in Strathclyde Region with an estim ated handicapped population of 63,000. This will make Dial-a-Bus available to 95% of the Region’s population, using 22 vehicles within the 14 services. 3.2

VEHICLE DESIGN AND VEHICLE SPECIFICATION

Between 1981 and 1983, SPTE developed suitable types of accessible vehicles and worked in conjunction with the D epartm ent of Transport and leading coachbuilders. Hand rails, lifts, ramps and wheelchair anchorages were installed on 4 types of bus: Citybus, Metroliner, and converted Renault and A tlantean. SPTE issue detailed vehicle and tender specifications when tendering for Dial-a-Bus services. They incorporate many of the features included in the Disabled Persons Transport Advisory C om m ittee’s Guidelines to improve access to local bus services which was published in June 1988 by this London-based statutory body. 3.3

CONDITIONS OF CONTRACT SERVICES AND SCHOOLS

FOR

SUBSIDISED

LOCAL

SPTE produced a guide in June 1986 for use by bus operators, of the Conditions of C ontract for Subsidised Local Services and School C ontracts. This was supplemented in May 1987 by additional requirem ents which included, as obligatory to the conditions of contract th a t, ’vehicles used on contracts must be constructed as to facilitate easy access for the elderly, and those carrying shopping or children’, and th a t, ’two seats must be specifically designated for the elderly and/or disabled passengers in the lower saloon.’ 3.4

RAIL SERVICES AND INFRASTRUCTURE

Strathclyde has the largest supported local rail network in Britain outside of London. The revenue support budget for 1988/89 is over £30 million. Services carry over 38 million passengers annually. There are 9 services and 145 stations on the Strathclyde network. In 1984, provision was made in electric rolling stock for wheelchair accommodation by removing seats in the passenger com partm ent. At this tim e diesel trains did not have autom atic wide-opening doors which are fitted to new ’’Sprinter” stock. SPTE will continue to provide in new rolling stock space for wheelchairs and designate seats for the elderly, infirm and disabled. Public address systems have been installed in new and refurbished electric rolling stock. SPTE are undertaking a Public Transport Development Study in Strathclyde, 1988/90, and any consideration of future development

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proposals will include evaluation of the introduction of measures to ensure services are accessible. Due to the segregated nature of the rail network, most stations are either in cuttings or on embankments, requiring stairs or ramps to gain access to one or both platform s. The following facilities have been or are being provided: ramps at rail stations to give access from stre e t to station building and platform s, at low gradients; lift access at stations (Exhibition C entre, Queen S treet and C entral Stations); handrails at station entrances; seating on platform s or in station buildings; wheelchair accessible toilets (Queen Street and C entral Stations); induction loops for the deaf; improved on-platform illumination; lighting of park-and-ride carparks; Dial-a-Bus designated bus stops in Glasgow city centre; portable ramps at key stations to facilitate access on to trains for wheelchair passengers; improved public address systems; rail inform ation and tim etable leaflets and panels on platform s. 3.5

UNDERGROUND

Scotland’s only Underground railway which serves Glasgow city centre, Glasgow’s West End and the area im m ediately to the south of the River Clyde, was reopened in 1980 a fte r undergoing an extensive modernisation programme. It has escalators from s tre e t to platform level at the most heavily used stations, same platform height/train floor height, and a public address system on-platform and in-train. The design of the new additional trailer cars which are due for delivery in 1990/91 will incorporate seating designated for elderly, infirm and ambulant disabled people. 3.6

STAFF TRAINING AND PASSENGER INFORMATION

Training programmes have been developed by at least one bus company in Strathclyde to cover issues concerning transporting mobility handicapped people. Before Dial-a-Bus services were introduced in February 1988, bus crews attended a day’s training session with the Council’s Social Work D epartm ent. It is SPTE’s responsibility to produce, promote and co-ordinate public transport as required, under the ’Strathclyde Transport’ corporate logo throughout the Region on public transport services subsidised by the Council. Public transport inform ation is available at key locations; the Travel Centre in C entral Glasgow, rail stations and Transagents. The local press is informed of specific promotions from tim e to tim e. Publicity for Dial-a-Bus is presented in a clear and concise form at using large print and gives service information, conditions which apply and a map of the operating area. 4

LOTHIAN EXPERIENCE

Lothian Regional Council’s policy document issued in 1986 by the D irector of Planning set out a number of priorities related to its statu to ry requirem ents for public transport under the 1985 Act and

THE SCOTTISH EXPERIENCE

for other services (eg education and social work). supported transport services were:

285

Priorities for

1

Movements to and from work, education, recreation and worship, for medical and w elfare purposes, or for shopping and personal business needs when no alternative public passenger transport is available.

2

Services to complement the restrain t of private vehicles in central Edinburgh.

3

Maintenance of regular inter-urban links between the main urban centres in the Region.

4

Any other socially desirable services.

The Council also has a policy of com pletely free travel for pensioners and disabled people on all public passenger transport services in the Region. Lothian Region has a population of 750,000 including the City of Edinburgh D istrict with 450,000. The three other D istrict Council areas of East, Mid and West Lothian comprise a mix of scattered rural and m edium -to-sm all town communities (many form er mining communities) but Livingston in West Lothian was designated a TNew Townf in 1962 and now has a population of 40,000. A 1987 study of the needs of disabled people in Lothian within the age group 16 to 64 [8] indicated th at 22,000 (3.1% of the to tal age group) were suffering from ’chronic physical im pairm ent’ and 17,000 (2.3%) were ’disabled or handicapped’. There was a higher incidence in West Lothian than in the rest of the Region. In relation to transportation, 25% of the la tte r group were unable to use a bus, 15% could not travel by train and 12% could not manage taxis. Many of those who could use these services did so with difficulty since 33% or 5,770 people found it hard to get to the bus stop or railway station and a sim ilar number had problems getting on and off a bus or train. A contem porary survey [9] of disabled and elderly people of varied ages showed nearly double the number having difficulty with getting on and off (61%). On frequency of travel (by any method), 6% of the 2,289 people interviewed (4.4% of the town populations in the survey) were ’effectively housebound’, 25% travelling once a month or less and 46% once a week or less. These figures were even higher in some towns and illustrated ’very significant levels of isolation’. If transferred to Lothian as a whole, these findings indicate th at at least 11,000 disabled and elderly people are not receiving even a basic public transport service, le t alone one relating to the first of the Regional Council’s priorities quoted above. It serves to highlight again the lim iations of a free trav el policy for this group without more atten tio n to vehicle design, routes and frequencies, etc. Clearly too, progress which had been made in supporting voluntary sector initiatives such as the Handicabs ’dial-a-ride’ service (established in 1982 and now undertaking an average of over 2000 passenger journeys a month li

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throughout the Region) is only a sta rt. The appointment of a Special Needs Transport Development O fficer within the Public Transport Unit of the Planning D epartm ent - an appointment arising out the recommendations of a Local A uthority/H ealth Board joint working party - gives rise to hope th at other developments will be not long in coming viz., a taxi-card scheme (capitalising on the increasing number of wheelchair accessible Metrocab taxis, at least in Edinburgh where the Edinburgh Cripple Aid Society has for years pioneered a subsidy scheme). But the evidence is th at the scale and nature of Transport disadvantage’ is such th at throughout most of the Region it is the ’conventional’ public services which should become more responsive before the place and role of the ’unconventional’ and mostly communitybased response can be assessed. 5.

CONCLUSIONS

Until relatively recently transport policy in Scotland has concentrated heavily on lowering the cost of travel for elderly and disabled people by bus, train, ferry, aeroplane, and latterly in some areas by taxi. It is certainly a most im portant aspect of policy, particularly with an aging population and for those on low incomes. Eligibility has recently been extended to the companions of those who are more severely disabled. However, increasing attention is now being given to the inability of many elderly and disabled people to use services however affordable due to the lack of ramps, lifts and toilets, inappropriate routes and tim etables, low frequencies, bad design, poor information, etc. etc. A ttem pts to respond to unmet need through ’conventional’ services are made difficult under current public expenditure constraints and particularly because of the present governm ent’s deregulation and privatisation policies which elevate profitability above social need as the dominant motivation amongst a larger number of independent operators and reduces the intervention powers of local authorities to establish standards, collect data, form networks and undertake other direct initiatives. It remains to be seen whether growing public pressure and lobbying for rights and equal opportunities, combined with codes of guidance and encouragem ent from com m itted agencies within central and local authorities, will effectively counteract the more general trend or whether in some areas, such as the new generation of wheelchair accessible taxis, a free m arket can be harnessed. As far as the widespread development of ’unconventional’ responses is concerned, th at is, beyond the lim ited and exploratory stage achieved so far, this too will largely depend on the availability of resources, both locally and centrally. The poor take-up of the modest Scottish Development D epartm ent’s Rural Transport Innovation Grant scheme (only £40,000 out of £170,000 in the first year and £41,000 in the second) is not encouraging. Transport planners have still to work out ways of making progress, 'particularly when it comes to involving the community transport sector which has so much to offer by way of representing and responding to ’grass roots’ opinion if guaranteed a basic level of funding and a clear endorsement of its role.

THE SCOTTISH EXPERIENCE

6

287

PROPOSALS

The following are necessary for significant progress through the next decade: (a)

a clear lead by Government Ministers at the Scottish Office in term s of policy and resources, in relation to both public and community transport;

(b)

a review of the overall consultative processes within Scotland and in relation to the United Kingdom and Europe;

(c)

improved co-operation between local authorities, based on policy guidelines developed through the Convention of Scottish Local Authorities (COSLA);

(d)

mechanisms to establish good practice and the improvement of services within the private (commercial) sector in respect of all forms of transport within Scotland;

(e)

the involvement of the community transport sector in local authority transport planning and delivery;

(f)

close collaboration between relevant local agencies in the Scottish health, education, social and allied services to support m ultifunctional transport and other joint services and facilities, particularly in rural areas;

(g)

the engagement of academic institutions within Scotland in researching transport needs, monitoring change, evaluating developments and providing other independent services (eg training and consultancy);

(h)

ensuring consumer participation in all of the aforegoing.

REFERENCES

[1]

Britain T88. C entral Office of Information. HMSO 1988

[2]

Office of Population & Surveys. Report: Handicapped and Impaired in Great Britain. HMSO 1971

[3]

Office of Population & Surveys. Report 1: the prevalence of disability among adults. HMSO 1988

[4]

Scottish Health Service Planning Council. HMSO Edinburgh 1988

[5]

Proceedings of the Second International Conference on Mobility Transport of the Elderly and Handicapped. Loughborough University of Technology 1978/9

[6]

Noel G Charlton. ’Machars Access - Potential for Voluntary Initiatives’, The Author, Rigmaden, Kirkby Lonsdale, Lancs 1985

SHARPEN Report.

288

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

[7]

Strathclyde Regional Council. Environment’. SRC 1981

’The Cost of Living in a Hostile

[8]

McAndrew & Hanley. Survey of the Younger Disabled in the Community in Lothian. Rehabilitation Studies Unit, University of Edinburgh 1988

[9]

West Lothian Voluntary Council for Disabled People, Bathgate 1988

The views expressed in this paper are the responsibility of the authors’ alone. [Edinburgh/Glasgow 1989]

MUNICIPAL POLICY AND STIMULATION OF MOBILITY OF ELDERLY AND DISABLED PERSONS Peter Snoeren traffic engineer 1. INTRODUCTION In order to be able to actively participate in social life it is necessary that one can go frcm heme to work, cultural institutions, shops, public buildings and other destinations. Everyone, so the elderly and disabled persons too, has a right to this mobility and should consequently be enabled to participate in traffic. The government policy with regard to elderly and disabled persons should be centred on furthering the possibilities of participating in these social activities. In our society too little attention is still given to the restrictions in the mobility of elderly and disabled persons. Notwithstanding the inconsiderable insight into the need of elderly and disabled persons for mobility, important steps can be taken to stimulate independent traffic participation. Municipal road authorities in particular can play a stimulating role in this. Research has shewn that many municipalities are indeed aware of restrictions in the mobility of a considerable number of their inhabitants. There seems to be hardly any structural municipal attention for this matter. Stimulating of independent mobility can only be effected, however, if already in an early stage, structural an integral attention is paid in the municipal policy to the demands of the elderly and the disabled. In this contribution after a short determination of the position of the elderly and disabled persons in Dutch society, emphasis will be put on principles of policy with a stimulating effect on mobility. 2. WHAT ARE WE TALKING ABOUT? 2.1 Population In the Netherlands today (1-1-88) 1.84 million people are 65 years of age or older. This is 12.5 percent of the population. In 1950 this was a mere 7.7 percent. According to calculations of the Central Bureau of Statistics the percentage of elderly people will be approximately 14.3 in the year 2000. In the year 2035 this will have risen to 26 or 27 percent of the total population of the Netherlands. In absolute numbers this means about 3.6 million -people, so twice as many as today. Based on the 1981 calculations of the Central Bureau of Statistics it has been established that over 9 percent of the population of the Netherlands of 5 years of age or older (1.2 million people) are disabled to a greater or lesser extent. More recent figures and further pre-calculations are not available. 289

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It goes without saying that more disabled persons are found in the category of the elderly. With the expected greying of society it is evident therefore that we have a great and graving problem at our hands. 2.2 Mobility The number of vehicles cwned by elderly and disabled persons, and consequently the number of movements and the distances covered is considerably lower than that of the average Dutchman. Especially the elderly are very rapidly catching up. For the average Dutchman of 12 years of age and older the average distance travelled by each person per day has since 1981 risen by 26 percent to over 33 km, whereas for men and women of 65 years of age and older this rise is 50 and 90 percent respectively over the same period. The number of kilometres travelled remains considerably behind however (men 65+:25 km; women 65+: 20 km). This spectacular increase in mobility is mainly caused by an enormous rise of car-usage and to a slightly lesser degree of usage of public transport. It is remarkable that the elderly cover about the same distance on foot as the average Dutchman and they make movements on foot just as much. Since the over-65 move about less and cover a shorter distance in total, however being able to move about on foot is relatively more important to than. Yet preliminary research shews that the mobility of the elderly can hardly be improved by relatively simple infrastructural measures. It would be much more effective to stimulate going out accompanied by volunteers, for instance, and to increase payable individual means of transport. Hardly anything is known about the mobility of disabled persons. On the basis of small scale research it would appear that their going places is about half and the distance covered not even 10 percent (over 2.5 km) of the Dutch average. About the means of transport used by the disabled persons no information is available. It is assumed, that the majority of movements are done on foot and by means of public transport and as carpassengers for greater distances. It is clear that the mobility of disabled and elderly persons knews many restrictions. On the basis of the mobility of the average Dutchman it may be assumed that the need for mobility among elderly and disabled people is very great. 2.3. Current state of affairs Fran the mid-seventies a cry for more and better means of mobility is heard more and more often from organisations of disabled and elderly persons. These cries for help and the realisation of a rapidly aging society slcwly dewn upon the authorities.

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As a first answer to the expected future problems a report "The elderly: more safely on the road!" appears in 1981. In this report recommendations are made regarding the traffic policy to be pursued, with extra attention for elderly people. In spite of the fact that this was given much publicity a structural traffic policy with regard to the elderly on municipal level, appeared to get off the ground but hesitantly. In 1988 a two-day traffic safety congress was completely devoted to the elderly. The most remarkable fact of this congress may well bave been that the elderly and they who outline traffic policies did new finally debate together the mobility problems of the elderly and how these could be solved. We are under the Impression that this congress will lead to a shift in traffic policy in a number of municipalities. Concrete examples are not yet available. For the benefit of the disabled persons experiments with various route-plans have been carried out frem 1980 onwards. The experiences gained through these experiments are in so far as this was possible at the time, summed up in the handbook Traffic Provisions for people with a handicap, which appeared in 1984. In 1987 the effect of the ideas and propositions in this manual was subject of research. It appears that in the larger municipalities (over 50,000 inhabitants) in particular, the extent and the nature of the problems regarding mobility of the disabled are generally recognized. Despite the general acceptance of the joint use with the disabled this unccmmitting attention appears, in reality, to take shape to a far lesser degree. It is clear, that municipalities must be considered capable of paying attention integrally in their traffic policy to elderly and disabled persons. Yet everything indicates that municipalities up to now hardly pursue an integral and inclusive policy. 3. DRAFT OF A POLICY 3.1 Organisation For the benefit of a municipal policy it is necessary to make a division in areas of policy. Three main areas can be distinghuised on which every-day life is concentrated: living, working and recreation. Apart from this there are sub-sectors demanding conditions: education, healthcare, welfare, traffic and transport, law and order. In all these fields of policy constant attention must be paid to removing obstacles with which elderly and disabled persons are confronted in society. Hew these things will be realised will differ from one municipality to another. Whether and how the attention is divided over the policy depends on the Court of Mayor and Aldermen and the public officials of each municipality.

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MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

Despite the fact that the division of fields of policy and structures of organisation of municipalities are very different it is yet possible to give sane generally applicable guidelines. * Within the Court of Mayor and Aldermen a member should be entrusted with the office dealing with "matters concerning the disabled and the elderly". The field of attention amounts to over 20 percent of the population directly involved and about 40 percent of the population indirectly involved (for example housemates). Within the Court of Mayor and Aldermen it is possible, as a result of the presence of someone in charge of this office, to take the elderly and disabled persons into consideration in all municipal fields of attention. Most matters in which attention is paid to the target group do not form a class to themselves but touch and influence other fields and can only function efficiently when also in these other areas of policy measures are taken. Hence this asks for interconnecting and attuning within the Court. The possibility of an inclusive policy announces itself. * Within the municipal organisation structure a co-ordinating official should be appointed. He is to be charged with fitting all matters concerning the disabled and elderly into the general policy. Greatly depending on the size of the municipal body one or more officials for each department should be especially appointed to this task. Testing the activities by the demands of the elderly and disabled should be taken as the most important duty. Within the municipal department a specific policy must be developed for so far this has not yet been done. * In order to structure the municipal policy concerning the disabled and the elderly in such a way that it does lead to effective results, it is necessary that regular consultation takes place between organisations of elderly and disabled persons and the municipality. For every field of policy or even for every executive project such consultation is indispensible. Consultation should not only take place when the policy aimed at the target group is concerned (i.e. when making up arrears) but, in fact, at any time, so also when the ideal situation of an inclusive policy has been reached. Yet the normal forms of participation and consultation within the municipal procedures may often suffice in an inclusive policy. The aim of this organisationstructure is first and foremost making up arrears in the situation of the elderly and disabled. This very organisationstructure makes it possible to create a cohesion between specific measures and general alterations/improvements . When arrears have been made up such an organisationstructure should remain intact in order to continue an inclusive policy.

MUNICIPAL POLICY AND STIMULATION

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3.2 AAU-Policy In spite of the fact that a municipal policy concerning the elderly and the disabled should be of an integral nature, this contribution will only concern itself with the problems of mobility. The municipal policy of mobility regarding the elderly and disabled should endeavour to offer such possibilities of mobility that everyone can safely and independently participate in traffic. For this independent participation in traffic the trinity approachability - accessibility - utility is of importance. Within the framework of the municipal policy the attention will have to be focused on all three facets. Disabled and elderly people in particular, experience a lay-out of the public domain as of buildings but also of public transport that limits their mobility, to a far greater extent than others. It is to be advised however, to juxtapose the technical approach to the mobility-restricting arrangement and other manners of approach to the arrangement of the public domain. In this respect aspects such as social safety should be borne in mind. If one of the three aspects of the AAU related problems is not met then the other two will substantially lose moment, however. With regard to the policy pursued in this field a distinction can be made between the wording of the policy and the execution. The very wording of the policy should be of an integral nature and cover various municipal fields of policy. By definition the AAU-policy is a traffic and transport affair. It is, therefore, this field of policy with regard to AAU that should be emphasized. With regard to drafting local regulations and by-laws elderly and disabled people should be taken into account. Hence the field of policy concerned with law and order should be implicated strictly in wording the AAU-policy. Limitations in the mobility of the elderly and the disabled are often caused by ignorance or a lack of awareness from fellcw road-users. Education and instruction will have to be a substantial and positive part of this matter of behaviour/mentality. On the level of drafting a policy the following points are noteworthy. * An AAU-policy should be developed in which for each aspect, the various sections that can be distinguished are integrated. At the same time priorities should be laid dcwn in this policy regarding the execution. * In an administrative level the responsability for this integral AAU-policy rests with a co-ordinating alderman. * The progress of the AAU-policy should be checked by a municipal council committee. * The organisations of the elderly and disabled specifically and the population generally should be involved in the AAU-policy. * For the execution of the policy, especially in the first years of making up arrears, funds should be made available.

294

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

On a municipal level of policy a number of tangents with AAUpolicy can be perceived. On top of the more or less generatpoints of attention mentioned above, aims must be drafted in thethese are of great influence on the possibilities for fields of policy related to the AAU-policy. Not untill then there be an integral coherent policy. 3.3 Traffic and Transport Policy Municipalities are responsible for many kilometres of roads,is streets, paths. The very design and lay-out and maintenance of these are of great influence on the possibilities for mobility of the elderly and disabled. All too often it is forgotten in the field of infrastructure that elderly and disabled people also want to be able to use them. Through the design and lay-out this is sometimes made impossible. With regard to the policy concerning the infrastructure the following points of attention can be summed up: * obstacle-free pedestrian routes A start should be made to make important destinations accessible by means of an obstacle-free routeplan. Then, in the course of sane years, all other pedestrian-routes can be made obstacle-free as well. * Smooth, closely-linked and non-slippery paving stones. The comfort and safety of everyone participating in traffic are served by a qualitatively good surfacing. Depending on the manner of transport and the frequency with which they are used, standards can be drawn up for roads and paths, determining the quality. By means of periodical maintenance this quality can be guaranteed. * crossing of roads and paths Complex traffic situations lead only too often to road accidents. Such a lay-out that it is clear to all road-users what can be expected in a certain traffic-situation is a condition. Yet the traffic-situation must be laid out in such a way that the interests of slew traffic participants (safety, controlling and comfort) are not at stake. At many crossings the traffic is controlled by traffic-lights. In those places where slew traffic has to make use of a push-button to ask for a green light, this push-button unit will have to be within reach and easy to use. For people who move slowly, and they are often the elderly and the disabled, the crossing time should not be too short. * re-surfacing When re-surfacing, adaptions in favour of the disabled and elderly should be carried out. Possible extra cost, especially when having been taken into account in the preliminary planning are often marginal. In all work, so not only when resurfacing, proper barriers should be placed in such a way that especially slew traffic is not hindered by the roadworks.

MUNICIPAL POLICY AND STIMULATION

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* utility Apart fran the maintenance for the benefit of the quality the paving-stones they should also be cleaned regularly. Fallen leaves, sncw and ice, dog-turds, dirt, etc. should regularly be removed. Through local regulations and the placing of litter bins, for instance, it is possible to keep regular cleaning to an acceptable level. The utility is also guaranteed by rapid repairs of the results of vandalism, streetlights that are out of order, etc. It are these relatively small details that largely decide ccmfort of the routes for slew traffic. With regard to the parking-policy the following points of attention may apply. * distance to destination Wheelchair-users and people with limited walking functions, benefit more than others by good parking-facilities near their hemes and destinations. When taking measures that limit the parking-facilities it would be wise to consider beforehand if the people living there are not seriously hindered in their possibilities of independent traffic-participation. * exclusive parking-space By means of regulations it is possible to reserve parking places for certain target groups (see page 8 regulations). This may concern general, that is for the entire target group as well as individual reserved parking-places. Beside national exemptions the municipality should also be able to establish local exemptions. * lay-out parking-space Especially wheelchair-users are in need of wider parking places than usual. In case of paid parking disabled people must be enabled to do their duty to pay (sloping kerbs, adapted parkingmeters or car-park ticket-vending machines). Many municipalities have no public transport services of their own. This limits the influence a municipality has on public transport. This limitation holds good especially for the utility and accessibility of the various means of transport. With regard to the situation and design of stops this influence is greater. With regard to the municipal policy concerning public transport the following points of attention are noteworthy. * utility and accessibility As a result of the limited right of say municipalities have in public transport the utility and accessibility of means of transport can only be influenced to a small degree. The municipality can help to achieve a real public transport by stimulating and supporting alternative transport services meant for transporting certain categories of the population.

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* situating stops The interests of the elderly and people with limited walking functions are served by stops near their hones and destinations. It goes without saying that the stops must be within easy reach (see page 6 infra-structure policy) of potential passengers. * design of stops Stops should provide the necessary information which should also be legible to visually handicapped. There should also be good seats and the steps should preferably be covered. * transport by taxi In the licence policy with regard to taxi-companies the council can see to it, that in its municipality there are also taxis available for the transportation of wheelchairusers. 3.4 Policy with regard to regulations and maintaining them local regulations offer municipalities the possibility to pay special attention to the possibilities for mobility of the elderly and disabled. Yet the extent to which these regulations are accepted and abide by will have to go together with instruction and supervision. Just as in the case with traffic and transport policy, the policy with regard to regulations will have to be of an inclusive and integral nature. Seme focusing points with regard to the policy of regulations and maintaining them: * obstacle-free routes The obstacle-free route should be at the basis of the municipal licencing system regarding the placing outside of advertising material, goods and terraces. This also goes for (building)permits, for sunshades, awnings, sign-boards. In development plans rules can be entered regarding overhanging vegetation. * comfortable routes The municipality should enforce laws about letting out a dog. Excrements should not be left on the pavement but in the gutter or in specially designed plots of land. If the municipality does not itself deal with slippery pavements caused by snow and ice, local regulations will have to guarantee that residents see to it. It goes without saying that obstacle-free strips of pavement should remain safe for walking during wintry periods. * exclusive use of parking-space Through a system of licences and/or exemptions the use of parking-places can be regulated. It is of course of great importance for the independent mobility of wheelchair-users to keep a constant check on the effectiveness here of. The iirmediate towing away of vehicles illegally parked in general parking places for the disabled, should in the policy of order have high if not top priority.

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297

3.5 Policy of education and information The municipality can inform the population and make than aware of the problems of mobility of elderly and disabled persons, the activities of the municipality in this and hew citizens can limit the problems to a minimum through their conduct by pursuing a policy of education and information. By also taking into consideration elderly and disabled personthey too can be made better skilled traffic participants. Focusing points for educational policy: * The educational programme of a number of schools can be influenced by the municipality fron its administrative responsability. * For schools in wich this direct influence is not possible, attention can be focused on the possibilities of mobility of disabled and elderly persons, by the presenting of teaching material. * Fran the municipal responsability for the welfare of its citizens it is also possible to approach private schools of motoring and to stimulate driver-students to pay attention to to elderly and disabled persons by providing teaching material. * Organising courses for elderly people in which they are taught to behave with less fear in traffic and in which they cue made aware of their limitations and hew to compensate for them. * In the educational programme for drivers in public transport (particularly within municipal transport services) it is possible to pay extra attention to disabled and elderly persons. Educational material is especially meant to draw of future road-useers to their conduct regarding less mobile. By constant attention in this field possible, in the long run, to create a change of

the attention people that are it seems mentality.

Information rather than education aims at shewing the population the existence of (new) rules, abuses and what to do in certain situations. Information, therefore, is much more tied to time. Just as educational material, information material should be of an inclusive nature. In other words, wherever possible, information, brochures and leaflets should pay attention to disabled and elderly persons. Focusing-points regarding the policy of information * When enforcing rules or granting permits attention should not oily be paid to the rules and permits themselves but also to the why thereof. This can be made* clear in a leaflet that is provided when the permit is granted.

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* Information is tied to time. We should pay attention to dealing with slippery pavements for instance when the first new falls and not in summer. * Information can usually only be effective when frequently repeated in a similar form or otherwise. 4. CCNCLUSICN Municipalities have many possibilities to stimulate the mobility of the elderly and the disabled. Frcm information available to us, we may conclude that there are tremendous arrears in mobility and that there is also a great need for independent mobility. With a reasonably simple integral approach much can be achieved to stimulate independent participation in traffic. By paying attention to the interests of the elderly and the disabled in the field of mobility at an early stage, so in the policy pursued, the necessary and desired integration into society will really take shape.

GUIDES AS TOOLS FOR BETTER MOBILITY AND TRANSPORT Trygve Roll-Hansen Senior Executive Officer

1

INTRODUCTION - CHAPTER 1

In 1986, the Norwegian National Assembly asked the Government to take care of that everybody responsible for transport and mobility, work out plans on how to improve the transport and mobility for disabled persons. One problem is how to achieve this when no law or rule demands it. Another problem is that nobody can improve the mobility and transport for disabled without knowing how to do it. If these improvements shall be done, it’s also a necessity to know something about the benefits gained by these kind of projects. One answer is information given through usable guides. On this background the Ministry of Transport and Communications has published a guide for planning and administration of transport service for the disabled, and a guide about roads for more people. The Ministry is also working on a guide about means of transport. These guides show practical measures for mobility and transport for the disabled. The guides also deel with the benefits from better mobility. A third topic covered in the guides is how to make planning easy and usable. The guides are meant to inspire local decisionsmakers to plan and work out usable mobility for everybody.

299

300

2.

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

VISUALISATION - CHAPTER 2

Pictures with short texts gives both quick information and inspiration. The following exampels are from the Norwegian guide "Roads and streets for more people" Measures for mobility for the disabled give the possibility for activity that gives better health both physically and psychologically. This gives better conditions both for induviduals and for society. More material and none-material goods are produced, and the needs of support from the socialand from the health-sector are reduced. The guide "Roads and streets for more people" calls attention to the fact that measures for disabled often gives benefits for everybody. For exampel, everybody will be helped in the dark with measures for the blind. The needs of space for disabled generally give a higher standard for most people.

Need of space for disabled

BETTER MOBILITY AND TRANSPORT

For The The The

the wheelchair: maximum gradient 1:12 maximum leveljump 2 cm maximum cross gradient 3:100

For the crutches: The maximum height of step 15 cm The instep 30 - 35 cm Walking distance maximum 100 m

301

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MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

On big open spaces without clues and leads it becomes difficult to orientate.

Different types of surface will especially help the weaksighted and the blind.

BETTER MOBILITY AND TRANSPORT

303

Lowering of kerbstone

Less carstops reduce polution and stress problems. Less stops can be achieved by narrowing the street/road, giving a shorter distance to cross it. With a shorter distance the pedestrian needs shorter time and the cars don’t need to stop so often an so long as before.

304

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

Obstructions

Stairs

Supplement

BETTER MOBILITY AND TRANSPORT

305

KureT i»«i

Route signs have to be easy to read, also for the blind(with help of braille). Sketch maps give quick, easy and useful information.

306

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

The bus for M o r e People. A p r o t o t y p e c r e a t e d by N o r w e g i a n Bus & Coach Lines A s s o c i a t i o n t o g e t h e r w i t h m e m b e r s from The A ss o s i a t i o n of the H a nd i capped, t e chnic al e x p er t s from chassis and b u s - b o d y constructors.

Bad maintenance creates problems for the disabled. Maintenance deals with snow, roadsurface, repair, marks, sign, sketch-map and other means of information.

BETTER MOBILITY AND TRANSPORT

3.

307

FORMS - CHAPTER 3

The guides have forms which can be used by the local authorities either directly or with some corrections. (See also 4.1) Such forms shorten the way for local authorities. The following form is from the guide for planning and administration of transport service for the disabled.

4.

PLANNING - CHAPTER 4

4.0

Steps and circel in the planning

Reality gives the input to the registration which together with needs and costs, forms the base of the priority list, the long-term plan, the yearly budget and the executions which are changing the reality. —*

4.1 Registration

I

r |

REALITY

l

1

l

4.3 Long-term plan,

|I

yearly revised

J1

i

Î

4.5 Execution

4.2 Priority list

-

4.4 Yearly budget

308

4.1

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

Registration

The guides have registration schemes. As an exampel follows the scheme for a bus-stop: Name of the stop: YES/NO ACCESSIBILITY Possibility to park Road for pedestrians and cyclists Pavement Place for crossing - leading fence - light signals - lowered kerbs - shortened crossing INFORMATION Name plate of the stop Light on the stop Timetable THE SHAPE OF THE STOP Place for waiting outside the roadway Leading fence Kerbs Shelter Bench Call box

COMMENTS

309

BETTER MOBILITY AND TRANSPORT

4.2

Priority list

Physical registration, needs and a price list form the basis for setting up a priority list as the following: PUBLIC TRANSPORT - measures for disabled Filled in by. County...... Nr

Description of project

Date Cost in 1989-kr

Remarks

1

2

3 4 5

4.3

Long-term plan

When knowing how much money is planned to be the projects each year, the priority list is easily into a long-term plan by suplementing implementation year for each project, and we

spent on changed the get:

PUBLIC TRANSPORT - measures for disabled Filled in by ............................ County.............................. Date Nr

Description of project

Cost in Implimen- Remarks 1989-KR tationyear 1989 1989

1 2 1-2 All project in 1989

= = = = = = = =

6

= = = = = = =

1990 1990 1990

3 4 5 3-5 All project in 1990

1989

= = = = = = = =

1990 1991

= = = = = = =

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MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

4.4

Yearly budget

By yearly revising of the long-term plan we get a up to date base for a yearly budget shown as for exampel: BUDGET FOR 1990 PUBLIC TRANSPORT - measures for disabled Proposed by......................................... County.......................... Date................ Description of project

Cost in 1990-kr

Total

4.5

Execution

The goal is to get the measures done. With more knowledge of the subject this can be done better and cheaper. It can be achieved by getting relevant information and experiences. We therfore need useful guides and long-term planning giving a continuously and predictable activity. The yearly budget, the executions and the measures needed for better mobility, give a new reality calling for new registrations, a new priority list and a new long-term plan as basis for the new budget.

SESSION B: ENHANCED MOBILITY

PROBLEMS OF ELDERLY ROAD USERS: A MATTER OF CHANGING PERSONS OR CORRECTING THE SYSTEM? Univ.Doz.D r .Ralf Risser Traffic psychologist Lecturer for traffic sociology at the University of Vienna "By request of my new and very efficient London editor Doosey and Hawkes I have compiled an orchestra version of the best parts of "Woman without shadow" (60 pages of score), which is thought to make the opus more popular in concert, as opera performances will probably remain impossible for a longer period. You see, one can still accomplish quite fruitful things facing ones 82n birthday if one has been diligent before and constantly has kept the needed mental capacity somewhat alert." Richard Strauss (1946) 1. SOMETIMES ONE HAS TO MOVE It is no t unusual to look upo n e1der ly pe rson s as on per s0ns being handi capped > in th e se nse that they ar< not q uite up to the stand ar d s se t by soci ety . Thi s i esp ecia11 Y ‘ true as far as tra ffi c/tr anspo rt iS CO n~ cer ned , In which wa y are th os e stand ar d s det ermin ed , how e V er ? It stands to rea so n tha t so ciety str ives fo the best trained an d f i11 es t spe cial ists to set the s ta ndard s for the profess io na 1 worid . Can one com Pare traf f ic/tra nsport whe re a11 peopl e ha ve t0 tak e Part , independ ently of thei r ef f ic ie n c y , to the pro fessio nal world, though? All people have to move from A to B every now and than , and one has to expect that only part of them are of high capacity performance. On the other hand ther e certainly are many people performing quite below average in many circumstances, who still have to be mobile, nevertheless. No democratic society can a f ford not to provide for adequate facilities for those people as well, can it? Now: 2. CAN WE EXCLUDE PERSONS FROM TAKING PART IN MOTORIZED TRAFFIC? Of course, we can do that: Think of blind persons who, at present, will not be able^and will not be allowed, to drive any motor vehicle. However, it is well 311

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defined which kind of visual impairments will defend persons from being allowed to drive any motor vehicles. This kind of definitory accuracy is missing as far as psychological and physological changes coming along with increasing age are concerned. We are not able to say exactly at which age which types of performance are changing, and how, having even less knowledge about impacts of those changes on traffic safety, on psychological compensation mechanisms neutralizing impairments of performance, etc. Thus, it will be very difficult to be fair in ones decisions on who is to be excluded from motorized traffic and who is not. A way to find out if and how psychological/physiological changes have taken place could be to once a year test and interview all persons over a certain age. But again, there is the question which changes should be looked upon as being incompatible with driving a vehicle. And if one answers that question, and thus can exclude a number of people from motorized road traffic, there still remains the problem that by doing so he did not change risks for elderly pedestrians at all, after all one cannot exclude than from traffic It is not very likely that these problems are going to be solved with help of scientific data in near future. Thus, political decisions will have to be taken. However, discussing the background for decisions on if, and under which circumstances, elderly people could be excluded from motorized traffic, one point has to be made: There are, without doubt, circumstances under which only a motor vehicle can provide for adequate mobility. This is quite frequently the case on the countryside, for example, this fact having an especially strong impact on elderly people facing physical difficulties to walk or cycle to distant bus or train stations, etc. Lack of possibility to use a motor vehicle in those cases could mean a substantial deterioriation of life quality. I do not equate life quality to being able, or allowed, to drive a motor vehicle. On the contrary, walking, cycling, or using public means can be of much better quality, regarding individual wellbeing as well as regarding environmental impact of motorized traffic, though only if there are ways to choose those alternative modes of transport, of course. It would actually look quite unfair if a society, allowing, and even inciting, its fittest members to use motor vehicles even in cases of utterly little necessity, excluded others, much more in need of motorized help, from driving motor vehicles.

PROBLEMS OF ELDERLY ROAD USERS

313

3. A MATTER OF CHANGING PERSONS OR CORRECTING THE SYSTEM? As far as psychological/physiological changes going along with increasing age are concerned, there is no certainty about which of those changes take place irreversibly, and which of them can be stopped, or reversed by training, information, etc. In this respect, as well, it becomes more and more evident that it is absolutely necessary to know more about quantity and quality of those changes so often mentioned, or if they mediate actual deterioration under all circumstances, and, in case deterioration can actually be identified, about its tolerable degree . Although, in this connection, one has to argue that the degree of tolerability of deterioration of performance very much depends on the characteristics of the traffic system: Rapid traffic, requiring fast decision making and quick reactions will tend to overcharge elderly persons, though not only as car drivers but also when using other transport modes. This might be quite a powerful incitement to think about in which respects the traffic system could reasonably and realistically be changed, in order to provide for better mobility, and at the samettLme for higher safety of elderly road users. Training for all elderly persons, including pedestrians, cyclists, users of public means, etc., leaving the traffic system unchanged, seems a task impossible to be achieved because of the gigantic amount of labour that would imply. Moreover, it seems an absurd idea from another point of view: Why should anybody who wants to sometimes visit his friends, to do his shopping, to go to the theatre, etc., have himself trained? However, one could agree upon establishing training facilities voluntarily to be visited by people who want to get training of that kind in order to improve their own preconditions for taking part in traffic safely. Before one starts thinking in detail about which system changes could be reasonable and possible to be achieved, resp., which training or information programs could be advisible, some other questions have to be answered:

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4. IS RISK OF ELDERLY ROAD USERS ACTUALLY HIGHER THAN THAT OF OTHER GROUPS? While increased risk of elderly pedestrians becomes transparent at once when looking into the Austrian accident statistics report (OSTZ 1984; table 1), still remaining accentuate when relating accident numbers to exposure data (RISSER et a l . 1988; figure 1), increased risk of elderly car drivers does not become transparent at once from accident statistics (OSTZ 1984; table 2): Table 1

Traffic-accidents per age; injured pedestrians age

Figure 1

Total absolute %

15-24 25-34 35-44 45-54 55-64 65 +

997 596 578 537 667 1707

14,28 8,54 8,28 7,69 9,56 24,46

Total

6980

100,00

Risk-index pedestrians ; injured pedestrians per 10 journeys

PROBLEMS OF ELDERLY ROAD USERS

Table 2

315

Traffic-accidents per age; injured car drivers age

Total absolute %

18-24 25-34 35-44 45-54 55-64 65 +

7912 4551 3534 1844 1128 603

Total

19572

AO,4 23,3 18,1 9,4 5,8 3.1 o o o

Only a very small group of drivers older than 64 get injured in road traffic in comparison to the percentage of population they represent. But, if one relates accident data to exposure data (RISSER et al.1988; figure 2), the risk of elderly car drivers is very high, indeed. The only group of car drivers with higher risk of getting injured in road traffic than elderly drivers are those between 18 and 24 years of age, although, as a study of SCHLAG (1987) has shown, this fact is mainly due to the extremely increased risk of car drivers older than 74, whereas he found no significant risk increase in comparison to younger groups with drivers between 65 and 74. Figure 2

Risk-index car driyers; injured car drivers per 10 kilometers

18-24 25-34 35-44 45-54 55-64

12

65+

316

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

We do not know exactly if these results correctly mediate the facts concerning pedestrians as well, but one could hypothesize that even there "very old” persons - over 74 years of age - run very high risks. This problem is not going to shrink in future: 5. ASPECTS OF POPULATION DEVELOPMENT Prognoses reaching 25 to 30 years ahead show some explicit tendencies of population development not only typical for Austria but also for other European countries: o The portion of people older than 64 years will slightly increase, nowadays portion being about 15% o The portion of people older than 74, a subgroup of all people above 64, will increase quite sharply, though. Especially the latter group will have to be dealt with adequately in future, in order to provide for safe and sufficient mobility for them, the alternative being isolation. 6. CHANGES IN TRAFFIC PARTICIPATION Until the year 2000 some groups of now younger people holding drivers'licenses to quite a high percentage will reach 64 or more years, thus joining the group of the elderly. ELLINGHAUS & SCHLAG (1985) have made a prognosis on approximately how many people above 64 are going to hold a drivers license, by then (table 3)* Table 3

People over 64 holding a driver^ licence (in West-Germany, years 1976 to 2000); ELLINGHAUS & SCHLAG (1985) year

number(in 1000)

1976 1986 1990 1996 2000

1591 2400 2900 4000 4600

% 17,7 28 34 46 53

It is interesting to observe how many of all the vehicle drivers will be older than 64 in the year 2000:

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ELLINGHAUS & SCHLAG (1985) assume that the portion of drivers older than 64 from 10% in 1983 will increase to more than 25% in the year 2000. Moreover, several authors agree that the portion of female drivers will further increase in future, especially within the group of drivers over 64. ELLINGHAUS & SCHLAG (1985) predict a duplication of the 1976 portion of 20% female drivers in this group by the year 2000 ( see also BRÜHNING & HARMS 1983). To let traffic standards develop considering mainly motor vehicle drivers between 25 and 64, as certainly was done up to now, in future will become less and less adequate one can see from this developments to be expected. (Thinking of the fact that up to now, of course, apart from elderly people women, children, handicapped people, adolescents, beginners, etc. have had to take part in traffic, as well, the question rises if the development of standards that way ever was adequate!) 7. WHAT DO WE KNOW ABOUT THE PROBLEMS OF ELDERLY ROAD USERS? In the framework of a study done by the Austrian Road safety board in 1986 (RISSER et al. 1988) this question was amply dealt with: Because of the complexity of the topic a number of different research methods were applied. From a psychological point of view it was interesting to get informations about changes in psychological performance (e.g. visual capacity, reactive capacity, stress tolerance, concentration, sensomotoric ability), in personality variables, in attitude towards road traffic and other road users, mobility needs, informations about problems with traffic surroundings and traffic circumstances. It was tried to get those informations by using a large range of methods: o Studies on the state of the art in literature o Analysis of accident- and population-statistics and analysis of representative surveys on mobility and choice of traffic means, Austrian and international o Standardized questionnaires and round-table-discussions dealing with attitudes towards road traffic, towards road users, mobility problems, etc.

318

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o Driving tests with groups of drivers younger and older than 64 years. o Psychological tests with the same subjects, o Observations of pedestrians. The main results of these analyses can be summed as follows:

up

A very complex picture of driving and mobility habits of elderly traffic participants appeared. A number of prejudices had to be revised. Generally there is no overall performance decrease with increasing age. Nevertheless there are some typical changes in prestation and personality: o Flexibility resp. adaptation-ability in new situations decrease (’flu id ability” ), o Regeneration and recreation successively take more time. That means that older people have to have longer rests after tiresome activities (like driving a car). o Concentration gets weaker, irritability increases, o Behavior becomes slower, movements and handling processes absorb more of the concentration and leave less sparecapacity ; that produces anxiety and sometimes is a barrier for mobility, o But: if there is general knowledge and experience, acceptance and understanding of gpneral facts do not decrease or even increase by training (’’crystallized ability”). Those are the most important facts to be found in 1iterature . Relations between tests applied in traffic psychology and the age are as follows: With the tests used in traffic psychological diagnostics data on psychological performance, basic intellectual abilities, and attitudes relevant for traffic participation were gathered. The most important results concernin'; the performance of people older than 64 yaers in these areas were the following: o Visual, reactive and concentrât?ve performance get slower. Reaction time gets longer, o Flexibility of concentration resp. concentration in new situations gets weaker in a quantitative sense (the number of items solved in flexibility testing gets lower). o There are no significant quality decreases in comparison to younger people! o Concerning personality and attitudes, risk taking tendencies (at least the verbal ones), and tendencies towards aggressive interactions as well as emotional

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tendencies towards car driving decrease, whereas regard for other traffic participants increases ! The most important results obtained by the observations of drivers'behavior on a standardized route as well as by the observations of pedestrian behavior were the following: o Handling of car instruments resp. the mechanical acts necessary for driving a car cause more problems and leave less spare capacity for the traffic circumstances • o Elderly car drivers show fewer errors in driving behavior (esp. concerning law infringements). But, communication with other traffic participants is quite reduced. That means, that less informations coming from the social traffic surroundings are perceived, which is a problem for interaction. Quite often, resulting problems have to be compensated by other participants in order to avoid collisions. This is one fact that, of course, cannot be reported by accident-statistics. Table 4

Percentage of participants in evasive activities of all conflicts persons got involved in age 18-24 25-34 35-44 45-59 60+

% participation in evasive activities 70 80 79 70 38

o Some typical forms of behavior of elderly car drivers are irregularely varying speeds and problems with the right of way; on the other hand elderly drivers hardly take any risks in overtaking, and speeding is very seldom in this group. o Eldery pedestrians are being kept quite busy by obstacles, e.g., parking cars, and by surface irregularities, e.g., pavement edges, their concentration on traffic processes thus being impaired. These results can be summarized, very shortly, making three points:

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o performance Quantity decreases, whereas quality does not.

performance

o Spare capacity problems because of handling difficulties become more frequent. o In complex situations whëre communication with other road users resp. with the physical and social surroundings is necessary, this necessity sometimes can not be fulfilled by elderly road users; thus, other road users have to compensate in order to avoid accidents. 8. WHAT COULD BE DONE TO IMPROVE THE SITUATION? After all the things that have been said above it only seems to be logical to think of possibilities to change system aspects in order to give elderly participants a chance to take part in a safe and comfortable way. Some possiblities for that are: o

Improvements in physical structure in order to achieve better survey possibilities. - Changes in traffic light phases (e.g. longer phases for pedestrians on some crossroads) and traffic light positions - pavement with oblique edges

- normal staircases or eLeveators instead of moving staircases only

- trafficators easier to survey

- better positioning of traffic signs - park and ride possibilities so elderly car drivers do not have to drive a car in complex city traffic o Changes in car construction - Displays easier to survey - Automatic gearshift - Servo-supported stearing o Law-enforcement in order to protect pedestrians, like - control of car drivers behavior around zebracrossings by police - prevention of speeding within inhabited areas

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- measures to keep pavements and streetcorners free from parking cars

o Lower speeds, so all existing groups of car drivers can take part in traffic in a safe way. o Changes of informal norms, like - mediation of philosophy that does not pronounce "the right of way for cars only" - safety campaigns ±1 order to increase understanding between traffic participants-groups (like for example elderly drivers vs. younger drivers, drivers vs. pedestrians). 9. CONCLUSION Analyses have shown that elderly people because of psychological/physiological changes need clearly structured traffic surroundings. Very complex and unstructured situations tend to overcharge them. The more aspects require concentration, the more likely elderly people become stressed and eventually confused. Speed in this connection is quite stressing a factor, frequently leaving too little time to react correctly in complex situations. The aim to produce conditions and physical surroundings better meeting the requirements of elderly road-tsers, and of other road user groups as well, quite clearly includes the appeal to the average driver to start practicing a driving style somewhat slower and less aggressive than he has got used to, For elderly road users the possibility to take part in traffic safely and flexibly - independently of chosen mode - means the basic difference between getting older still remaining an active and selfconfident member of society, on one hand, and being forced into isolation by the circumstances, on the other hand. REFERENCES BRÜHNING E. & HARMS H . 1983, Unfallbeteiligung und Sehfähigkeitsverminderung älterer Pww-Fahrer, ZVS 29, Heft 1 ELLINGHAUS D. & SCHLAG B. 1985, Alter und Autofahren Uniroyal Verkehrsuntersuchung Nr. 11

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ÖSTZ 1984, Datensammlung des Österreichischen statistischen Zentralamtes, Statistisches Handbuch, Wien RISSER R., STEINBAUER J., AMANN A., ROEST F., ANDERLE F.G., SCHMIDT G.A., LIPOVITZ G. & TESKE W. 1988, .Probleme älterer Personen bei der Teilnahme am Straßenverkehr, Literas Universitätsverlag SCHLAG B. 1987, Leistungsfähigkeit und Fahrverhalten älterer Kraftfahrer, in: Unfall- und Sicherheitsforschung Straßenverkehr, Heft 63

THE ELDERLY IN TRAFFIC: MOBILITY AND ROAD SAFETY Dr. P.I.J. Wouters SWOV Institute for Road Safety Research, The Netherlands

1. INTRODUCTION In the western nations, the average age of the population is rising. There are more elderly people, who are also able to play a full part in society for longer and who wish to continue to do so. In order to take part in the life of the community, it is often essential that they participate in traffic. The elderly will therefore play an increasingly important role in the traffic scene. Mobility goes hand in hand with danger on the road. In the Netherlands, more than a quarter of fatal accidents are suffered by those aged 65 and above. This is twice as high as one would expect on the basis of the population composition. A similar situation is found in other North-West European countries (World Health Organization, 1986). If the proportion of elderly people in the population rises, as forecast, from one eighth today to a quarter in the year 2035, and if circumstances remain unchanged, half of all deaths on the road will therefore occur in this age group. In other words, while there is already sufficient reason today to tackle the problem of the elderly and road safety, a look ahead to the future makes this all the more essential. If we wish to avoid this unfortunate consequence of mobility, so that the elderly can use our increasingly busy roads independently and safely, the reasons for these risks must be investigated and solutions found for the problem. This contribution is devoted to that subject. 2. THE MOBILITY OF THE ELDERLY Human patterns of activity change with age. There are also social factors which affect participation in traffic, such as prosperity, the emancipation of women, environmental considerations etc. This is reflected in the purpose, intensity, time and mode of road use. A comparison of the data available on four countries (OECD, 1985), namely Denmark, Federal Republic of Germany, the Netherlands and Great Britain, shows the following regarding the level of road use of those aged 65 and above in relation to that of the 25 to 64 age group (See Table 1). Age

65+ 25-64 Ratio

Average annual distance (km) travelled Car occupants Cyclists UK Den. FRG NL UK NL Den. FRG 2350 7355 .32

1998 7735 .26

2976 1579 8554 5536 .29 .34

280 530 .53

100 146 .68

429 22 785 58 .55 .37

Pedestrians NL Den. FRG

UK

440 363 313 302 322 311 314 392 1.33 1.17 1.00 .77

Table 1 . Average annual distance travelled (km) in four countries by travel mode and age (Source: OECD, 1985)

323

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MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

Increasing numbers of women are also going out to work, making them more dependent on cars than in the past and also more likely to be able to afford this mode of transport in future. Generally speaking, better health care, greater educational opportunities, a shift from physical to mental work and higher incomes etc. will also mean that future generations of the elderly are fitter, and will become less housebound. Again, this will largely mean more travel by car. This, after all, is the mode of transport which can be used freely, without waiting etc. and without too much physical effort, and which also offers protection against the weather and social insecurity. Only 'The Limits To Growth' seem likely to brake this development. Walking and cycling will also increase, albeit to a lesser degree. Their limited radius of action means that they are used mainly for travel close to home, primarily for reasons such as "shopping" and "visiting family or friends". Few changes are to be expected here; changes in travel for the purpose of "sport and recreation" can be expected. In addition, more and more people are withdrawing from the labour process earlier than in the past. Their activities will probably start to show the same patterns as those of the elderly. 3. THE SAFETY OF THE ELDERLY ON THE ROADS A process and product analysis of the situation in the Netherlands (SWOV, 1987) highlighted three determining factors in the safety of the elderly. Furthermore, they proved to be interrelated. These factors are: - physical vulnerability; - loss of mental and physical function; and - declining mobility. The first two only briefly will be discusses here; mobility and its relationship with the other factors will be discussed in more detail. Biological processes result, with increasing age, in a reduction in resilience to trauma. This is shown in the lethality of the different age groups, i.e. the proportion of fatalities in road accidents. Figure 2 gives lethality by sex and age group, by reference to the 25 to 34 age group. As shown, lethality rises progressively with age and is higher for men than for women. The high vulnerability of the elderly is a major factor in the road safety problem of that age group. As a consequence of ageing, perceptual, cognitive and motor skills deteriorate. In traffic situations this leads, among other things, to difficulty in estimating distance and speed, particularly at dusk and in darkness. Overtaking traffic, for instance, is noticed later as hearing deteriorates. Complex situations, such as heavy traffic and traffic travelling at high speed, are more likely to cause problems in the selection of information and decision-making. The elderly are no longer able to take and execute different types of decision more or less simultaneously, but must do this step by step. In such cases they are likely to revert rather inflexibly to a standard type of behaviour. Walking and driving become more awkward.

325

THE ELDERLY IN TRAFFIC ag« group 2 5 -3 4 yaar»(man ♦ woman) 5100

ago

ago

FIGURE 1 . Annual distance travelled by pedestrians (P), cyclists (C) and car drivers (A), by sex and age group, 1983 + 1984. The average annual distance that the elderly travel by car falls to about one third of that of other adults, and the distance travelled by bicycle to about half. In walking, a variation between an increase and a decrease is seen. A more detailed analysis can be made of the data for the Netherlands. Figure 1 shows the average annual distance travelled according to sex and age group, standardised by reference to the 25-34 age group. This not only shows that road use diminishes with age, but also that women travel far less than men, except as pedestrians. Moreover, the distance travelled by women starts to diminish at a younger age. These data relate to the situation today. What will happen in future is not clear, although there are some indications. Naturally demographic developments are of overriding importance. The growing number of elderly people will undoubtedly lead to an increase in the mobility of this group. If individual mobility also increases, as is to be expected, group mobility will rise even further. As a result of the emancipation of women, the gap between male and female mobility will shrink. This is especially true in the case of driving, as shown by data on the rising number of women who hold driving licenses and own cars.

326

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS ag« group 2 5 -34 y«ars(m«n ♦ woman) =100 standardised lathallty

ago

FIGURE 2 . Lethality (number of fatalities per 100 casualties plus those hospitalised for their injuries) for pedestrians (P), cyclists (C) and car drivers (A) by sex and age group, 1983 + 1984. The consequences of loss of function can be anticipated to an extent by compensation. For instance, the elderly can avoid traffic situations which they find difficult, and could be given more time to observe, decide and act. Loss of function starts to appear as early as the age of 45 and becomes more marked with age, although there are considerable individual differences. Loss of function cannot be prevented, but can be significantly postponed if skills are practiced regularly, including in traffic situations. Routines are kept up in this way as well. This brings us to the mobility of the elderly, and in particular to the link between road safety and the loss of mobility discussed in par. 2. If we turn to the fatality risk, i.e the number of fatal accidents per unit of distance travelled, again for Denmark, Federal Republic of Germany, the Netherlands and Great Britain (OECD, 1985), we find that this is markedly higher for the elderly than for the 25 to 64 age group, particularly among cyclists and pedestrians (See Table 2). In short, elderly people participate less in traffic, but once they do, their risk of a fatal accident is many times greater than that of other adults. However, the high fatality risk for elderly cyclists in the Netherlands, as shown by the table, can partly be explained arithmetically. It is also partly due to the fact that the distances are travelled in heavier traffic.

327

THE ELDERLY IN TRAFFIC Age

65+ 25-64 ratio

Fatalities per 100 million km Car occupants Cyclists UK Den. FRG Den. FRG NL 2.9 .7 4.3

3.2 1.1 2.9

2.6 .7 3.7

2.7 .9 3.1

NL

UK

11 43 21 31 2.1 7.7 1.8 7.1 4.8 5.5 11.8 4.8

Pedestrians Den. FRG NL

UK

20 33 21 43 4.9 8.2 3.8 6.2 4.0 4.0 5.7 6.9

Table 2. Fatality risk in four countries by travel mode and age (Source: OECD, 1985). These findings too can be analysed in more detail on the basis of the data for the Netherlands. Figure 3 shows the casualty risk, i.e the number of fatalities plus injured persons per unit of distance travelled, by sex and age group with the 25 to 34 age group as the base. Apart from the fact that this risk again rises with age, it is also notable that the rise clearly begins at an earlier age among women and reaches a higher level than among men. Unlike men, the risk of cycling is higher than walking for women.

aga group 2 5 -34 yaars(man ♦ woman) 3 100

aga

aga

FIGURE 3. Casualty risk (numbers of casualties per 1000 million km travelled) for pedestrians (P), cyclists (C) and car drivers (A), by sex and age group, 1983 + 1984.

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The results for risks as compared with those for mobility (Figs. 3 and 2 respectively) lead to a remarkable observation. Among road users aged 25 and over, there is evidence of a relationship between the average annual distance travelled and the casualty risk. The shorter the average annual distance travelled, the higher the risk. Considered in more detail, a reduction in the distance travelled results almost immediately in a rise in the level of risk. Finally, the relationship between the three factors. Ageing entails loss of function. In addition, road use decreases with age, partly because travel to work stops at a certain point, partly because the elderly are less confident about using the roads because of their loss of function and greater vulnerability. Less frequent road use means that loss of function is not adequately counteracted and routine is not maintained. As a result, road use becomes more of a risk. In short, a vicious circle is created. 4. A STRATEGY FOR SOLUTIONS Armed with the knowledge of the factors which largely determine the dangers to the elderly on the roads, it is possible to draw up a strategy for resolving the major problems. Such a strategy might appear as follows: - Loss of function in the elderly should be slowed down as much as possible and routine should be maintained. Opportunities for compensating loss of function should be reinforced; - Other road users must (learn to) improve their conduct towards the elderly, taking account of their possibilities and limitations; and - As far as road conditions are concerned, situations must be adapted to ensure that the elderly, too, can participate safely in traffic. Where this is not possible, the vulnerability of the elderly demands that exposure to such dangerous situations be avoided. The first point entails stimulation of mobility. For individual elderly people this will improve their participation in society and safety in traffic. But although greater mobility leads to a lower accident risk per unit of distance travelled, on balance it does lead to a higher number of accidents. We are therefore faced with a social choice with far-reaching consequences, involving conflicting central government targets. On the one hand, government policy in most western countries is aimed at enabling the elderly to play a full role in society for as long as possible. At the same time, these governments generally aim to reduce the number of road accident victims. The two goals can be achieved at the same time only if the risk of accidents involving the elderly falls sharply. This requires attention to the other two points. 5. A PACKAGE OF MEASURES Breaking the vicious circle which characterises traffic dangers for the elderly demands an effort on the part of everyone involved in

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traffic and in traffic and transport policy: not only the elderly themselves, but also other road users and both their interest groups; not only central government but certainly local authorities as well. In joint consultation, they must arrive at a coordinated package of measures which will guarantee the safety and the mobility of the elderly in future. In this context, we have developed the strategy discussed in par 4. We follow the 'phases of the transport and traffic process' (OECD, 1984) here, a process which starts with social activities. These lead to travel and traffic behaviour, and to encounters with other road users. Accidents can occur here, requiring rescue work and possibly after-care. Social activities and travel The obvious point at which to start is information on loss of function and routine. Effective advice can give the elderly an insight into their own possibilities and limitations and present to them useful forms of compensatory behaviour. At the same time, it can encourage them to practice functions in traffic and elsewhere and to maintain the routine. Information should also be directed at society as a whole. In this way, other road users too will be informed about what they can and cannot expect from the elderly in traffic. Besides information, the elderly can also be offered training courses in traffic and elsewhere, aimed at maintaining functions which are vital in traffic, or bringing these up to standard. These courses, which still require some development, could be used in existing forms of sports and games designed to improve the mental and motor functions of the elderly. In order to allow the elderly to practice safely in traffic, recreational facilities and safe pedestrian and cycling routes are needed. Although loss of function can be slowed down, it is progressive and ultimately the time comes when certain modes of transport become undesirable. Just as young people are required to prove that they have sufficient skills before they are permitted to drive on the roads, a similar requirement for the elderly could be considered. However, reliable criteria for assessing their performance must be developed first. Furthermore, there must be sufficient guarantees of their right to mobility. Public transport which is accessible and affordable for the elderly could offer a solution here. Individual modes of transport such as taxis and call-up bus services should certainly be considered as well. Traffic behaviour Participation in traffic involves following a route and selecting an appropriate course, speed and position on the road. The expectations of the elderly, right or otherwise, regarding traffic and traffic situations play an important role in these choices. Electronics in cars and at the roadside can ensure proper route selection and that signals are given in good time. Elderly pedestrians and cyclists usually travel in their own immediate neighbourhood and will have no problems in this respect. However, they do need to be informed about temporary or permanent alterations to the infrastructure. In selecting their course, speed and position on the road, predictable traffic situations and the appropriate traffic rules and regulations are particularly important for the elderly.

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Observance of these rules should be encouraged, certainly in the case of motorised traffic, which quite rightly causes the elderly anxiety. Besides traffic control, which need not necessarily be manned control but can also be done through electronic aids in or outside the vehicle, road design can also be of assistance here. Elderly people's knowledge of the rules, particularly new ones, also requires attention. Such measures can increase their capacities for anticipation and improve their self confidence in traffic. Encounters with other road users The problem of 'strong' versus 'weak' types of traffic plays a key role in direct confrontations between participants. Separating motorised vehicles from pedestrians and cyclists in time and place, or the integration of these categories, can offer genuine solutions for all pedestrians and cyclists. A more specific problem for the elderly is that of complex situations demanding the performance of multiple tasks, and rapid and accurate perception, selection of information and reaction. Old people in particular need to carry out multiple tasks step by step. This should be taken into account in road design. It is also closely related to the time in which events take place; this depends to a large extent on the speed of the motorised traffic. In (parts of) urban areas the speed limit of 50 km per hour can be too high. Observance of this limit is the least that can be required. Little is known about the informal rules that play a role in traffic and how road users communicate during encounters. Doubtless many problems are solved by road users themselves, without recourse to formal legislation. The elderly are probably more willing to observe rules and regulations than other adults, perhaps because keeping to definite rules is less complicated than dealing with informal ones. In addition, their deteriorating auditory and visual acuity limits their ability to communicate. This calls for greater observance of formal rules and (research into) their integration with informal rules. Accidents The great vulnerability of the elderly justifies additional efforts to prevent their involvement in accidents. Once an accident occurs, there are few ways to limit the severity of the consequences. The majority of casualties in slow traffic result from collisions with cars. If the speed on impact is well below 30 km per hour, the consequences are not usually fatal. This is therefore an important point for action. Rescue and aftercare Many elderly people use medicines. Moreover, their age alone means there is a high chance that previous injuries, illnesses etc. will have taken their toll on their physical condition. Rapid and reliable identification of medical history and the use of prescription drugs is therefore important in rescue work involving elderly victims. The elderly suffer multiple injuries more often. Improved diagnosis and medical treatment in special trauma centres for severe road accidents could save lives among the elderly in particular. The consistently serious consequences of road accidents involving the elderly and the high risk of permanent medical and

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psychological effects can cause them to withdraw further from the life of society and to degenerate more rapidly as a result. Research into these consequences should lead, among other things, to recommendations for methods of regeneration and the appropriate services: in other words, aftercare. 6. CONCLUSION Improving the safety of the elderly on the roads will improve the safety of all road users. REFERENCES OECD (1984). Integrated road safety programmes. Organisation for Economic Cooperation and Development, Paris. OECD (1985). Traffic safety of elderly road users. Organisation for Economic Cooperation and Development, Paris. SWOV (1987). Analyse van de verkeersonveiligheid van oudere fietsers en voetgangers (Analysis of the traffic safety of older cyclists and pedestrians). SWOV Institute for Road Safety Research, Leidschendam. WHO (1986). World Health Annual Statistics Annual 1986. World Health Organization, Geneva.

DIFFERENTIAL RESPONSE BY ELDERLY AND OTHER PEDESTRIANS TO TWO SAFETY CAMPAIGNS Allan Kat z , Deputy Di r e c t o r , Transportation Research I n s t i t u t e , Techni on-I srael I n s t i t u t e of Technology, Hai f a , Is r a e 1 1.

THE PRIORITY OF THE ELDERLY PEDESTRIAN SAFETY PROBLEM

Developing countries n a t u r a l l y place somewhat more emphasis on the e l d e r l y pedestrian safet y problem than they do on the e l d e r l y dr i v e r problem* This emphasis is in response to the s i t u a t i o n ex i s t i n g in those countries where o v e r a l l motori zation rates are low - - 25 to 200 vehicles per 1,000 persons. In the developed countr i es, with rapidl y aging populations and many years of high motori zation (300 to 400 vehicles per person), there are ever increasing numbers of e l d e rl y d r i v e r s. In terms of t r a f f i c deaths, 78% of the over 65 year olds k i l l e d in Israel were pedest r i a n s , whereas in the U . S . A . , the percent is 29%. Notwithstanding this d i f f e r e n c e , both developed and less developed countries fi nd that the e l d e r l y represent a s i g n i f i c a n t portion of t h e i r t ot al pedestrian deaths and i n j u r i e s . In a d di t i on , the e l d e r l y are over-represented in this type of t r a f f i c inj ury when compared to t h e i r proportion in the population. 6$+:% of pedestrian fatalities 65+;% of population (1986) 10% in A . (1986) 2C

10%

28%

SAFETY CAMPAIGNS AND OTHER COUNTERMEASURES TO REDUCE ELDERLY PEDESTRIAN INJURIES

There is l i t t l e reported success in the area of countermeasures s p e c i f i c a l l y aimed at helping the e l d e r l y road user - - as dri ver s or pedest rians. Nevertheless, whi le the physical t r a f f i c e n v i r onment remains extremely unf ri endl y to the e l d e r l y pedest ri an, engineering measures taken to help a l 1 pedestrians - - refuge i sl ands, improved s t r e e t l i g h t i n g , the re s i de n t i al Woonerf, the closed pedestrian s t r e e t - - lower the inj ury rates f or the e l d e r l y. In a d d i t i on , new engineering appl i cat i ons such as curb cuts, comfortable stai rway and ramp dimensions, designed s p e c i f i c a l l y with the e l d e r l y and disabled in mind, can be expected to f u r t h er improve the inj ur y s i t ua t i o n for this age group. The u nf ri e n dliness to the e l d e r l y pedestrian that continues to be b u i l t into the t r a f f i c system — r i ght turns on red, any bridge or tunnel requiri ng non-grade crossing, pedestrian b a r r i e r fences forci ng long detours in natural walking paths, i nappropriate sidewalk and roadway surfaces (rough and s l i pper y) — requires s t i l l 332

TWO SAFETY CAMPAIGNS

333

f u r t h e r engineering e f f o r t for increased s a f e t y . Enforcement of pedestrian t r a f f i c regulations f or any age pedest r i a n , and for the e l d e r l y in p a r t i c u l a r , is rare and has not been reported as a p a r t i c u l a r l y useful countermeasure, except when the enforcement level is 100%, i . e . , the policeman is permanently stat ioned at the s i t e — a crosswalk f or example. Pedestrian t r a i n i n g and education - - the use of informal audio visual present at i ons, formal classroom presentati on and the media - - are considered indispensable f o r improving pedestrian behaviour. There are no safet y professionals recommending d i s continuation of such programs, notwithstanding the lack of e v i d ence r e l a t i n g them to accident reduction. In f a c t , increased e f f o r t aimed at improving thi s type of countermeasure is taking place. Some problems which have been i d e n t i f i e d in making these countermeasures e f f e c t i v e are: - where to d e l i v e r the message: formal frameworks are not re a di l y a v a i l a b l e ; the e l d e r l y are not a captive audience - - in clubs for the r e t i r e d , an audience has to be a tt r a c t e d to a safet y l ect ur e or safet y a c t i v i t y ; old age homes have a high percentage of non-mobile resi dents, only a percentage of the h e a l t h i e r residents being pedestri an. - what messages to d e l i v e r ; - how to package the message; - who is ready and able to be tr ai ned to d e l i v e r the message; doctor, social worker, p ol i c e , et c. - what media is e f f e c t i v e : othe r. 3.

pri nted m a t e r i a l , audio v i s u a l ,

EVALUATION OF TWO PEDESTRIAN SAFETY CAMPAIGNS

The campaigns reported on in thi s paper represent recent e f f o r t s in Israel to improve pedestrian safet y through the use of media and innovative p ubl i c p a r t i c i p a t i o n as part of the campaign. In li ne wi th the recognized but g ener al l y ignored need for e v a l uating safety countermeasures, p a r t i c u l a r l y those in the area of education and t r a i n i n g , a decision was made at the Israel Mi ni st r y of Transport Safety Aut hori ty to evaluate the campaign cal l ed "A Golden Word for S a f e t y . " A second campaign in which pedest rian and d r i v e r p a r t i c i p a t i o n were planned was subjected to a pret est in order to evaluate the pot ent i al usefulness of the proposed par t i c i pat i on. Both campaigns were addressed to a l l pedest ri ans, i r r e sp e c t i v e of age. In this r epor t , the data col l ect ed have been restudied to learn of the d i f f e r e n t i a l response to the campaigns according to

334

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

pedestrian age. To understand the planning and execution of a media campaign in I s r a e l , i t is necessary to take note of the f act that the t e l e v is i on , radio and newspapers are a l l national in scope. The t ot al population is 4,500, 000 persons and is serviced by one major t e l e v i s i o n channel and one pa r t - t i me experimental and educational channel. The radio has four programs servi ci ng the e n t i r e population. The newspapers are d i s t r i b u t e d each morning or a f t ernoon throughout the e n t i r e country, reaching every c i t y and town with very l i t t l e time d i f f e r e n t i a l , There are two major bus companies covering a l l urban and interurban routes, so that posters on buses and at bus stops are contracted for c e n t r a l l y . Obviously, given the uni fi ed nature of the media channels, a na t i on al l y direct ed media campaign is highly l i k e l y to reach a very subst ant ial part of the population. 3. 1.

The "Golden Word For Sa f e t y 11 Campaign Evaluation

The pedestrian campaign "A Golden Word for Safety" was designed to e x p l o i t the national media network - - T . V . , radio and newspaper — i nt ens i v e l y for the one month period, April 1987. In addi ti on to the use of the media, the campaign was designed to have extensive publ i c p a r t i c i p a t i o n through the use of thousands of volunteers in each c i t y and town. The volunteers were to bring the messages of safe pedestrian behaviour to the s t r e e t s of t h e i r towns by t h e i r personal presence. The vol unt eers, members of the National Safety Council, men's and women's c i t i z e n s groups, youth groups and school c hi l dr en , were to receive in advance of the campaign pri nted material and verbal instruction* r e l a t i n g to pedestrian s af e t y . During the month of A p r i l , they were to appear at act i ve i n t e r se c t i o n s , in accordance with a l o c a l l y agreed upon schedule of time and place, wearing an i d e n t i f y i n g cap. In a hel pful s t y l e , they were to approach e r r i n g pedestrians and i nform them of the a l t e r n a t i v e legal and safer ways to cross the street. They were also to d i s t r i b u t e free pocket calendars with pri nted pedestrian safety messages. As o r i g i n a l l y conceived, i t had been hoped to i n s t i t u t i o n a l i z e the exchange of personal "golden words" of pedestrian safety between c it i z e n s begun during the campaign as an ongoing behaviour acceptable to both sender and r ecei ver. Although e x p l i c i t goals had not been de t ai l ed at the outset of the campaign, i t was possible for the purpose of evaluati on to agree on the foll owi ng aims: 1.

to convey general information on the nature and extent of the pedestrian accident problem;

2.

to inform of s p e c i f i c safe pedestrian behaviour and unsafe behaviour;

3.

to reduce pedestrian i n j ur i e s during the campaign month and perhaps a f t e r ;

TWO SAFETY CAMPAIGNS 4.

335

to i n s t i l l the idea of the a c c e p t a b i l i t y of exchanging helpful pedestrian safety messages between c i t i z e n s ,

The evaluati on was carr i ed out by means of s t r e e t interviews of 1,000 pedestrians in the c i t i e s of Tel Aviv and Haifa before the campaign, towards the end of the month of the campaign, and six weeks a f t e r the campaign. Interviews were also conducted wi th the di r ect or s of the campaign in several c i t i e s and with a small number of volunteers. 3. 2.

The Pedestrian Flag, Driver Evaluati on

I nt er act i on Pret est and

In the search f or ways to couple media pedestrian messages to meaningful a c t i v i t y in the s t r e e t , i t was decided to promote the use of a fl ag or hand signal f or pedestrian communication with approaching d r i v e r . The f e a s i b i l i t y of this idea was pretested in two r e si den t i al neighborhoods - - one location near a medium size shopping centre and the other on a r e s i de n t i al c o l l e c t o r road, The national media was not act i vat ed for the p r e t e s t , and t h e r e fo r e, it s message was "del i vered1' by sat urat i ng the two neighborhoods with posters, mail drops and car windshield pamphlets. The flags were as described in the material d i s tr i b u t e d to the homes, and were set out in colourful baskets at the approaches to the crosswalks being studied, The i nstr uct i ons were to cross the s tr e e t holding the fl ag a l o f t in a v i s i b l e manner and deposit i t in the basket on the f a r side of the s t r e e t to be reused, On days when there were no f l a g s , the instructions indicated how to give a hand s i gn a l . Drivers were told about the flags and hand signals in the pri nted m a t e r i a l , and were also asked to give a hand signal to any foll owi ng car that they were about to stop to give a pedestrian the r i ght of way. The evaluati on of the technique included c o n f l i c t studies with and without the f l a g s , interviews with pedestrians and d r i v e r s , and observation of fl ag use. 4,

RESULTS OF THE EVALUATION OF THE TWO CAMPAIGNS

4 . 1 , The "Golden Word" Campaign 1.

The central messages of the campaign were understood;

2.

83% of those interviewed had heard of the campaign;

3.

73% of those interviewed viewed the T.V. campaign p romot i on ;

4.

Other media means were seen by at l east 25% of the popu1at i on ;

336

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

5c

The level of volunteeri ng was very uneven - - in many c i t i e s , i t was almost non-exi stent and in others the preparati on of the volunteers for t h e i r task was poor;

6c

Six weeks a f t e r the campaign, 85% s t i l l main f eat ur es;

7c

People did not obj ect to being " ca l l ed to order" in respect to t h e i r e rr a n t pedestrian behaviour. They did not understand that thi s Golden Word idea was to be kept a l i v e a f t e r the campaign;

8C

Accidents of both dri ver s and pedestrians declined by about 10% during the campaign month (Apri l 1987);

9c

Accidents returned to t h e i r normal

remembered its

level a f t e r April»

4»2. The Pedestrian Fl a g- Dr i v e r I n t e r a c t i o n Pretest 1.

About 15% of a l l

crossing pedestrians used the f l ags;

2*

There was a smal l , but steady day to day ri se in the use of fl ags during the eval uati on period;

3.

Flags were used by pedestrians more often i f they followed a f l a g- us i ng pedestrian;

4.

By mid-campaign, 62% of the people in the neighborhood knew of the campaign;

5.

60% of the people interviewed c l e a r l y knew what they were to do with the flags and hand signals»

6.

Pedest ri an- vehi cl e c o n f l i c t s did not decrease in volume with the use of the f l a g signal»

5c

RESULTS OF THE EVALUATION OF THE TWO PEDESTRIAN SAFETY CAMPAIGNS: di f f erences in response by pedestrian age

The data col l ected for the eval uati on of the two campaigns and reanalyzed here by pedestrian age, consisted of the answers to f i ve questionnaires administered to 1,550 pedestrians in the c i t i e s of Haifa and Tel Aviv. The Golden Word campaign questionnaires were administered bef ore, during and si x weeks a f t e r the campaign. For the Pedestrian Flag campaign, the questionnaires were conducted at the very beginning of the campaign and at the very end. In a d d i t i o n , the observational data of pedest r i a n crossings made during the Flag campaign were restudied. The interview populations are given below: Golden Word Campaign: age pedestrian No.of questionnaires

8-15 227

16-60

60 +

584

240

TWO SAFETY CAMPAIGNS

337

Pedestrian Flag Campaign: age pedestrian

5-14

15-18

19-64

NOc of quest ionnai res

71

80

278

65+ 94

The data were analyzed by pedestrian age wi th the purpose of answering the f oll owi ng questions: lo

Are the e l d e r l y as aware of campaigns in progress as other age groups?

2c

Do the e l d e r l y use the same sources of information as other age persons in learning of a campaign?

3.

Do the e l d e r l y absorb the messages being communicated by the campaign? : a.

the basic safet y themes;

b.

s p e c i f i c fact ual

information«

4.

Do the e l d e r l y foll ow i nstr uct i ons which are part of the campaign program?

5.

Do the e l d e r l y p a r t i c i p a t e in and cooperat ivel y support a c t i v i t i e s which are part of the campaign program?

6.

Is the declared behaviour of the e l d e r l y influenced by the campaign messages?

7.

Do the e l d e r l y learn during the campaign and ret ai n messages a f t e r the campaign?

5.1.

Awareness of A Campaign in Progress:

E l der l y persons appear to be less aware of a campaign in progress. In both campaigns, about 10% to 15% more adults were aware of the campaign than were e l d e r l y persons over 60 years of age. Golden Word: % aware, during campa i gn Pedestrian Flag: % aware, end campai gn 5 . 2.

8-15 92% 5"14 67%

16-60

60+

89%

79%

15-18

19-64

65+

74%

55%

39%

Sources of Information About A Campaign:

In the Golden Word Campaign, where national t e l e v i s i o n and radio were a c t i v a t e d , the e l d e r l y reported learning of the

338

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

campaign somewhat less by way of t e l e v i s i o n (69%) than other adults (78%), and more by radio (30%) than other adults (17%). Young people, who were the age group most involved in the volunteering connected with the campaign, reported personal contact as an important source of information about the campaign. The e l d e r l y , a group that was not a ct i vat ed in v ol unt eeri ng, r e p o r t ed l i t t l e personal contact as a source of information, In the Pedestrian Flag Campaign, !where the media were not a c t i v ated, 33% of the e l d e r l y reported learni ng of the campaign through personal contact compared with 12% to 15% f or other ages Golden Word:

( mul t i pl e repii e s , % mention) 8-15

Source T.V. Rad i 0 Newspape r Bus Posters St r eet Posters Voluntee rs Other Persons Pedestrian Flag;

84% 24% 19% 26% 20% 15% 23%

16-60

60+

78% 17% 17% 20% 24%

69% 30% 26% 24% 17% 11% 3%

6% 4%

(si ngl e repl y, % mention)

Source

5-14 50% 38% 1 2 %

15-18

19-64

65+

63%

46% 41% 13%

53% 14% 33%

16% 15%

1

IO IO

i70 years) that occurred in Sweden during 1986. 641

642

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

There were 508 such accidents in densely built-up areas, and 421 in rural locations. Approximately half of all personal injury accidents in 1986 involving older drivers can be referred to 4 specific types of accidents. All of these occur in intersections, either with no turn involved, or involving a left turn by the older driver with the second party approaching from the right, the left, or straight on. These types of accidents all place great demands on the driver’s ability, because he/she must pay attention to several flows of traffic simultaneously. This common feature was the reason why these 4 types of accidents were chosen to analyze in depth. Hence, the in-depth analysis encompasses the following 4 types of accidents: *1* *2* *3* *4*

crossing, no turn involved left turn, second party coming from the right left turn, second party coming from the left left turn, second party coming straight on.

In all cases, it is the older driver who made a left turn. The analysis charts 80 accidents. The study is based on material in the police reports. The accidents were selected evenly distributed between densely built-up areas and rural locations. Within the two kinds of population areas, the four types of accidents were distributed proportionally according to their accident number during 1986. Then the individual accidents within each type were chosen randomly. The in-depth analysis is based on all the material available in connection with the police reports, e.g. the testimony of the parties involved and other witnesses, court hearings, fines, doctor’s certificates, photographs, etc. The amount of material available about an accident depends on the degree of severity of the injuries. The in-depth analysis of an accident begins with a general description of the circumstances surrounding it, and of the parties involved. This is followed by an effort to look more closely into the accident. This part

TRAFFIC ACCIDENTS INVOLVING ELDERLY DRIVERS

643

consists of a psychological analysis, based particularly on the hearing protocol, testimony of witnesses, doctor’s certificate and similar material that may be available. The objective of this analysis is to discover what lack of information (affecting both parties involved) contributed to the accident. Results The accident The majority of the 80 accidents examined occurred under good external conditions, which is also true for traffic accidents in general. 80 % of these accidents happened when the weather was dry and the light conditions were favourable. Most of the accidents (ca. 65 %) occurred at four-way intersections, 30 % at three-way intersections or staggered three-way intersections and 5 % at approaches and exits. Slightly more than half of the accidents at four-way intersections occurred in densely built-up areas. Accidents at three-way intersections were about equally distributed between built-up areas and rural locations. About 60 % of all accidents occurred in unchannelized intersections or in intersections with a small island in the minor road. Every fourth accident occurred at a fully channelized intersection. Accident type 1 (crossing, no turn involved) occurs most often, 80 %, in an unchannelized intersection and this represents a greater number than all other types of studied accidents together. Somewhat more than half of the accidents occurred in four-or three-way intersections classified as complex, i.e. the major road had more than two lanes and some form of channelization. In less than half of the accidents the actual situation was judged to be uncomplicated, i.e. only 2 cars or pedestrians were present in the intersection when the accident occurred. In all of the accidents studied, only two vehicles were directly involved. The parties involved in the accident In the selected accidents none in the second parties were over 70 years of age. The majority of those involved in these accidents were men (95 % of the older drivers, 80% of second parties). The available material indicates that 2 of the older drivers were under medication for some particular illness. Alcohol was very seldom involved in the accidents.

644

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

About 15 % of the older drivers were driving a car no more than 5 years old, whereas this applied to 40 % of the second-party drivers. The driver was usually alone (in a good 50 % of the accidents) in his or her vehicle; this was true for both the older drivers and the second parties. The collisions of about 60 % of the older drivers happened in their home municipalities; this was true for 45 % of the second-party drivers. Whereas the second-party driver was travelling on a major road in a majority of the cases of the accident types 1, 2 and 3 (in 80 %), but only 10 % of the older drivers. The majority of the accidents, 75 % for the older drivers and 70% for the second-party drivers, occurred in situations involving 2-lane roads. In nearly all of the cases studied both the older driver and the second party had their vehicles in the correct lane just before the accident. Visibility impediments in connection with an accident occurred somewhat more often among the older drivers (ca. 15 % of the accidents) than among the others (ca. 10 %). The distribution of various kinds of vision impediments - vegetation, terrain, parked vehicles, etc. - was rather similar for both categories of drivers. The speed limits for the roads travelled on when the accidents occurred were different for both categories. The majority of the accidents, 78 % for the older drivers, occurred in the speed interval of 70 kph or less, when most accidents for the second-party drivers occurred where the speed limits were 70 kph or above. There were even greater differences between them, however, regarding speed just before the accident. While in 40 % of their accidents the older drivers were at a standstill and had then begun to accelerate just before the collision, this was true for only 3 % of the second-party drivers. Similarly, in only 8 % of their accidents were the older drivers travelling 50 kph or more; ca. 40 % of the secondparty drivers were travelling at more than 50 kph. For the older driver, it was principally only accident type 1 (crossing, no turn involved) that occurred at speeds of 50 kph or above. For secondparty drivers, all accident types occurred virtually equally often at higher speeds. It should be observed that there is a strong connection here between the types of accidents selected and the respective speeds of the older and second-party drivers. Another effect of the selection of accident types was the difference between the two categories with regard to the point of impact on the vehicle. Regarding the older drivers’ vehicles, the collisions were nearly equally distributed between the front ends and the sides. On the other

TRAFFIC ACCIDENTS INVOLVING ELDERLY DRIVERS

645

hand, there was a clear predominance of straight on collisions, 80 %, for the second-party drivers. Whereas the second-party drivers tried to avoid collision by braking and/or dodging in 70 % of their accidents, only about 10 % of the older drivers react similarly. The older driver was more often injured in collisions than was the driver of the second-party vehicle, 55 % vs. slightly more than 40 %. In addition, serious injuries and fatalities were much more common among the older drivers ~ in ca. 10 % respective 10 % vs. 5 % respective 0 % of the accidents. Accident type 1 (i.e. a crossing course involving no turn) had the most serious consequences for passengers and drivers in both the older driver’s vehicle and in the second parties. The number of indictments for infractions of the law in connection with accidents was significantly higher for the older drivers (over 75 %) than for second-party drivers (only ca. 15 %). Interplay The accidents were investigated into what extend lack of information contributed to accidents. Lack of information in connection with an accident was found to be greater among older drivers than among second parties. Seven different types of accident factors, (1. - 3. perception problem due to the driver, the vehicle and the environment, 4. inappropriate adjustment of speed and 5. - 7. inadequate evasive action due to the driver, the vehicle and the environment) were defined. A total of 276 accident factors have been recorded in the investigation, which corresponds to an average of 2.7 factors per accident for the older drivers vs 0.7 factor per accident for the second-party drivers. An inadequate evasive action was most frequent among the older drivers and occurred in about 90 % of their accidents and this could be due either to inappropriate adjustment of speed (in 65 % of all accidents) and for to a perception problem (in 60 % of all accidents). The commonest accident factor among the second-party drivers was inappropriate adjustment of speed (in 20 % of their accidents), followed by a perception problem or an inadequate evasive action from the driver (each 15 %). The distribution of accident factors was similar for both parties to an accident, in both densely built-up areas and in the countryside. Among older drivers, however, perception problems arose somewhat more often when the complexity of the accident situation was assessed as high,

646

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

rather than when it was judged to be low. Perception problems were even more frequent involved when the complexity of the location was judged as high. Poor adjustment of speed was 50 % higher among older drivers when the accident location was highly complex than when it was assessed as low and nearly twice as common when the accident situation was judged as highly complex. It should be pointed out that "poor speed adjustment" also applies to driving too slowly. Among the second parties in these accidents, the same tendency was found, i.e. perception problems arose more often when the complexity of the accident situation was judged to be high. The same is true for the complexity of the location of the accident. Shortcomings in information acquisition arose simultaneously for both parties to an accident in 60 % of the cases. The overall assessment is that the older drivers had inadequate information acquisition in 96 % of the accidents; the corresponding figure for the second parties is 62 %. Perceptual deficiencies were commonest among older drivers and occurred in 70 % of their accidents, followed by cognitive (48 %) and mechanical deficiencies (38 %). For the second parties, cognitive deficiencies were commonest (in 48 % of their accidents), followed by perceptual and mechanical deficiencies (each 15 %). Perceptual and cognitive deficiencies in combination arose more often among the older drivers (in 20% of the accidents) than among the second parties (in 1 % of the accidents). There were no great differences between densely built-up and rural areas as far as mechanical, perceptual and cognitive deficiencies were concerned. Among the older drivers, however, the number of cognitive deficiencies increased dramatically in proportion to the increasing compexity of the accident situation, whereas among the second-party drivers, perceptual deficiences increased significantly. Conclusion

This in-depth analysis of certain types of accidents in which older drivers were involved has shown that the design of the physical environment was a contributing factor. That was demonstrated in the problems confronting older drivers e.g. when making a left turn in a fully channelized

TRAFFIC ACCIDENTS INVOLVING ELDERLY DRIVERS

647

intersection. Furthermore, both the location and the amount of information at the intersection contributed greatly. The majority of the older drivers involved suffered deficiencies in information acquisition. The analysis has also indicated that older drivers’ functional ability influenced the course of the accident. It did not appear, however, that physical disabilities like poor eyesight or generally poor health were directly contributing factors. On the other hand, the older drivers’ impaired reaction capacity was often noted as a direct cause of an accident. This was demonstrated when older drivers, after having been at a standstill at an intersection, reacted too slowly, which resulted in their not getting out of the intersection quickly enough. The in-depth analysis has also shown that the interaction between the drivers involved was deficient. Apparently the older drivers acted on their own experiences with speed and how fast they move, and thus made a faulty estimation of time gaps and the timing of second parties, which resulted in an accident. The second parties, who were often younger drivers, expected that a vehicle at a standstill, and obliged to stop or yield, would have observed an approaching vehicle and would wait for it to pass. These perceptual and cognitive deficiences of the drivers involved explain a large number of the accidents. Further research in this area should therefore concentrate on trying to deepen our knowledge about the causes described here of the types of accidents that were studied. There are, however, other types of accidents, some revealed in the basic analysis in this project, that deserve attention as well, such as the high accident risk among older drivers for collisions involving an unprotected person, primarily in urban areas. It is also important to analyze these types of accidents more deeply, to try to achieve a better, well-functioning traffic environment for older drivers, and hence for other road users as well.

AGE-RELATED CHANGES IN ACCIDENT CAUSATION AS A GUIDE TO COUNTERMEASURES Lindsay R. Matthews, Ph.D., and Wayne R. Jones, Ph.D. Scientists, Traffic Research 1.

INTRODUCTION

It is w e l l - r e c o g n i s e d t h a t d r i v i n g p e r f o r m a n c e d e t e r i o r a t e s in m a n y e l d e r l y d r i v e r s ( P l a n e k , 1 9 81 ) . D r i v i n g a b i l i t y has b e e n i n v e s t i g a t e d in o n - r o a d s t u d i e s o f v e h i c l e c o n t r o l a n d s e n s o r y c a p a c i t y ( B r a i n i n , 1 9 8 0 ) a n d in t h e l a b o r a t o r y (Mourant, 1979). Accident investigations provide an alternative technique for assessing the effect of declining p s y c h o m o t o r c a p a c i t y in t h e e l d e r l y o n d r i v i n g p e r f o r m a n c e . Several studies have shown that the involvement of older d r i v e r s in m u l t i - v e h i c l e c o l l i s i o n s as a r e s u l t o f f a i l u r e to yield right of way or improper turning is d i sp r o p o r t i o n a t e l y high (review by Ernszt and O'Connor, 1988). H o w e v e r , in m a n y o f t h e s e s t u d i e s i n a d e q u a t e measures of exposure have been used. Exposure, when c o n s i d e r e d , is u s u a l l y m e a s u r e d o n a k i l o m e t r e s t r a v e l l e d basis (Ernszt and O'Connor, 1988). This p r ocedure does not provide a precise measure of the frequency of exposure to traffic events that lead to particular types of crashes. An a l te r n a t i v e pr oc e d u re can be d e rived f r o m 2- ve h i c le collision statistics and appears to provide a better measure of exposure (OECD, 1975). T h i s m e a s u r e is b a s e d o n t h e a s s u m p t i o n t h a t t h e n u m b e r s o f d r i v e r s in a n y a g e g r o u p a n d c r a s h t y p e t h a t a r e n o t a t f a u l t is p r o p o r t i o n a l t o t h e exposure of that age group to that type of crash. The a c ci d e n t risk (causation or c u l p a b i li t y ratio) for an age g r o u p is d e r i v e d by d i v i d i n g t h e n u m b e r s o f d r i v e r s d e e m e d at f a ul t by the numbers of drivers deemed not at fault. T h i s i n d e x is b e s t s u i t e d t o t h e a n a l y s i s o f c r a s h e s i n v o l v i n g t w o v e h i c l e s o n l y , a n d it is a s s u m e d t h a t t h e driv e r s invo l v e d can be d i vi d e d into those p r i m a r i l y responsible for causing the collision and those not responsible. Accident data are subject to reporting biases across accident types and age of driver (OECD, 1975). The use of the causation ratio measure to determine risk should be i n d e p e n d e n t of such biases since both the n u m e r a t o r and d e n o m i n a t o r w o u l d be i n f l u e n c e d in a s i m i l a r w a y. 648

AGE-RELATED CHANGES IN ACCIDENT CAUSATION

649

The r a tio takes a value greater than 1.0 when more than 50 p e r c e n t o f d r i v e r s a r e a t f a u l t , a n d is l e s s t h a n 1 . 0 w h e n less than 50 percent are to blame.

Garwood and Jeffcoate (1955), Carr (1969), Kontaratos (1974) an d E n ge l s and D e l l e n (1983) h a ve all u s ed c a u s a t i o n r a t i o s t o i n v e s t i g a t e a c c i d e n t r i s k in o l d e r d r i v e r s . For all multi-vehicle accident types combined, the distribution of i n d i c e s a c r o s s a g e is U - s h a p e d w i t h b o t h y o u n g e r a n d o l d e r d r i v e r s s h o w i n g e l e v a t e d i n v o l v e m e n t in c r a s h e s . The highest levels overall were for the oldest age group.

The present study used accident causation measures to e x a m i n e v a r i a t i o n s in a c c i d e n t r i s k w i t h age f o r a w i d e range of different crash types. 2.

DATA BASE

T h e n u m b e r s o f d r i v e r s i n v o l v e d in 2 - c a r i n j u r y a c c i d e n t s a n d r e c o r d e d in t he M i n i s t r y o f T r a n s p o r t T r a f f i c A c c i d e n t Reporting S y st e m between 1975 and 1987, unless othe r w i se stated, s e r v e d as the d a t a base f or the p r e s e n t study. The m a j o r v a r i a b l e o f i n t e r e s t in t h e f o l l o w i n g a n a l y s e s w a s t h e numbers of drivers that were primarily responsible for causing an accident. For each accident, one driver only was assigned responsibility or fault. In intersection collisions, the driver that failed to yield right of way was a s s i g n e d p r i m a r y r e s p o n s i b i l i t y . In o t h e r t y p e s o f c r a s h e s the vehicle movements prior to the collision were used to d e t e r m i n e f a u l t . F o r e x a m p l e , in h e a d - o n c r a s h e s , v e h i c l e s that failed to keep left (left side driving) were assigned fault. This provided consistent and objective definitions of causation. The drivers were grouped according to age and w e r e not d i f f e r e n t i a t e d by sex. 3.

RESULTS

3.1 Overall accident Involvement

T h e d a t a in t a b l e I ( d e r i v e d f r o m all a c c i d e n t s in t h e y e a r s 1980 to 1987 and not just 2-car collisions) show that drivers aged under 25 years were responsible for causing a significant proportion (45 percent) of the total number of accidents. Drivers aged 60 or over were p rimarily at fault in 10 p e r c e n t o f all c r a s h e s .

650

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

TABLE I

NUMBERS OF DRIVERS RESPONSIBLE FOR ACCIDENTS IN V A R I O U S AGE GR OU P S Age

15-19

20-24

25-29

30-39

40-49

50-59

60+

Number of Drivers

15927

15852

9017

11288

6700

5033

7284

T h e n u m b e r s o f a t f a u l t d r i v e r s i n v o l v e d in t h e t w e l v e m o s t c o m m o n type s o f c o l l i s i o n (for all a c c i d e n t s ) w e r e e x a m i n e d in d e t a i l . F o r all a g e s c o m b i n e d , t h e m o s t c o m m o n a c c i d e n t types were lost control on straights and curves ( p redominantly single vehicle crashes), and head on, right turn^ against and crossing no turns (predominantly m u lt i - v eh i c l e crashes). The most common crash types of the youngest drivers were lost control and head-on collisions, while for the 60 and over drivers, intersection accidents t e n d e d t o d o m i n a t e . T h e p r o p o r t i o n s o f d r i v e r s in e a c h a g e group that caused the five most common accident types (over a l l a g e s ) a r e s h o w n i n F i g u r e 1. T h e c h a n g e s in t h e r a n k i n g s o f the f i ve a c c i d e n t types a c r o s s age g r o u p s can be s e e n in t h i s f i g u r e . 3.2

Exposure-adjusted accident Involvement

Exposure-adjusted measures of accident culpability were derived by calculating the ratios of the numbers of drivers primarily at fault to those not at fault for 2-car collisions. It is i n a p p r o p r i a t e , f o r o b v i o u s r e a s o n s , t o include single vehicle crash data (for example, collision with^ an obstruction, single vehicle run-off-road, or c o l l i s i o n w i t h a p a r k e d v e h i c l e ) in t h e s e c a l c u l a t i o n s . In addition, crashes involving more than two cars were excluded from these analyses.

AGE-RELATED CHANGES IN ACCIDENT CAUSATION

3.2.1

651

All accident types

T h e c u l p a b i l i t y I n d i c e s f o r all a c c i d e n t t y p e s c o m b i n e d are s h o w n as a f u n c t i o n o f a g e In f i g u r e 2 ( a ) . T h e f u n c t i o n w a s U-shaped with the oldest (60 and over) and youngest (15-19 years) drivers being the only age groups more likely to cause an accident than not cause an accident (ratios g reater than 1.0). The drivers aged between 30 and 39 were l e ast l i ke l y to be at f ault. R e l a t i v e to the s a f e s t group, the o l d e s t d r iv e r s we re 3.4 times more likely to be c u lp a b l e and the y o u n g e s t w e re 1.9 times m o r e like l y to be cu lp a b l e. 3.2.2. Individual accident types

The culpability ratios were following types of accident

calculated

for

each

of

the

overtaking head-on

lost control on straights

lost control on curves

rear-end

following vehicle turning vehicle

collides

with

a

Intersection collision - no turns

Intersection collision - turns

merging

right turn against

manoeuvring (mainly U-turns).

The ratios were p l ot t e d as a f u n c t i o n o f age for each of these accident types. The shapes of these functions typically followed either of two distinct curvilinear p a t t e r n s , d e s i g n a t e d T y p e I a n d II. T h e s e p a t t e r n s a r e s h o w n 1 n F i g u r e 2.

652

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS head on — ©— lost control-straights — 0 ---lost control-curves .. A .. crossing-no turns — •_ right turn against

F i g u r e 1.

T h e p r o p o r t i o n s o f d r i v e r s in e a c h ag e g r o u p t h a t w e r e at f a u l t in e a c h o f t h e f i v e m o s t common types of accident. (a)

Type I

In th is p a t t e r n the c u l p a b i l i t y i n dex was highest for the youn g e s t drivers, d e cr eased with age up to the 40 to 59 age groups and then showed a small upturn for the drivers aged 70 and over. Figure 2b shows the causation r a t i o s f or the a v e r a g e o f all the t y pe I c ollisions [head on, over t a k in g , lost control (straights and curves), and rear end type (collision with a turning or n o n - t u r n i n g v e h i c l e in f r o n t ) ] . D r ivers up to age 29 were likely to have caused a particular accident (ratios g r e a t e r t h a n 1.0), w h i l e all o t h e r drivers were likely to have not caused the crash (ratios less than 1.0). Drivers aged 70 and over were 1.5 times more likely to have caused a crash than d r i v e r s a g e d a b o u t 40 to 69.

653

15-19 20-24 25-29 30-39 40-49 50-54 55-59 60-64 65-69 70+

1.31 0.98 0.81 0.71 0.73 0.85 0.85 1.16 1.46 2.39

Age

Index

15-19 20-24 25-29 30-39 40-49 50-54 55-59 60-64 65-69 70 +

1.79 1.34 1.06 0.79 0.62 0.63 0.57 0.68 0.63 0.84

Age

Index

15-19 20-24 25-29 30-39 40-49 50-54 55-59 60-64 65-69 70+

1.02 0.77 0.64 0.65 0.83 1.08 1.12 1.64 2.36 3.76

C u lp a b ilit y

index

^

C u lp a b ilit y

index

C u lp a b ilit y

index

AGE-RELATED CHANGES IN ACCIDENT CAUSATION

Age (yp)

Figure 2.

C u l p a b i l i t y Indi c e s as a f u n c t i o n o f age for all a c c i d e n t t y pe s c o m b i n e d (a), and f o r T y p e 1(b) a n d ' T y p e 11(c) crash types. The indices f o r e a c h a g e g r o u p a r e s h o w n 1n t h e t a b l e s .

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

654

(b)

3.2.3

T y p e II

In t his p a t t e r n the c u l p a b i l i t y i n de x was m u c h h i g h e r f o r the d r i v e r s a g e d 60 an d o v e r t h an all other age groups, decreased with age down to the 25-29 group and then showed a small upturn for drivers aged 15-24. Figure 2c shows the c a usation r a t i o s f o r t h e a v e r a g e o f all t h e T y p e II collisions (crossing-no turns, crossing-turns, right turn against, merging and manoeuvring).

Drivers aged 60 and over were much more likely to h a v e c a u s e d an a c c i d e n t t h a n n o t c a u s e d it w h i l e the rema i n i ng drivers were o f ten not at fault. Drivers aged 65 and over were about 5 times more likely to have caused a crash than drivers aged 25-29 years.

Effects of time of day and location

Separate culpability index-age functions were plotted for t h e m a j o r T y p e I a n d II a c c i d e n t t y p e s o c c u r r i n g in u r b a n (speed limit less than or equal to 70 km/h) and rural (speed l i m i t o v e r 70 k m / h ) , a n d f o r c r a s h e s d u r i n g the d a y (5 a.m. t o 7 . 5 9 p . m . ) a n d at n i g h t (8 p.m. to 4 . 5 9 a . m . ) . T h e d a t a for accident types where the causal factors and shapes of the functions were similar were aggregated. Thus, data for lost control on s t r a i g h t s and curv e s w e re c o mb i n e d , as w e re the data for intersection type collisions (crossing-no turns, crossing-turns and right turn against). The f u n c t i o n s f o r t h e s e m a j o r a c c i d e n t t y p e s a r e s h o w n in F i g u r e 3. (a)

Type I Accidents

The typical type I U-shaped pattern (highest c u lpability for the y o ungest drivers) was evident in all d a t a s u b s e t s (day, n i g h t , u r b a n , r u r a l ) f o r the head-on and lost control crashes. However, the level of risk appeared to vary under d i ff e r e nt driving conditions.

For the drivers aged 65 and over the c u lpability ratios were higher during the day for head on collisions (t-test, p - NEXT, B - BOTTOM

Shift Number Shift Key Vehicle Trip No. Shift Finish Time

2 7703/2/E 8891826 22:00 Zone Map Ref. 25B1 24E2 34D2 25B2

Whch. Cum. 0 0 +0 0 -0 0 +0 0 -0 0 0 0

Di st. 2.7 6.6 11.2

Figure 8. Dial-a-Ride shift enquiry screen. 5. S U M M A R Y A N D N EX T STEPS M U LTI TR IP has been d esigned to m eet the needs o f the CT sector in the U K , w here there is a co m p lex range o f operators providing d ifferen t services sin gly or in com b in ation s. T h e softw are has been d evelop ed through a p rocess in v o lv in g a high le v e l o f collab oration w ith ex istin g CT operators. Central to the u se fu ln e ss o f the softw are are fa cilities w h ich p rovid e an interactive on -lin e diary and dial-a-ride scheduling. T h ese allow the operator to w ork in a m ore in tu itive w ay than in a purely m enu-driven text-based environm ent. In m any w ays, w hat has been outlined in this paper reflects work in progress. T he n ex t step in the d evelop m en t is to enhance the scheduling functions available in the dial-a-ride m odule. There are a num ber o f w ays in w hich this cou ld be d one. F irstly, it w o u ld be p o ssib le to u se a linear-program m ing op tim isin g approach to re-sch ed u le b ookin gs for trips w hich have b een taken during the day in order to m in im ise costs w h ile not having to ring back and refuse bookin gs w hich have already been accepted. S econ d ly, it w ould be p o ssib le to provide additional functions for the dispatcher in assessin g the su itability o f an allocation o f a p assen g er trip to a shift: this w ould in v o lv e a sse ssin g the co sts o f in serting trips into ex istin g tours, and our in terest in this area extends to the use o f artificial in telligen ce techniques to assist in this p rocess. T hirdly, it w ould be p o ssib le to p rovid e the dispatcher w ith a m ore visu al dispatching tool: the sy stem already holds lo ca tion al inform ation about trip origin s and destinations w hich are converted to x ,y coordinates and stored in the sch ed ule, and these data cou ld form the basis o f a graphical d isplay, overlaying the location o f veh icles on a map o f the operating area. W h ich ever o f these is ch osen , they can be built onto a system w hich has been d esign ed to m eet the requirem ents o f operators using a w ide range o f operating practices and offering a w id e range o f services. T he preference o f the IT in CT Project is for the second and third o f the three options listed above, and it is intended to base this developm ent on an analysis o f the w ay in w hich human dispatchers m ake d ecisio n s about allocation s o f b ookings to v eh icles, using both system s analysis and k n ow led ge en gin eerin g tools.

912 MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS REFERENCES P. Ford and Forkin, JM "U tilising data base m anagem ent system s in CT group hire", in J. C. Sutton w ith G illingw ater, D ., "Computer A pp lication s in C om m unity Transport - W hich W ay Forward?", D ep artm en t o f Transport T e c h n o lo g y , U n iv ersity o f T e c h n o lo g y , L ou g h b o ro u g h , R ep ort N o . T T 8 7 0 3 , 1987. P. Ford, "Derby Winner", C om m unity Transport M agazine, 1988, V ol. 7, N o .6 , p.38. T . G eeh an , T h e A p p lication o f C om puters to S p e cia l Transit S erv ices: A R eview " , Transport Canada, TP 6856E , 1985. D . G illin g w a ter and Sutton, J. C ., "Inform ation T e c h n o lo g y A p p lica tio n s in V oluntary S ecto r T ransport O perations: W P1 O b jec tiv es and Program m e o f W ork", D ep artm en t o f T ransport T ec h n o lo g y , U n iversity o f T ech n o lo g y , Loughborough, R eport N o .T T 8 5 0 1 , 1985. D . G illin g w a ter and Sutton, J. C ., "Inform ation T ec h n o lo g y A p p lica tio n s in V oluntary S ecto r T ran sport O p eration s: W P 2 P roject Im plem en tation " , D ep artm en t o f T ran sport T e c h n o lo g y , U niversity o f T ech n ology, Loughborough, Report N 0 .TT8 6 OI, 1986. E. Jones, "What Can C om puters D o for Us?", Com m unity Transport M agazine, 1988, V ol. 7 N o.3,

P-39. T. M ead ow s, "The C om pu terisation o f D ial a Ride", N ation al A d v iso r y U nit for C om m un ity Transport, R eport N o .141, 1987. P. R. O x le y , " Stage C arriage B u s S e r v ic e s for W h eelch a ir-B o u n d P eo p le" , S p e c ia liz e d Transportation Planning and Practice, 1986, V ol.2, N o.3, pp. 16 5 -1 8 4 . J. C. Sutton, "IT in CT: N ation al Com puter Survey - B riefing Paper 1: Initial R esults", IT in CT Project, D epartm ent o f Transport T ech n ology, U niversity o f T ech n o lo g y , L oughborough, 1986. J. C. Sutton, "A review o f trends in com puter applications in the CT sector", in J. C. Sutton with G illin g w a ter , D ., "Com puter A p p lication in C om m un ity T ransport - W h ich W ay Forward?", D ep artm en t o f T ransport T e c h n o lo g y , U n iv ersity o f T e c h n o lo g y , L ou g h b o ro u g h , R ep ort N o. T T 8 7 0 3 , 1987. J. C . Sutton and G illin gw ater, D ., "Inform ation T ec h n o lo g y A p p lica tio n s in V oluntary S ecto r Transport O perations: W P4 Final Report", D epartm ent o f Transport T ec h n o lo g y , U n iv ersity o f T ec h n o lo g y , L oughborough, R eport N 0 .TT8 8 OI, 1988. J. C. Sutton, G illingw ater, D. and Bennett, S. C., "BOOTING UP: A N o v ic e ’s G uide to IT in CT, (IT in C T Project, D epartm ent o f Transport T ec h n o lo g y , U n iversity o f T ec h n o lo g y , L ou gh borough , 1 9 8 7 ). Urban M ass Transportation A dm inistration, "M icrocom puters in T ransportation - S oftw are and S ource Book", U M T A , W ashington, 1984. J. W illiam son , "Scheduling by Computer", C om m unity Transport M agazin e, 1987, V o l. 6 , N o .4,

P-15-

Computer-Assisted Management of Special Transit Services for the Disabled Bruce Chown Manager, Custom Transit, BC Transit Vancouver, Canada 1.

INTRODUCTION

BC Transit is a provincial Crown corporation. It has responsibility for transit systems and services in communities throughout British Columbia, Canada's most western province. This includes planning, funding, and, in some cases, operating urban transit systems. Included are both conventional transit services and parallel custom transit systems for disabled people. Centred on the City of Vancouver, the Vancouver regional transit system is the largest in the province. The service area encompasses 1500 square kilometres and contains 1.4 million residents. One percent of these residents, or 14,000 people, are registered to use the custom transit service known locally as handyDART. It provides a door-to-door service for people who are unable to use regular buses because of mental or physical disabilities. 2.

handyDART SERVICE

BC Transit operates the regular transit system in the Vancouver region with its own staff. The handyDART services are provided by contractor organizations which operate under annual contracts with BC Transit. These organizations, most of which are non-profit societies, each serve a defined area in accordance with policies, service levels, and annual budgets established by BC Transit. Modified lift-equipped vans which will accommodate four passengers in wheelchairs and four seated passengers are used for the handyDART service. In the past year, eight contractors used 110 vehicles to provide 210,000 hours of service in the Vancouver region. They carried 492,000 passenger trips by disabled people and another 27,000 trips by attendants and escorts. Users are required to book service in advance by telephone. In the early years, 1980 to 1985, all information was recorded manually ~ client registrations, trip requests, vehicle run sheets, etc. 913

914

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

The system was consequently labour-intensive, both in the office and on the road. It was also prone to errors and misplaced information. The average productivity throughout the region was about two passenger trips per hour of service. 3.

THE DART COMPUTER PROJECT

Computers appeared to offer a way to automate some of these procedures and better manage the flow of information. In 1985, BC Transit and the Transportation Development Centre of Transport Canada initiated a two-year demonstration project in the Vancouver region. The purpose was to develop, install, test, and evaluate two software packages identified as DART Manager Plus and DART Graphics. The objective was to improve the operating efficiency of special transit services by providing managers with an effective tool to better match the supply of service with ever increasing demands for this type of public transportation . Two of the Vancouver region handyDART contractors agreed to participate and provided the test sites for the two software programs. Based on the requirements of the Transportation Development Centre for systems that could be easily transferred to other special transit operations in Canada, it was decided that the software should be developed for IBM-PC microcomputers . The test site for the DART Manager Plus software was the office of the Western Society for Senior Citizens* Services. In 1986, the Society used 17 vehicles to provide about 3,000 hours of handyDART service each month for 1,500 registered users. The service area included Burnaby, New Westminster, and Coquitlam. The demonstration project was completed successfully in 1987. It was concluded that either of the two software packages could provide significant benefits compared with a completely manual system. Since then, both programs have been offered to and put into use by other special transit operators in British Columbia and across Canada. They tend to prefer DART Manager Plus which is described in more detail below.

MANAGEMENT OF SPECIAL TRANSIT SERVICES 4.

915

DART MANAGER PLUS

DART Manager Plus is available as either a multi-user or single user system. The multi-user version was installed at the Western Society. The hardware was an IBM-PC with a 30 megabyte hard disk and one megabyte of RAM. At the time of installation, the cost of this eguipment was about $13,000. The single user system requires an IBM-PC/XT with a 10 megabyte hard disk. System functions include client registration, trip reservation, and operations monitoring. Trip scheduling is a manual procedure, but the system assists in storing, retrieving and displaying client information and trip requests, and printing daily trip sheets. The operations monitoring function assists in analyzing daily trip logs and producing vehicle statistical summaries and performance reports . Menus are employed to direct the user through various program components, which include:

the

Client Registration: The client master file contains all pertinent personal information on each registrant, including a registration number that is automatically generated by the computer. The computer provides rapid access to this data by either client number or name. Information can be added, deleted or changed easily. Trip Reservation: For trip reguests, the operator enters the client's number or last name which produces a split screen display of registrant and trip information. The computer prompts whether the trip is outbound or return. If the trip is outbound, data from the registration file (e.g. name, origin address) is used to supplement user input. For a return trip, addresses from the previous trip are reversed. The system will display all trips currently booked for any client, and can be purged to remove all expired trips. Scheduling Function: DART Manager Plus displays scheduling information on the screen and provides a summary of vehicle activities. Within each time slot for each vehicle, the display shows the number of passengers and vehicle location by zone.

916

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

The operator thus has the information necessary to assign trips to vehicles and can easily scroll through the list of vehicles or transfer between screens from trip booking to trip assignment. After trips are assigned, driver trip sheets can be produced. These are either given to drivers at the beginning of their shifts or used by office staff to dispatch vehicles by radio. Report Generation: Daily Trip Reports are produced which contain information necessary for drivers to proceed with their daily runs. Daily, monthly and year-to-date reports on vehicle statistics (ridership, hours, kilometres, etc.) are also available. Another report, Client Statistics, groups clients by disability and zone as well as providing a breakdown by trip type. The system is also capable of printing client mailing labels by zone or registration number. Operations Monitoring: At the end of each day, the trip file is updated to reflect what actually took place on the road. After information on fuel usage, distance travelled and shift time is added, the computer has all the necessary information to produce a statistical report. Vehicle and system information is available by day, month and year-to-date. A monthly report on each vehicle provides a comparison of vehicle utilization. The supervisor is able to adjust schedules based on this information to ensure that all vehicles are well utilized. The breakdown of ridership by vehicle by day assists in the allocation of trips to vehicles. DART Manager Plus is written in RM-COBOL, a standard business application language. It runs on any IBM PC/XT, PC/AT, or 100-percent compatible unit running under XENIX or DOS 3.1 with 384KB to 640KB of RAM with one floppy drive and a hard disk. The software was developed originally for special transit services using 32 or fewer vehicles. Program capacity has since been doubled so that the system can maintain vehicle schedules for up to 64 vehicles. The multi-user version of DART Manager Plus is now being used by Pacific Transit Cooperative which operates 52 handyDART vehicles in the City of Vancouver. The hardware acguired for this application was a Sperry mini-computer with eight workstations.

MANAGEMENT OF SPECIAL TRANSIT SERVICES

5.

917

FINDINGS

At the conclusion of the demonstration project in 1987, the task of monitoring the computer operations became part of BC Transit’s administrative functions. The ongoing reguirements of a computer system should not be underestimated. Learning the programs, training new staff, developing better operational procedures and trouble-shooting hardware and software problems are particularly time consuming. The most freguent comment heard from the users was that insufficient time had been allotted for training. Once all the staff at the Western Society felt comfortable using the new technology, however, many benefits were evident. These include: -

more efficient information handling greatly reduced paper flow shorter telephone calls to book trips faster processing of trip requests faster assignments of trips to vehicles better staff utilization

From the passengers' point of view, the advantages included simplified booking procedures and fewer errors in recording trip information and dispatching vehicles. As indicated by Table 1, the Western Society was able to increase productivity from 2.60 trips per hour in 1985 to 2.94 trips per hour in 1987 and 1988. TABLE 1 WESTERN SOCIETY handyDART ANNUAL SERVICE LEVELS PRODUCTIVITY

PASSENGERS

33,660

2.60

87,520

17

35,930

2.74

98,450

1987

17

35,700

2.94

104,960

1988

18

35,870

2.94

105,460

YEAR

VEHICLES

1985

16

1986

INCREASE

31

HOURS

7%

13%

20%

918

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

Greater productivity means that passenger trip can be reduced, minimized. As shown by Table the Western Society's service between 1985 and 1988 . During average cost per trip increased

the average cost per or increases can be 2, the total cost of rose by 28 percent this same period the by only six percent.

TABLE 2 WESTERN SOCIETY handyDART ANNUAL COSTS PASSENGERS

COST PER TRIP

902,580

87,520

$10.31

1986

997,970

98,450

10.14

1987

997,640

104,960

9.50

1988

1,156,190

105,460

10.96

28%

20%

COST

YEAR 1985

$

INCREASE

6%

There has been a large increase in the number of registered users in the Western Society's service area. As a result, the fleet will be increased from 18 to 24 vehicles and the level of service will be raised from 36,000 to 46,000 annual hours of service this year. It is expected that this increase can be phased in with no need to hire additional office staff. 6.

CONCLUSION

The specific objective of the demonstration project was to improve the guality and cost-effectiveness of transit services for disabled people through the use of microcomputer technology. Service guality was improved in terms of (1) a reduction in the number of booking and scheduling errors, (2) improved reliability and better adherence to promised pick-up times, and (3) a lower percentage of unmet trip reguests. The Western Society achieved better productivity and a reduction in the average cost per passenger trip.

MANAGEMENT OF SPECIAL TRANSIT SERVICES

919

The cost-benefit evaluation of the project found that the low cost of microcomputers makes it worthwhile to convert to a computer-assisted system provided that extensive software development costs are not incurred . BC Transit continues to work with the Transportation Development Centre and regional handyDART operators to make both DART Manager Plus and DART Graphics more "user-friendly", and to share this technology with other organizations providing special transit services for disabled people. More information about either software package may be obtained from the Transportation Development Centre in Montreal or from BC Transit in Vancouver, Canada.

EXPERIENCE OF COST-REDUCED HANDICAP TRANSPORTS WITH MAINTAINED LEVEL OF SERVICE H&kan Ambert 1.

Introduction

Although transports for handicapped and disabled persons are common in Sweden, the organization and coordination of such transports is rather poor. Many Swedish municipalities have left it to the local public transport company or to the taxi organizations to administer and plan the handicap transports at will. Other larger municipalities have attempted to make the most of manual combination of trips, sometimes using smaller computer systems to assist in the planning process. Such efforts mostly seem to have been made with rather little consideration of the service level required of the individual transport in each specific situation. The reason for this situation is not difficult to understand: although the transport cost per person has declined over the years, the number of transports has increased to such an extent that the net effect is an increase in costs. The complex task of handling all journeys may therefore not have permitted any in-depth analysis of the various resources required. M SEK

-o

920

Socialstyrelsen SC8

COST-REDUCED HANDICAP TRANSPORTS

2.

921

New technologies offer new possibilities

Recent advances in computer system technology, however, have enabled a modification of attitudes towards the planning of handicap transports. Today, an advanced computer system can assist the planning operator with immediate computation of the most efficient planning of the desired journey. The operator can therefore present the proper information to the customer, e.g. pick-up time, time of arrival at destination, fare, etc. The planning decision can easily be given to the customer while he or she is still on the phone, thus eliminating the need for an extra phone call. Planning is, however, in no way hampered by such rapid answers. The planning process can be designed in such a way that a certain amount of replanning potential is retained. This secures the benefits of linked, sometimes shared, trips with only a marginal loss in the level of individual service. A tool now exists, therefore, that provides the opportunity to handle different personal transport requirements while also calculating the resources which should be made available to meet those particular requirements.

922 MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

3.

Service level

Transport service level usually means different things to different people. When developing a new booking and planning system for regional areas, VTS Transportation Systems Co. assumed that many journeys could take place, each within a certain — sometimes rather long — time interval. This seems to be possible in many cases as long as the customer knows when the vehicle will arrive or reach the destination — and as long as it really does so. WHAT IS IMPORTANT? Being picked up at the promised time and arriving at the promised time are often crucial points in the assessment of a good service level. Within certain limits a slight detour may not in itself affect the service level. In other words, many people regard transport service level as a question of getting reliable transport that suits the type of errand in hand. Furthermore, travelling alone in a vehicle is seen as being positive by some people, while others appreciate someone to talk to during the trip. WHAT IS ADEQUATE? An adequate service level might consist of being able to reach the nearest city and then return home the same day after having spent at least some hours in the city. In other situations the same person might require a transport that can be relied on not to miss the departure time of a certain train or flight. In such cases the service level is completely dependent on whether or not the transport arrives in time. CONCLUSIONS In general, the implication is that it is preferable to organize resources in such a way that: a fast and direct trip is planned in particular cases, where necessary departure times can be adjusted slightly in other cases. In all cases, however, the customer must be given a fixed departure time. The degree of adjustment is a matter of policy. It could be zero, or it could be set to correspond in so far as is possible with that of the public services.

COST-REDUCED HANDICAP TRANSPORTS

4.

923

Restrictions

The above discussion tells us that a transport situation consists of a mix which consists of flexibility and — from time to time — various restrictions. Such restrictions may be expressed in terms of: * * * * *

arrival/departure times type and size of vehicle resources the capacity or desire of the driver to carry the customer limitations on the planning of trip for certain persons together standard limitations (detours etc.,) imposed by the paying organization

It is crucial to the planning process to define the restrictions which apply to each individual person and trip, since it is this data that determines how efficient the subsequent plan will be. Many of these restrictions are complex and take some time to investigate. Others, such as time restriction, can more easily be determined. A great deal of complex information can be sorted and stored in advance, however, in cases where such information is relatively stable. In order to achieve the most efficient decisions, it must be possible to express time (ride time, waiting time etc) and cost in equal terms for driver and vehicle alike. This must be done in order to optimize planning. Once this has been determined the single most efficient solution can be determined in each planning situation. ALWAYS A LOWER LIMIT Optimization according to criteria such as the total cost and standard level might be detrimental to standards if the cost increase is large. This must therefore be supplemented with absolute restrictions for the lowest permitted level of service in each service parameter. If priority is given to a special trip then another set of rules will be required for that trip.

924 MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

5.

System design

INFORMATION AND RULES Once there is sufficient infonnation for a system of rules to determine the amount of flexibility in each case, and once the principles for linking and planning have been defined in terms of computer rules, it is possible to utilize the basic flexibility offered by each situation. The system is then required to plan automatically on the basis of the prerequisites entered by the planner in conjunction with other facts already registered. PLANNING OF SPECIAL VEHICLES In most cases, special vehicles for handicap transports are owned by the municipality, which means that cost margins for such vehicles are lower the more they are used. At the same time, however, these vehicles cannot satisfy the full required transport capacity — they have to carry handicapped individuals who cannot manage to travel in ordinary taxi cabs. In such a planning situation a powerful computer system can, if required, handle last-minute replanning that books all these vehicles just minutes before they are ordered by the control system, in order to eliminate the need of buying more external taxi transports than necessary. This replanning process is performed without affecting any promises already given to the customer. Only when a change takes place in the total resource situation or if a vehicle suddenly breaks down may the customer become involved. DIFFERENT RESULTS FOR DIFFERENT ORGANIZATIONS A system can be designed for optimum flexibility and therefore also for different service restrictions when different organizations or private individuals are the users. The complete range of service levels that may be created extends from the highest quality taxi cab standard to shared vehicles with, if necessary, long waiting and detour times. It is possible to create such widely differing service types. They do have one thing in common, however, and that is the possibility of rapid handling of orders and reliable decisions. The computer system here forms the tool in a planning process in which the planning operator plays the active part in designing the individual transport. The system itself is simply able to meet the needs of each customer, paying organization and transport situation.

COST-REDUCED HANDICAP TRANSPORTS

6.

925

Planning and booking

A really efficient system must not only draw up effective plans, it must also book the most appropriate vehicle for those plans. This is obvious, of course, but the way it is done in practice depends on the existing traffic situation in the area in question. URBAN CONDITIONS Urban areas represent major transport volumes not only because of the concentration and number of people living there but also because of the fact that the transport need per person is higher in cities than in rural areas. Where transport volumes are high the possibility of increasing efficiency is also high. There are two reasons for this: 1) Each percentage reduction in empty driving creates substantially improved results. 2) The handling of transport volumes is much more complex above a certain limit. One planning centre may not handle more than a certain number of trips manually without efficiency being impaired. When it comes to handling more complex situations, a computer system needs to be more powerful and sophisticated, but is able to achieve higherquality results. In order to handle city transports properly, any system should take advantage of the probability of obtaining a certain vehicle resource in a certain area at a certain time. This dynamic situation, once it is known, creates a good basis for the allocation of transports, whether shared or single, private taxi or otherwise. In urban areas, particularly during the daytime, there is therefore a certain probability that an optimum vehicle can be found and booked in a predefined area. This means that a decision as to which vehicle is to take a specific order is not taken until very late. It is sufficient that there is an adequate number of cars to handle all the transports. RURAL CONDITIONS In a rural area the system may count a suitable vehicle in the area in question as being optimum for the interlined transport plan. Apart from the short driving distance to the first boarding address, points in favour of such a choice include the fact that where there are many smaller addresses

926 MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

knowledge of local conditions is an advantage. Such a system may consider such knowledge as being of a greater or lesser degree of importance. Nevertheless, there may be situations where a vehicle from outside the local area is the very best choice to pick up a fare from a specific local address in the rural area. This can, for instance, be when the car is on its way to the same destination. The cost margin for the detour is therefore very low. It is obvious today that potential exists for optimum interlining of rural and urban traffic. Current statistics show that the rural areas are the most rapidly growing sectors of society when it comes to the utilization of transports for the handicapped. ;rowth %

-1 5

15-49

50-99

1 00-1 99

Population, thousands

200-

q -j

Service entitled

■

Single trips

Whole country

COST-REDUCED HANDICAP TRANSPORTS

7.

927

The VTS PLANET system

The VTS PLANET system handles not only the planning of rural traffic but also the requisite areas of urban traffic. It also operates in large areas, taking into account mixed situations where cities, smaller villages and rural areas are combined. The PLANET system has been designed to meet flexible requirements, restrictions and a wide range of wishes and customers, etc. In order to get the best results from the PLANET system it should be combined with automatic traffic control systems such as the VTS TAXI 80 for vehicle management. This, combined with local radio systems or the MOB1TEX network, provides adequate flexibility and power to handle future transport requirements.

A MODEL PROGRAM FOR THE COST-EFFECTIVE DELIVERY OF TRANSPORTATION SERVICES FOR ELDERLY AND DISABLED PERSONS

Robert L. Martin, P.E., AICP Associate Director, The UNC Institute for Transportation Research and Education

1.

INTRODUCTION - CHAPTER 1

A model program for the cost-effective delivery of transportation services for elderly and disabled persons has been developed at The University of North Carolina Institute for Transportation Research and Education (ITRE) as a result of innovative programs conducted in North Carolina and initiated in South Carolina. The programs’ objectives were to improve mobility and transport for elderly and disabled persons, primarily in regional (rural) and local (urban) areas, by reducing operating, maintenance and administrative costs. The program in North Carolina, called Van Care Clinics, was part of a Vehicle Maintenance Public Awareness Program sponsored by the Energy Division of the North Carolina Department of Commerce. Nine clinics were held throughout the state from May through September, in cooperation with the North Carolina Department of Transportation, Public Transportation Division (NCDOT/PTD), and in coordination with Car Care Clinics that were conducted by the Independent Garage Owners of North Carolina (IGONC) under subcontract to ITRE. Based on ITRE’s experience, the model program described herein can be applied to any vehicle fleet in the world to deliver cost-effective transportation services for elderly and disabled persons. Money saved from reduced costs could then be used to provide additional transportation services for the elderly and disabled. This paper addresses the three elements of the model program: I. II.

III.

Vehicle Clinics: includes site selection, scheduling, publicity, diagnostic testing of vehicles, and results. Training Workshops: for mechanics, drivers, and administrators; includes publications and information, workshop conduct and results, and a summary of cost-saving maintenance procedures. Vehicle Fleet Management: includes record-keeping, decision-making, computerized fleet management, and training workshops. 928

COST-EFFECTIVE TRANSPORTATION 2.

VEHICLE CLINICS - CHAPTER 2

2.1

Site Selection

929

Clinic sites should be selected in areas with concentrated vehicle fleet service and significant population. Adequate parking areas are needed at the site for vehicle analysis (and appropriate meeting spaces are needed for the training workshops). Clinics can be held at the sites of local transportation providers if sufficient space is available. 2.2

Scheduling

Scheduling should be on days when most participants can attend. In the programs in North and South Carolina, the clinics were held on Fridays and/or Saturdays from late spring through late summer (during good weather). 2.3

Publicity

Invitations to participate in the clinics should be sent to public, private-nonprofit and private-for-profit (paratransit) transportation service providers. Included with the invitation should be pre-registration forms, a letter of explanation and a schedule of the clinics. Follow-up publicity is strongly suggested. Two weeks prior to each clinic, registration packages should be mailed to preregistered transportation providers. In North Carolina, ITRE and the NCDOT/PTD followed up on these registrations to insure good participation in the clinics. 2.4

Publicity Response Results

In North Carolina, 41% of the 278 providers contacted responded to the invitation. Of the 114 respondents, 34% actually participated in the clinics. The 39 agencies taking part in the clinics had 124 vans tested (and 116 personnel trained in the workshops). 2.5

Diagnostic Testing of Vehicles

Diagnostic testing will determine the vehicles’ current operating efficiency. In North Carolina this part of the program was conducted for ITRE by IGONC, and coordinated with Car Care Clinics that were held at the same time. The testing included:• • Comprehensive tire pressure and wear inspections. • Comprehensive under-the-hood inspections, including air and PCV filters, hoses and belts, and engine oil and transmission fluid levels.

930 MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

• Electronic analysis of engine emissions, through an infra-red probe, for: — % carbon monoxide — Hydrocarbons (parts per million) — % oxygen — % carbon dioxide • Some general problem-solving of existing conditions with drivers/owners. After the diagnostic testing, vehicle owners and operators received a copy of all test results, with recommended repairs and maintenance procedures to increase vehicle energy efficiency and reduce operating and maintenance costs. In North Carolina’s program, participants also were given the following brochures on energy efficient vehicle driving and maintenance techniques: • Car Care Clinic site specific brochure by IGONC, showing the dates and location of the clinic and listing local IGONC members. • "16 Steps to Conserve Energy on North Carolina Highways" by the State Energy Division. • "Routes to Fuel Economy" by ITRE. • Shell Answer Book #3 - "The Gasoline Mileage Book." • "How to Find Your Way Under the Hood and Around the Car" by the National Car Care Council. • "Diesel Fuel (Questions and Answers) for Your Car" by the American Petroleum Institute. 2.6

Vehicle Testing Results in North Carolina

Of the 124 vans tested in North Carolina, 92% did not "pass" the diagnostic testing. The following summary shows the number and percent needing repairs and maintenance procedures (corrections of problems): • of Problems *

#of Vans Tested

% of Vans Tested

None One Two Three Four Five

10 37 37 28 10 2

8.1 29.8 29.8 22.6 8.1 1.6

* Out of a possible seven problems: Tire pressure, tire wear, air filter, hoses and belts, engine oil level, transmission fluid level, electronic engine analysis.

COST-EFFECTIVE TRANSPORTATION

3. 3.1

931

TRAINING WORKSHOPS - CHAPTER 3 Publications and Information

Prior to the training workshops, existing information on the best and most costefficient vehicle driving and maintenance techniques should be reviewed and then assembled into an information packet for workshop participants. In North Carolina the packets included the following: • "Driving Efficiency Quotient (DEQ) test on the "Featherfoot" film of the American Institute of Driving Efficiency. • "Routes to Fuel Economy," produced by ITRE. • Shell Answer Book #31 - "The Longer Car Life Book." • Shell’s Question and Answer Guide to Heavy-Duty Motor Oils. • A "Fixed and Variable Costs Budget Sheet" (example). • An "Annual Individual Equipment Record" (example). • Preventive Maintenance (PM) Program checklists. • An "Informational Memorandum" with a sample calculation of estimated energy savings. • A "Description of DRIVEC," a driving for energy conservation program developed in North Carolina. • A "Van Care Clinic Workshop Evaluation Form." During the workshops, the instructor should adapt the materials to fit the participants’ situations. Agencies participating in North Carolina were later given the following additional instructional and administrative information: • "A Guide to Planning Your Transportation System for Energy Conservation." • DRIVEC (Driver/Vehicle Economy and Conservation) Instructors Training Manual. 3.2

Conduct of Workshops

The two-hour indoor workshops can be held at the time of the vehicle clinics. In North Carolina the workshops generally were held on Saturdays from 1 p.m. to 3 p.m. The workshops began with the 30-minute film "Featherfoot," which included the Driving Efficiency Quotient (DEQ) test, followed by a review of the information packet. Each participant received a certificate of completion.

932

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

The following is a typical workshop agenda: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10.

Welcome, sign roster, submit registration slips. "Featherfoot" film with DEQ test. Review of publications on driving habits. Review of record-keeping. Review of preventive maintenance. Review of vehicle maintenance. Review of routing and scheduling (trip planning). Review of driver training programs. Review of driver incentive programs. Evaluation of the workshop.

An evaluation completed at the end of the workshops by the participants will give the program constructive information for conducting future clinics. It is also recommended that a follow-up effort be established to help the participants continue their cost-effective transportation services. 3.3

Workshop Results in North Carolina

Of the 116 personnel trained from across North Carolina, 69 were drivers (59%), 38 were administrators (33%), and 9 were maintenance personnel (8%). On an evaluation scale of 1 to 10, with 10 being the "best," participants’ total evaluation of the workshops was 9. The workshop and clinic elements of the program reached 39 transportation providers that predominately met the needs of the elderly and disabled in rural and small urban areas. Those 39 were approximately 30% of the state’s transportation providers, accounting for about 40% of all vans used to transport elderly and disabled persons. Every participating agency indicated an interest in continuing both the workshops and the clinics. 3.4

Summary of Maintenance Procedures

The following summary of maintenance procedures discussed in the training workshops was derived from research into efficient maintenance techniques that will provide for the cost-effective delivery of transportation services for the elderly and disabled: Pre-drive inspection: • Tires inflated to maximum (lose 1% mpg per 2 pounds below). • Check oil level. • Check battery posts and cable ends. • Check electrical system wiring. • Check fluid levels (radiator, power steering, transmission). • Check belts and hoses.

COST-EFFECTIVE TRANSPORTATION

933

• Check lights, horn, mirrors and windshield wipers. • Check lift equipment (if any). Preventive maintenance: • Change oil and oil filter (multi-viscosity 3-5% more mpg). • Check air filter (blow out, vacuum, rotate, change). • Check lubricants (use multi-viscosity, lubricate chassis). • Check spark plugs (1 worn lose 7% mpg; 2 mis-fire lose 20%). • Check/set ignition timing, distributor points, cap, rotor (or check electronic ignition). • Check PCV valve and filter (clean or replace). • Check fuel filter (clean or replace). • Check carburetor (clean, adjust, set choke, tighten bolts), or check and adjust fuel injection. • Check thermostat; pressure test cooling system. • Check alternator and battery. • Check brake linings and master cylinder (adjust brakes). • Check wheel balance, wheel alignment and wheel bearings. • Check exhaust system for leaks and damage. • Check fuel lines and pump for leaks. • Tighten transmission bands if necessary. • Rotate tires (as directed). • Diagnostic test (gas analyzer) for emissions and efficiency.

4.

VEHICLE FLEET MANAGEMENT - CHAPTER 4

4.1

Overview

Effective vehicle fleet management also reduces administrative, operating and maintenance costs, and should include an ongoing preventive maintenance program. (Side benefits are reduced fuel consumption, decreased vehicle emissions, and better information for making purchasing decisions and improving delivery of services.) The total vehicle fleet management program should involve planning, scheduling, operating and maintaining fleet vehicles, and include personnel training. Then, decisions can be based on accurate, up-to-date information. 4.2

Record-Keeping

The first step to more effective vehicle fleet management is to determine the total transportation costs of the fleet. These costs vary greatly from one fleet to another. However, by providing a monthly log for each vehicle, and recording

934 MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

miles driven, maintenance costs, oil use, tire costs, fuel costs and consumption, and miles per gallon, the monthly and annual fleet costs can be determined. Of course, with each newly purchased vehicle a new record should be made. Computer software programs have been developed for data management, and they can be applied to all or parts of fleet management. The programs range from keeping up-to-date inventory to asking M what if" questions. 4.3

Decision-Making

The second step to more effective vehicle fleet management involves combining vehicle and personnel information into a form suitable for decisionmaking. If this is done manually, the layout can be professionally drafted and printed, adapted from a suitable tablet of accounting forms, or hand designed and photocopied. A good record-keeping system allows flexibility; however, creating the system with computer software makes this task easier. 4.4

Computerized Fleet Management

The use of computer applications in vehicle fleet management will depend on many variables and should be investigated as to whether or not its use would be appropriate for the vehicle fleet size and complexities. Some of the elements of a computerized vehicle fleet management system follow: Equipment management: Equipment inventory Personnel available Equipment maintenance (preventive and major) Equipment utilization and fluids consumed (gasoline, diesel fuel, oil) Budgeting and planning Parts Management: Parts inventory Parts usage history Budgeting and planning Equipment downtime related to parts available Computerized fleet management systems need to be able to handle a wide variety of fleet sizes and a mixture of vehicle and equipment types. The system also should allow internal programming changes to suit different modes of operations. In addition, the hardware and software need to be user-friendly and good support services and training need to be available.

COST-EFFECTIVE TRANSPORTATION

4.5

935

Training Workshops

A basic instructional program can be accomplished through training workshops in vehicle fleet management. These workshops should include the following: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12.

Introduction to fleet and maintenance management. General maintenance management. Preventive and corrective maintenance programs. Maintenance record-keeping. Equipment replacement decision-making. Maintenance for fuel efficiency. Contracting out maintenance. Fleet utilization. Purchasing. Alternate fuels. Fuel control and recording. Driver training and motivation.

A second workshop (if applicable) should cover the use of computers in vehicle fleet management. Participants would receive a copy of the computerized vehicle fleet management system software. Also, complete system documentation, assistance in preliminary implementation, and ongoing support, along with computer hardware and software installation assistance, should be provided. A computerized vehicle fleet management system (where applicable) can minimize overall costs by reducing maintenance and breakdowns, and, through careful monitoring, increase fuel efficiency, prolong vehicle and engine life, and manage personnel and vehicle allocation. 4.6

Conclusions

Results from a vehicle fleet management system can be realized over a period of time. Rather than relying on an accounting system for budgeting, a management system can systematically track fixed and variable costs so that budgets can be analyzed and modified for efficiency. Whichever method is used, manual or computerized, efficient vehicle fleet management will reduce operating, maintenance and administrative costs, providing for the cost-effective delivery of transportation services for elderly and disabled persons.

CONDUCTING NEEDS BASED PLANNING AND SERVICE EVALUATION G e r a l d J. Kane P r o g r a m M a n a g e r , NJ T R A N S I T C o r p o r a t i o n I.

INTRODUCTION

This paper will d i s c u s s the i m p o r t a n c e of d e t e r m i n i n g need when planning and implementing speci al transportation services fo r e l d e r l y and d i s a b l e d p e rsons. The concept of nee d is o f t e n v i e w e d t o g e t h e r w i t h d e m a n d or too g e n e r a l i z e d by t he t r a n s p o r t c o m m u n i t y , b o t h at the fede ral and state funding level as well as the o p e r a t o r level. In the United States se veral s t ates have initiated efforts to assist transportation disadvantaged persons to access es s e n t i a l s e r v i c e s such as s h o pping, m edical care, n u t r i t i o n , e d u c a t i o n and employment. Such transportation programs are often d e f i n e d to i n c l u d e all elde r l y , e.g., all p e r s o n s 60 y e a r s of age and a b o v e and all p e r s o n s ha v i n g a t e m p o r a r y or p e r m a n e n t disability. The eligibility c r i t e r i a is then use d as a factor in distributing or a l l o c a t i n g funds f or operating transit sy st ems. Such an arrangement provides little incentive fo r d e t e r m i n i n g w h e t h e r p e r s o n s w h o are most in n e e d are r e c e i v i n g b e n e f i t s f r o m the program. T h e p r i m a r y p u r p o s e in a d v o c a t i n g fo r n e e d s b a s e d p l a n n i n g is to ensure th e m o s t e f f i c i e n t and e f f e c t i v e allocation of available resources. Since pe rsonal mobility needs are d y n a m i c , it is n e c e s s a r y to c r e a t e a f r a m e w o r k for m o n i t o r i n g tra ve l requirements and to e v a l u a t e h o w well transit is m e e t i n g travel needs . G e n e r a l l y , n e e d has been b r o a d l y d e f i n e d by p o l i c y m a k e r s and transit operators si n c e t h e r e has be en d i f f i c u l t y in the definition, determination, and measurement of need. To overcome these o b s t a c l e s t e c h n i c i a n s hav e r e l i e d upon the conventional methods of d e t e r m i n i n g ne e d by using demand estimation t e c h n i q u e s w h i c h use e c o n o m i c p r i n c i p a l s such as consumer w a n t s and w i l l i n g n e s s to pay. Thi s has r e s u l t e d in a t e n d e n c y to c r e a t e p r o g r a m s w h i c h attempt, on one hand, to be comprehensive in sc o p e by a l l o c a t i n g f unds based on population figures for target groups (transportation disadvantaged) f o l l o w e d by p r o g r a m i m p l e m e n t a t i o n which, if th e measurement of need is c o n s i d e r e d at all, u t i l i z e s the n a r r o w d e f i n i t i o n of d e m a n d in p l a n n i n g and o p e r a t i n g t r a n s i t serv i c e s . Closely related to the c o n c e p t o f need is the notion of evaluation, in t erms of h ow well t r a n s i t n e e d s are bei n g accommodated. Th i s is a n o t h e r area w h i c h has not received sufficient attention in th e p l a n n i n g and i m p l e m e n t a t i o n of specialized t r a n s i t se rvices. Ca s e s of s e l f - m o n i t o r i n g are the exception and the m a j o r i t y of funding agencies are usually concerned with p e r f o r m a n c e as it relates to its specific funding so urce. Service evaluation and its relationship to nee d will be d i s c u s s e d in S e c t i o n III of the paper .

936

PLANNING AND SERVICE II.

937

NEEDS VERSUS DEMAND

A major c o m p o n e n t of m o s t t r a n s i t p l a n n i n g s t u d i e s is the estimation of pote n t i a l r i d e r s g i v e n a p r e s c r i b e d level of transit s e rvice. A common p r a c t i c e in this task is to utilize a c c e p t e d t r i p m a k i n g r ates and to c o m p a r e t h e s e rat e s to t he p a r t i c u l a r a r e a u n d e r study . Suc h an a p p r o a c h uses economic demand as th e ba sis fo r estimating potential ridership and therefore may exclude certain users as potential riders of a g i v e n sys tem . Th i s a p p r o a c h is also characterized by a t e n d e n c y to fo cus p r i m a r i l y on the work trip as the m a j o r t r i p p u r p o s e of s y s t e m riders, howe v e r , elderly and d i s a b l e d p e r s o n s e x h i b i t travel h a b i t s tha t are non-work related and a v a r i e t y of trip purposes must be considered in su ch an anal y s i s . T h e r e f o r e , it is necessary to d i s t i n g u i s h nee d f r o m d e m a n d in t h a t n e e d m a y be thought of as an ideal or conce p t , w h e r e a s , d e m a n d is d e t e r m i n e d by what is available. D e m a n d is esse n t i a l to p l a n n i n g but a narrow definition may exclude certain persons from system u se.l S i n c e d e m a n d is o f t e n m e a s u r e d in t e r m s o f w i l l i n g n e s s and a b i l i t y to pa y fo r t r a n s i t s e r v i c e the d e m a n d for spec ial transit service m a y be v e r y low, a l t h o u g h the nee d may be quite high. T h i s d i s t i n c t i o n has be en c h a l l e n g e d s i n c e it has be en one of the p r i m a r y o b s t a c l e s to a formal c o m m i t m e n t to servicing certain transportation disadvantaged g roups. The variables or characteristics most frequently used in e s t i m a t i n g trav el d e m a n d are p o p u l a t i o n , f a m i l y size (p e r s o n s p er household), aut o o w n e r s h i p , and income p er household. When these v a r i a b l e s are a n a l y z e d for e l d e r l y and disabled they ten d to s u b s t a n t i a t e the ne e d for i m p r o v e d m o b i l i t y and accessibility. An i l l u s t r a t i o n o f th e c o n c e p t s of ne e d and d e m a n d is sho w n in Figure I. S a t i s f i e d d e m a n d is d e f i n e d as t he level at which existing transportation s e r v i c e s are used. Latent d e m a n d r e p r e s e n t s the q u a n t i t y of add i t i o n a l t r i p s tha t w o u l d be taken if i m p r o v e m e n t s w e r e m a d e in existing se r v i c e s . From an e c o n o m i c s t a n d p o i n t , th is m a y r e p r e s e n t p e r s o n s who are unable or unwilling to pa y the prevailing price of trav e l , e v e n t h o u g h t h e y m a y be j u d g e d to n e e d it. F i n ally, induced demand i n c l u d e s t h o s e tr i p s g e n e r a t e d by improving th e transportation syst em . It is thi s c o m p o n e n t of demand g e n e r a t e d by the i n c r e a s e d supply. II.1

E X I S T I N G A P P R O A C H E S TO D E T E R M I N I N G N E E D A N D D E M A N D

In addition to the m e t h o d of u t i l i z i n g a c c e p t e d tripmaking rates fo r p r e d i c t i n g t r a n s i t r i d e r s h i p , t h e r e are two other a p p r o a c h e s c u r r e n t l y used for this task, as fol lows: -

Extensive survey us ers; and

of

existing

-

T r i p g e n e r a t i o n ra te m odels.

and

pote n t i a l

938

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS FIGURE I

C o n c e p t s of Need a nd D e m a n d

So urce:

B r i ggs, R. D e s i g n i n g T r a n s p o r t a t i o n S y s t e m s fo r M e d i u m or L ow D e n s i t y Rural R e g i o n s , O c c a s i o n a l W o r k i n g Paper, U n i v e r s i t y of T e xas at A u s t i n (April, 1975) , P. 10.

939

PLANNING AND SERVICE

local s u r v e y s o f e x i s t i n g and p o t e n t i a l u sers ten d Although to p r o v i d e a h i g h e r level of c o n f i d e n c e for p o l i c y m a k e r s , it has been sho w n that n o n - u s e r s r a r e l y b e h a v e as they st a t e they will in a sur vey . Thus, the reliability of thi s approach must be v i e w e d w i t h c a ution. W i t h r e s p e c t to the use of complex mathematical formulas they require extensive data d e v e l o p m e n t at a d e t a i l e d level and have not p r o v e n to be a ny m o r e a c c u r a t e tha n a v e r a g e travel b e h a v i o r figures. Recently, h o wever, an approach which combined the survey t e c h n i q u e and th e e s t a b l i s h m e n t of a local c i t i z e n s g r o u p m e t with s u c c e s s in d e v e l o p i n g a p r o g r a m to i m p r o v e the m o b i l i t y of t r a n s p o r t a t i o n d i s a d v a n t a g e in a t a r g e t area. This study of local n e e d s in rural A l a b a m a used s u r v e y f i n d i n g s and the h e l p o f a local s u p p o r t g r o u p to d e v e l o p g o a l s and o b j e c t i v e s fo r a t r a n s p o r t a t i o n p r o g r a m to a d d r e s s the i d e n t i f i e d need s. This technique wa s identification of needs public transportation. t he f o l l o w i n g :

especially successful in the in a ru ral, i s o l a t e d a r e a w i t h l i t t l e T he r e s u l t s of the s u r v e y indicated

1. A significant own a vehic l e .

n u m b e r of the r e s i d e n t s di d not ( S l i g h t l y less than 50 p e r c e n t ) .

2. A majority i n d i c a t e d that the f a m i l y had one vehic l e , but tha t th e r e s p o n d e n t s had no a c c e s s to th e v e h i c l e d u r i n g all, or a l a r g e port i o n , of th e day. 3. T r i p s which one-vehicle households needed to make had to be d e l a y e d or not m a d e due to the l a c k of t r a n s p o r t a t i o n d u r i n g w o r k i n g hours. 4. T h e l a c k o f t r a n s p o r t a t i o n to m a j o r centers has i m p a i r e d som e c i t i z e n s ' to a t t a i n e m p l o y m e n t .

employment ability

5. T h i s lack of transportation has similarly impaired the s e arch for e m p l o y m e n t amo n g those w h o are p h y s i c a l l y able to work. 6. T h e health ca r e n e e d s of the r e s i d e n t s m a y suffering d ue to the l a c k of t r a n s p o r t a t i o n m edical f a c i l i t i e s . 2

be to

The i m p o r t a n c e of th e f i n d i n g is that local s u r v e y s are very hel pf ul in d e t e r m i n i n g th e e x t e n t of travel r e q u i r e m e n t s in a given community. By f o c u s i n g on the problems surrounding tr avel requirements, rather tha n questioning hypothetical tra ve l b e h a v i o r , th e s u r v e y can y i e l d s u b s t a n t i a l f i n d i n g s to assist in designing transit programs suited to identified needs .

940

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

organization of a transportation steering committee T he further identified transportation nee d s and resources to improve mobility and this e f f o r t wa s a key link in the planning proc e s s . Th e k n o w l e d g e of local r e s i d e n t s p r o v i d e d a more complete p i c t u r e of th e i m pact w h i c h the lac k of transportation w as h a v i n g on th e e c o n o m i c and socia l a s p e c t s of r e s i d e n t s lives . In a d d i tion, the k n o w l e d g e o f t h o s e w h o are providing service and administering transportation programs wa s i n v a l u a b l e in d e s i g n i n g a rational a p p r o a c h for a d d r e s s i n g t r a n s p o r t a t i o n ne eds. To summarize, there is a n e c e s s i t y to d e v e l o p methods of d e t e r m i n i n g u s e r n e e d s w h e n p l a n n i n g and i m p l e m e n t i n g spe cial transit serv i c e s . A l t h o u g h t h e r e will c o n t i n u e to be d e b a t e on th e m o s t a p p r o p r i a t e m e t h o d s of d e t e r m i n i n g ne e d s this should no t diminish the importance of conducting nee d s assessment. Since ne ed is a r e l a t i v e c o n c e p t it is bes t d e t e r m i n e d at the local level, ho wever, the i d e n t i f i c a t i o n of needs ca n be f o l l o w e d by the o r g a n i z a t i o n of a local bod y to further refine needs uncovered from surveys and study methods. Emphasis should be placed on t he direct consideration of travel r e q u i r e m e n t s , e s p e c i a l l y g i v e n the range of tri p p u r p o s e s oft e n ci t e d by s e n i o r citizens and disabled p e rsons. C u r r e n t l y , such c o n s i d e r a t i o n s are not widely r e f l e c t e d in m a n y p r o g r a m s w h i c h are aim e d to i m p r o v e m o b i l i t y of the t r a n s p o r t a t i o n d i s a d v a n t a g e d . II.2

MULTIPLE FUNDING SOURCES

As s t a t e d earl i e r , c u r r e n t special t r a n s p o r t p r o g r a m s in the USA receive fu n d s from numerous sources to support operations, maintenance, and capita l replacement. E l i g i b i l i t y c r i t e r i a o f t e n r e s t r i c t s the use o f c e r t a i n f unds to specific s e g m e n t s of the p o p u l a t i o n or p l a c e s l i m i t s on the t y p e s of t r i p s al low ed. In the sta t e of N e w Jers e y , as well as in m a n y o t h e r st ates, the p r i m a r y r e s p o n s i b i l i t y for speci al transportation is the local government. Specifically, c o u n t y g o v e r n m e n t has a s s u m e d the p r i m a r y role in the delivery of special s e r v i c e s and it is at thi s g o v e r n m e n t level that the true d e t e r m i n a t i o n of t r a n s i t ne e d s are ma de. A listing of the major funding sources directed toward spe cia l transportation s e r v i c e s is l i s t e d in T a b l e I. As shown, the Table is d i v i d e d into tw o parts, the f irst indicates fu nds used from fed er al t r a n s i t s o u r c e s (DOT), and the t he s e c o n d is a l i s t i n g of h uman s e r v i c e grants which directly or i n d i r e c t l y c o n t r i b u t e f unds to transportation serv i c e s .

PLANNING AND SERVICE

TABLE

941

I

M a j o r S o u r c e s o f Fe deral Funds fo r E l d e r l y and D i s a b l e d Transportation Services Eligibility Requirements

Program Fed er al

Transit

Proqrams

S e c t i o n 9: Urban Mass T r a n s p o r t ation A d m i n i s t r a tion

Ge neral Pu b l i c - M o s t l y for U r b a n A r e a s for S e r v i c e O p e r a t e d by P u b l i c and P r i v a t e Operators.

S e c t i o n 1 6 ( b ) (2): U r b a n Ma s s T r a n s portation A d m i n i stration

E l d e r l y (60 y e a r s and abov e) and D i s a b l e d - A l l o w s for tne P u r c h a s e of Capital E q u i p m e n t to be O p e r a t e d by P r i v a t e NonPr o f i t O r g a n i z a t i o n s .

S e c t i o n 18: P u b l i c T r a n s p o r t a t i o n for N o n - U r b a n i z e d Area s, U r b a n Ma s s T r a n s portation A d m i n i stration

Ge neral P u b l i c - For P e r s o n s Li v i n g in Rural or Small U r b a n A r e a s for S e r v i c e O p e r a t e d by P u b l i c or P r i v a t e O p e r a t o r s .

Fed er al

Human Services

Programs

T i t l e XIX: M e dical A s s i s t a n c e (Me di caid)

L ow Income P e r s o n s R e q u i r i n g T r a n s p o r t a t i o n to Medical F a c i 1 ities

T i t l e XX: Social S e r v i c e s B l o c k Gra n t

Low Income P e r s o n s R e q u i r i n g T r a n s p o r t a t i o n to Im p r o v e Self Sufficiency

T i t l e III: O l d e r A m e r i c a n s A c t (Parts A&B)

P e r s o n s 60 Y e a r s and A b o v e Receive Transportation to S e n i o r M u l t i p u r p o s e Cent e r s , S h o p p i n g , and O t h e r L o c a t i o n s

T i t l e III: O l d e r A m e r i c a n s A c t (Part C)

P e r s o n s 60 Y e a r s and A b o v e R e c e i v e T r a n s p o r t a t i o n to N u t r i t i o n C o n g r e g a t e Meal S i t e s

942

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

w i t h th e a b o v e l i s t e d e l i g i b i l i t y r e q u i r e m e n t s t h e r e is Ev en still opportunities to conduct ne e d s planning for transportation s e r v ices. T i t l e III and DOT fun d s o f f e r w i d e latitude fo r d e s i g n i n g t r a n s i t s e r v i c e pl a n s and programs, with th e opportunity to determine what the mobility requirements of a g i v e n are a m ay be: ca r a v a i l a b i l i t y , and availability of transit s e r v i c e s m u s t be i n c l u d e d in the a n a l y s i s of t r a n s p o r t a t i o n needs. It is als o i m p o r t a n t to n o t e that fed eral f u n d i n g if often s u p p l e m e n t e d by s t a t e and local m o n i e s to a l a r g e de g r e e . In New Jersey t he 1984 S e n i o r C i t i z e n and Disabled Resident Transportation Assistance Act allowed the state to tax revenues form the casino gaming industry for senior and disabled transportation. P e r s o n s 60 y e a r s o f age and above and an y p e r s o n w i t h a t e m p o r a r y or p e r m a n e n t d i s a b i l i t y is eligible fo r t he p r ogram. Su ch flexibility permits the state's 21 c o u n t i e s to d e s i g n p r o g r a m s best s u i t e d to the local c i r c u m s t a n c e s . Commonly referred to as the C a s i n o R e v e n u e Fund, the most recent a l l o c a t i o n o f f u nds to c o u n t i e s t o t a l e d $13 million. The distribution o f the fu nds is ba s e d upo n the number of p e r s o n s 60 y e a r s and a b o v e in ea ch co unty, as a p e r c e n t a g e of the state's total p o p u l a t i o n of 6 0+ pers o n s . Population numbers are taken f o r m the mos t r e c e n t decennial c ensus. Needless to say, the f u n d i n g p r o g r a m has bee n a significant resource in the efforts to improve the mobility and accessibility of the eligible population, howe v e r , the program is' so b r o a d l y d e f i n e d that l i t t l e e f f o r t is m a d e to d i r e c t th e fu n d s to w h e r e t h e y are m o s t neede d. This is c h a r a c t e r i z e d , initially, by th e f u n d i n g allocation formula which fa i l s to i n c l u d e an y n e e d s related criteria other than g e n eral e l i g i b i l i t y r e q u i r e m e n t s . In e ffect, the funds ar e c h a n n e l e d on the ba sis of total 6 0+ p o p u l a t i o n in th e c o u n t i e s v e r s u s the e l i g i b l e p o p u l a t i o n m o s t in nee d of speci al transportation. Thi s d i s p a r i t y b e c o m e s m o r e e v i d e n t in view of the e x i s t i n g t r a n s i t s e r v i c e s a v a i l a b l e in some counties, i.e., c o n v e n t i o n a l bus and tra i n service. Th i s situation underscores the necessity of giving full consideration to the r a n g e of tra ve l o p p o r t u n i t i e s in each county, rather than s i m p l y d e p e n d i n g on total population figu r e s . In the w o r s t case, a s e n i o r or disabled person could liv e c l o s e to a f i xed ro u t e bus line and also have the opportunity to request a p a r a t r a n s i t ride f r o m the local county operator. In r u r a l , less p o p u l a t e d counties where t h e r e is l i t t l e or no bus s e r v i c e th e special s e r v i c e p r o g r a m mu st^ b e a r th e complete b u r d e n of service provision yet r e c e i v e s f unds o n l y on the ba s i s of its s e n i o r p o p u l a t i o n .

PLANNING AND SERVICE

943

to remedy th is disparity include the Suggestions incorporation o f m e a s u r e s to d e t e r m i n e tra vel n e e d s w i t h i n a given c o u nty: fo r ex a m p l e , the a m o u n t of bus s e r v i c e miles is a f a c t o r in the ov erall s u p p l y o f t r a n s p o r t a t i o n se r v i c e s . The ratio o f bus m i l e s to the total a m o u n t of m i l e s served c o u l d be use d as a d e t e r m i n a n t in the f u n d i n g f o r mula. Other measures of m o b i l i t y n e e d s d i s c u s s e d e a r l i e r c o u l d als o be used to h e l p a l l o c a t e f u n d i n g in an e q u i t a b l e f a shion, in c o n t r a s t to r e l y i n g on ov erall p o p u l a t i o n figur e s . III.

PROGRAM AND SERVICE EVALUATION

Closely l i n k e d to th e c o n c e p t of n e e d s b a s e d p l a n n i n g is the necessity of r e t a i n i n g an e v a l u a t i o n m e t h o d f or measuring bo t h th e d e g r e e to w h i c h ne e d s are bei n g m e t and the overall economic performance of th e system operator. Thi s requirement, h o wever, brings together t he concepts of effectiveness and e f f i c i e n c y w h i c h are o f t e n in c o n f l i c t due to th e nature of speci al transit service operation. Unfortunately, there d o e s not a p p e a r to be a m e t h o d which combines bo t h efficiency and e f f e c t i v e n e s s to produce a comprehensive e v a l u a t i o n meth o d . Ins te ad , it is p o s s i b l e to identify a range of indicators which address t he ne e d s i d e n t i f i e d and d i s c u s s e d e a r l i e r w i t h the p e r f o r m a n c e o f each s e r v i c e or m o d e p e r f o r m e d by an o p e r a t o r . Measures o f e f f i c i e n c y m a y be d e s c r i b e d in t e r m s o f h o w well resources are ut i l i z e d , fo r e x a m p l e cost p e r v e h i c l e m i l e or cost per trip. Whereas effectiveness is concerned with m e a s u r i n g n o n - e c o n o m i c f a c t o r s su ch as the r e l i a b i l i t y of the s ystem, t he percent of w h e e l c h a i r t r i p s ca r r i e d , or the number o f total tr i p s c a r r i e d p er hour. In short, e f f i c i e n t determines w h e t h e r t he total e x p e n s e p er o u t p u t for a g i v e n service a r e a is r e a s o n a b l e for tha t type of s e rvice, and the effectiveness deals with service utilization, which is closely linked with th e d e g r e e to w h i c h the service is a d d r e s s i n g t h e u s e r ' s needs. Listed b e l o w is a r a n g e of i n d i c a t o r s w h i c h a d d r e s s som e of t he key aspects associated with evaluating spec ial transportation s y s tems. The list is by no means comprehensive but offers a sampling of indicators and measures w h i c h c o u l d e a s i l y be i n c o r p o r a t e d into an ove rall e v a l u a t i o n p r ogram.

944

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS TABLE

II

PROGRAM EVALUATION A.

EXAMPLES

EFFICIENCY

Indicators

Measurement

-

Co st pe r mile, h o u r or tri p Vehicle hours per employee V e h i c l e h ours p e r v e h i c l e O f f i c e pers o n n e l p e r v e h i c l e T r i p s pe r mile , hour, v e h i c l e

B.

E x p e n s e s p e r s e r v i c e uni t P r o d u c t i v i t y of e m p l o y e e s Vehicle utilization Administration efficiency Service productivity EFFECTIVENESS

- Service delivery - Accessibility - Area coverage - Trav e l

tim e

T r i p s pe r v e h i c l e h o u r P e r c e n t o f w h e e l c h a i r tri p s P e r c e n t of use r s v. e l i g i b l e population A v e r a g e on b o a r d trav el time per tri p

Having identified i n d i c a t o r s and m e a s u r e m e n t s to evaluate service it is p o s s i b l e to d e t e r m i n e ho w well a particular system is a c h i e v i n g m o b i l i t y and a c c e s s i b i l i t y objectives. Ide al ly , such o b j e c t i v e s w o u l d be e s t a b l i s h e d by a steering c o m m i t t e e f i r s t r e s p o n s i b l e fo r i d e n t i f y i n g tra vel n e e d s in a given community. T h e s y s t e m o p e r a t o r w o u l d be r e p o r t i n g the information on a c o n s i s t e n t ba sis to m o n i t o r the p r o g r e s s of a s y s t e m in a c h i e v i n g o b j e c t i v e s . On e o f t he m a j o r d i f f i c u l t i e s in thi s ef fort, howe v e r , is the accountability of s e r v i c e s to the n u m e r o u s f u n d i n g sources which comprise the operating system's bud get. Funding a g e n c i e s r e q u i r e su ch i n f o r m a t i o n for p u r p o s e s o f k n o w i n g ho w much service is b eing p r o v i d e d and h o w the fu n d s are be i n g spent. S i n c e t he m a j o r i t y of sp ecial s e r v i c e o p e r a t o r s mix many of the clients on th e same v e h i c l e an in the sam e service mode it is important fo r operator to have an accounting m e t h o d w h i c h c h a r g e s fo r s e r v i c e in an equitable ma n n e r .

PLANNING AND SERVICE

945

This may be accomplished by collecting the necessary financial and non-financial data associated with a transit program . The financial data includes all of the operating and administration costs over a given time period and the non-financial data includes the actual break down of services supplied, that is, the vehicle hours and miles for each time of service supplied. This information is collected ard reviewed in such a way as to identify the total cost of eacn service type to achieve an average unit cost which is then charged against a particular funding source. The amount of the charge depends upon the number and type of units supplied to each funding program. V.

SUMMARY

Special transportation services for elderly and disabled persons continues to gain recognition as a way of accommodating many of the mobility and accessibility requirements of the transportation disadvantaged. In light of this development it is necessary to ensure that resources for transit services are targeted toward those most in need of program benefits. This paper has emphasized the necessity of conducting needs based planning for planning and implementing programs which aid the transportation disadvantaged. Success in best determining needs is possible when there is strong local involvement and framework for measuring how well the need is being accommodated. Transit operations must be prepared to evaluate how well travel needs are met by incorporating indicators of efficiency and effectiveness in their programs. Such indicators and appropriate measures assist operators in achieving objectives expressed during the needs identification process, and provide for accountability to agencies which provide funds for transporting elderly and disabled persons.

946

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

NOTES 1

Banister, D. Bould, M., and Warren, 1984, Towards Needs Based Transport Planning, Traffic Engineering and Control, 25 (718) p. 372.

Jordan, Constance W., Developing Local Support and Funding for Transportation Service in Rural Alabama. Final Report February, 1987 US Department of Transportation. Urban Mass Transportation Administration. Washington, D.C. 3

Ibid. REFERENCES

1

Bannister, David. Transport needs in Rural Areas-A Review and Proposal. Transport Reviews, 1983. Vol. 3, No. 1, 35-49.

2

Banister, D. Bould, M., and Warren, 1984, Towards Needs Based Transport Planning, Traffic Engineering and Control, 25 (718) p. 372.

Jordan, Constance W., Developing Local Support and Funding for Transportation Service in Rural Alabama. Final Report February, 1987 US Department of Transportation. Urban Mass Transportation Administration. Washington, D.C. 4 Koustopoulos, K.C., Concept of Transportation Need Revisited. Transportation Research Board, Washington, D.C. 1980, 66-69. y 5 Rosenbloom, Sandra, The Mobility Needs of the Elderly. Transportation In An Aging Society. Transportation Resource Board Special Report #218, Volume 2, 1988, 2171.

MANDATED STATEWIDE PROGRAM OF COORDINATED A SPECIALIZED TRANSPORTATION: THE FLORIDA EXPERIENCE William G. Bell Professor The central issue germane to this paper is this: in a period of declining real dollars, largely from national sources, available for the support of specialized transportation, then what were the positive and negative effects in one state, Florida, of a legislatively mandated approach to local coordination of specialized services? Local transportation providers in the US, offering specialized services are facing a decline in public funds devoted to specialized transportation. One of the strategies available to states seeking to maintain or expand a level of cost-effective specialized transportation services is to strengthen coordination of specialized transport service at the local level. The term, coordination, has been too loosely applied to a wide range of local transportation planning activities. These activities range from informal meetings and discussions among colleague agencies, to shared use of vehicles, drivers, maintenance and other resources, to the merging of ownership and control of all specialized transportation resources in a community under a single agency. The three alternate forms of so-called coordination could more properly be termed respectively, cooperation, coordination and consolidation. In the US, sub-state units like counties and cities are creatures of the state and subject to its promulgations. States concerned with transportation developments affecting its elderly citizens are not resistant to direct intervention in an area such as specialized transportation. There are various approaches available to states seeking improved local service coordination. These measures range from stimulating voluntary cooperation to mandating cooperation through legislative measures. Florida is among a small number of states who have chosen to initiate state legislation requiring each of the state*s 67 counties to designate a single coordinated provider. The target population of these efforts are those designated as the transportation disadvantaged, essentially persons without access to a private automobile and reliant on socially provided services, largely persons who are elderly or disabled or with limited sources of income. 947

948

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

As a state attractive to in-migration of both elderly persons and disabled people by reason of its inherent physical and other attributes, Florida is said to have approximately 40% or about 4.5 million of the state*s population, who are transportation disadvantaged.1 Some transportation planners question whether coordination should be imposed at the local level since it legitimates a monopoly held by a sole provider, however designated. Nevertheless, the Florida legislature in promulgating Chapter 427, Florida Statutes in 19792 set in motion a process of local designation of a single local provider to reduce a perceived fragmentation and duplication of local services for the transportation disadvantaged. In some localities in Florida it helped establish a fresh system where none existed prior to the arrival of Chapter 427. In other committees it helped stabilize existing systems. According to the legislation establishing the Council, coordination means the arrangement for the provision of transportation services to the transportation disadvantaged in a manner that is cost effective, efficient and reduces fragmentation and duplication of services. The Florida law, established a Coordinating Council on the Transportation Disadvantaged whose major function was to provide leadership and oversight to the statewide coordination effort. The 7 members of the Council were appointed by the Governor and included representation from the relevant state agencies and consumer groups. The Coordinating Council had no state funds at its inception to reward or punish local compliance with the statutes. The Council simply had the power to grant sole provider status to an agency enabling it to receive the appropriate federal funds and generate such other resources necessary to supplement the federal grant, and to operate, contract and subcontract with other providers, taxi companies and others to serve the transportation disadvantaged in the assigned geographic region or catchment area. However, some 9 years have passed since these efforts were undertaken. There are legitimate questions regarding attainment of the Council's two major goals: reduction of costs per trip and increase in the availabiltiy of local services. To what extent have these aims been realized? A study commissioned by the Council in 1988, utilizing a firm of outside

THE FLORIDA EXPERIENCE

949

The study design consultants, was published in 1989. used data from a 5 year period, 1983-1987, or the heart of the years the Council has been operational. The consultant's findings indicated limited but positive benefits have accrued for users of existing local coordinated services: 1) the statewide average trip cost declined from $8.05 in 1983 to $5.62 in 1987; 2) in terms of system productivity, the average trips per vehicle hour increased from 2.49 in 1983 to 3.08 in 1986 and then declined to approximately its original level of 2.48 in 1987. On balance the study concluded it was clear that while savings in unit cost per trip cannot be readily guantified, some of the cost savings noted were the result of improved productivity arising out of the coordination campaign pursued by the Coordinating Council for the Transportation Disadvantaged. The general concept of the state legislation, that is, elimination of duplication through coordination or consolidation, actual or potential, if necessary, was in the view of the local informants deemed to be essentially correct. Virtually all parties interviewed believed that the Council's mandate and objectives were appropriate and should continue to be pursued actively. While the consultant's report indicates that over the 9 years of the Council's existence it has the appropriate mechanisms for improvement in place, it has not achieved some of its major objectives. Three of these were: 1) a lack of funding to assist local communities in planning and addressing the administrative costs of local systems; 2) a failure to clarify the respective roles and responsibilities of participating organizations such as the State and district DOTs, the Coordinating Council and other units immersed in the coordination process; and 3) implementation of a rational basis for service rates to assist providers in contract-for-service arrangements, and standardization of rate charges to enable comparability among local systems. However, in the main the report comes down on the positive side of what was achieved by local coordinated providers, and cites "elements of success" associated with positive achievements apparent among the more successful local providers.4 These were: Cooperation. Interagency cooperation, especially between district DOTs and the state's human services

32

950

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

personnel, the Metropolitan Planning Organization and designated provider. Planning. Where there was an upfront, start-up planning investment that helped achieve local consensus with respect to appropriate local implementation, success was achieved more rapidly and with greater ease. Funding. Where there was funding assitance, and administrative costs, there was an added incentive. In a number of cases, the UMTA Section 18 funding and F DOT support combined to provide this incentive. Public Interest. Where strong County interest and participation were involved, success came more easily due to the leverage the County could lend to bring about change. Flexibility. When creative flexibility was applied to the structuring of service delivery to meet agency and individual needs, support, consensus and participation were more readily achieved. Education. When there was an individual and/or a planning process where by key individuals and agencies were educated as to the reasoning and benefits behind coordination and/or consolidation of services, higher levels of success were achieved. Mainstreaming. Where human service agencies had a generally positive attitude toward folding their clients together with other transportation disadvantaged groups in a transportation system, rather than isolating them through insistence upon exclusive service, system acceptance and participation was improved. As of the time this paper was prepared there were 48 specialized transit systems covering 63 (of the 67 counties) in operation; many of the rural counties opted for regional transit systems to serve their transportation disadvantaged, as a more efficient alternative to a single county system. As this is being written the future for statewide mandated coordination in Florida looks promising and suggests more major positive changes lie ahead. Attesting to the positive impact by the Council on achieving its mission, the state legislature in July 1989 extended the life of the Councils by an

THE FLORIDA EXPERIENCE

951

additional ten years. Appointed Council and Commissions in Florida are subject to periodic review by the legislature? each Council or Commission must establish its worth in order to remain alive. The Council was elevated to the status of a Commission, the Transportational Disadvantaged Commission, and its membership increased from 7 to 11 members for broader representation on the policy-making body. To address the lack of funding to support local specialized transportation, the legislature established the Transportation Disadvantaged Trust Fund, to be derived from a 50 cent tax of each license plate issued in Florida for vehicles 5,000 pounds and under. The Trust Fund is expected to generate about $5 million or more annually.5 After staff salaries and other administrative costs of the Commission are taken off the top, the remainder will go into a grants program to be divided on a formula among the counties operating a coordinated specialized transit program. One third of the grant received by the county will be assigned to planning, the remaining 2/3 will be assigned to two areas: capital needs and payment for clients whose fees are not paid by an agency. Such clients are referred to as non-sponsored. Essentially the grant formula rests on four criteria: county*s overall population, square miles in the county, passenger trips generated in the prior year by the local provider, and vehicle miles driven in the past year by the local system. The use of the latter two criteria are viewed as incentives for local coordinated providers to increase the efficiency of their operations.

952

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

References ‘"Florida Statewide 5 Year Transit and Paratransit Development Plan for the Transportation Disadvantaged,11 1984. Commissioned by the Florida DOT, prepared by Schimpeler-Corradino Associates, Tallahassee, FL 32301. 'Chapter 89-376, Laws Florida Statutes.

of

Florida,

Section

427.011

'Carter Goble Associates, HA Program Analysis for the Coordinating Council on the Transportation Disadvantaged," Executive Summary, February 28, 1989. 4Ibid.

Carter-Goble Associates, p. 2-9 & 2-10.

5Florida Transportation Disadvantaged Commission, "Transportation Disadvantaged Trust Fund Distribution." Adopted by the Commission January 10, 1990. Unpublished memorandum.

HOW TO FILL UP YOUR BUS: THE READIBUS EXPERIENCE Mr. P. Absolon & Dr. S. Bowlby (ReadiBus, Controller) (University of Reading) 1.

INTRODUCTION

ReadiBus is an urban dial-a-ride service operating in Reading and surrounding suburbs in England, covering an area of approximately 70sq. miles. Reading has experienced unprecedented growth in recent years and the housing stock within the ReadiBus operating area varies enormously from terraced streets to leafy suburbs. The population in the operating area is about 200,000 people. ReadiBus was launched in 1987 following a research project which identified the isolation of those who were not able to use the public transport system and had no access to private transport. Although operated and funded separately from the public transport system it was intended to be an extension to the ordinary bus service by operating from doorto-door with fully accessible minibuses, in the same livery as the ordinary buses and charging an equivalent b u s - f a r e (Bowlby et al, 1985). Initially it was funded jointly by central and local government through the Urban Aid programme. Today it is funded entirely by local government. In this paper we will d i s c u s s the v a r i o u s modifications that have been made to the operating system during the last 7 years in attempts to increase the numbers of people carried/bus hour and to cope with a permanent problem of excess demand. 1.2.

The Original Service

The original service operated 16 hours per day, 7 days per week, using 4 Mercedes minibuses fully adapted. Trips were booked by passenger.the day before travel from 8am. on a first-come, firstserved basis, the trip-requests being scheduled into a demand-dependent flexible routing system. The number of buses was expanded to 6 in 1984 with an appropriate expansion in the number of drivers. 1.3.

Problems of Excess Demand

Problems of excess demand came about immediately. Current estimates suggest that about 10% of the population are unable to use an ordinary bus (G i l l i n g w a t e r , 1988). Therefore there were 953

954 MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

approximately 20,000 potential users of the service, four buses and one telephone-line. More significantly, the operating area was so large relative to the capacity of the service that efficient scheduling to secure high levels of passengers/bus hour was impossible using a firstcome, first-served booking procedure. Some solutions had to be found rapidly. 2.0

MEASURES TO RELIEVE PROBLEMS OF EXCESS DEMAND (1983-8)

One of the severest difficulties in adopting solutions to the problems described is that very little can be achieved rapidly when dealing with funding agencies. Any massive expansion of the service to meet the excess demand was out of the question. A succession of service changes were therefore introduced from 1983-7 to attempt to find solutions within only a moderately-expanded budget. 2.1.

Introduction of a Call-Queuing Telephone System (1983-8)

The introduction of a call-queuing telephone system enabled 6 people to simultaneously call ReadiBus, one would be answered, while 5 would hold on. The intention of this was to e x p a n d R e a d i B u s ' capabilities to receive telephone bookings. T h e r e wer e two m a jor d r a w b a c k s w i t h this development. First, the number of people answering the phone was still the same (one), so any expansion of capability was illusory rather than real. Secondly, many passengers and potential passengers did not, and still do not, understand a call-queuing telephone system. When no one answers the phone when it has been ringing for more than a minute, the natural assumption is that there is no one to answer the call. The call queuing system therefore deterred new users and some existing users from gaining access to ReadiBus contributing to the image that ReadiBus began to develop during this period of serving only a small clique of favoured, existing customers who understood how to 'operate the system'.

THE READIBUS EXPERIENCE

2.2.

955

Introduction of 7-day Prioritised Advance Booking (1985-7)

The alternative to measures to expand supply to meet excess demand is to try to ration supply and the introduction of 7-day prioritised advanced booking effectively sought to do this. De m a n d for ReadiBus was separated into two categories. ‘Priority' trips could be booked 7 days in advance, while 'non-priority' trips could only be booked one-day in advance. Priority trips were trips to work; p r e - b o o k e d s c h e d u l e d appointments (eg. dentist, theatre); church; and education. By separating booking times of priority and non-priority trips into morning and afternoon, the peak of telephone demand was also split into two. This made the telephone-queues easier to deal with. The advantage of this latter fact were more than offset by considerable disadvantages of this system:1.

The distinctions drawn between priority and non-priority trips were difficult for schedulers to define and implement in everyday practice and confusing to passengers and perceived as unfair. They became the source of resentment and confusion.

2.

The division of booking times also was confusing to passengers.3

3.

Most importantly, the schedules became dominated by 'priority' trips which formed 25% to 80% of a day's trips. This meant both that 'non-priority' t r i p s w e r e v e r y d i f f i c u l t to accommodate and that the scheduling of trips was inefficient because the times of the priority (advance booked) trips could not be altered. Passengers expected priority trips to be provided like a taxi-service. Table 1.0 shows the poor passenger/bus hour figures achieved under this system following the better figures of 1 984 (eg. 2.50 passengers/bus hour in March 1984). The dominance of priority trips also contributed to the 'closed club' image of ReadiBus as new customers found it

956 MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

difficult to gain access to the service while a few regular customers were able to make frequent use of the service. 2.3.

Tendering for contract work (1987)

In an attempt to expand the supply of the service, ReadiBus tendered for and won a Social Services contract to transport clients to day centres. The intention was that the revenue from the contract would permit an expansion of the dial-a-ride service during the hours in between collection and delivery of people to day centres. This was unsuccessful. The collection and return times of the contract work spanned 4 hours within 10, per day, 7 days per week. It therefore required 2 different drivers each day. The hours of the contract also coincided with peak dial-aride demand, so capacity was only improved during 'off-peak' hours. The contract was therefore discontinued after 12 months. 2.4.

Use of Taxis (1987-1988)

For a short time, an expansion of supply was sought from allocating passengers refused a trip on ReadiBus because of lack of capacity to taxis. However:1.

Taxis are not particularly suitable vehicles for many disabled people.

2.

Taxi drivers are untrained in the care of elderly and disabled people.

3.

It was possible for alert ReadiBus customers to take advantage of the system in order to obtain a subsidized taxi-fare.

4.

The scheme did not improve the routing and scheduling of the ReadiBus service - it simply allowed 1 or 2 extra passengers per week to be carried at the cost of their taxi fares.

In 1988, a modified scheme was tested for a period of 3 months . In this scheme some trips were allocated to a taxi if the scheduler felt it more

THE READIBUS EXPERIENCE

957

efficient and suitable to do so. This use of taxis was much more effective in expanding the capacity of the service at the margin since it allowed scheduling efficiency to be improved (see Tables 1 and 2). Points 1 and 2 above still applied however, and any use of taxis as a marginal expansion of capacity still costs extra money, which in ReadiBus 1 case, has not yet been allocated. However, in our view such a use of taxis is likely to be a cost-effective method of expanding capacity and improving scheduling efficiency and is worth continuing if money became available. 3.0.

REVIEW OF OPERATIONS 1987

After 5 years of experimentation, which had not produced effective results, a major review of the ReadiBus service took place in 1 987 and a new approach was adopted to the twin problems of dealing with excess demand, yet finding ways to i m p r o v e e f f i c i e n c y by 'filling buses up' (increasing passengers/bus hour). This review i t s e l f f o l l o w e d a total r e a p p r a i s a l and reorganisation of the administrative structure, drivers rostas and training programme for all personnel. This reorganisation took place from July 1987 - Jan. 1988 and was itself a contributing factor to the improvements in efficiency in carrying passengers and in recruitment of new users that took place during 1988. These two goals were now more clearly specified to all workers. As a result of the review the measures taken between 1 983 and 1987 have been progressively abolished, and replaced with new initiatives which will be described below. The success of any dial-a-ride operation depends upon its system of booking. The system must be simple, easy to understand and fast. A callqueuing phone system that people do not understand, or an unduly complicated system of priority categories, will not lead to full utilisation. On the other hand, unless the capacity of the service is very large, a purely random first-come firstserved booking system will not produce ordered 'patterns' of trips, or the most e f f i c i e n t scheduling, except by chance, despite the intricate skills of most schedulers.

958 MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

A balance is therefore required between the capacity of the service, the ordering or structure of the b o o k i n g s y s t e m , and its ease of comprehension. The balance that ReadiBus has introduced since June 1988 is one of limited differential booking times, limited structuring, and an expansion of the ability to deal with increasing calls by increasing the number of schedulers. 3.1.

The Booking System

Seven-day advance booking was abolished in June 1988 and replaced with day-before booking only. This simplified administration immediately and made the service more widely and equitably available (Table 3 and 4). Table 3 shows that the recruitment of new users has been improved both by the appointment of a mobility officer and by the new booking system. The low figure for OctoberDecember 1988 is thought to be due to a temporary decrease in home visiting by the mobility officers and possible delays on the 1phone due to new scheduling staff. Some limited priority was retained however by differentiating between two booking times on the morning of the day-before. Passengers can 1phone at 8am for trips to work, to further education and for trips on the new pre-scheduled services (see below). The booking lines are then closed down for half an hour between 9am and 9.30am to reopen from 9.30am until 3.30pm for all other bookings. This priority seems to have been accepted by all passengers without exception as being fair and comprehensible, and unlke to the previous system of priority, facilitates efficient scheduling. Passengers do not see these priority trips as a 'taxi-service' and schedulers can ring back and modify times during the day without passengers seeing this as unreasonable. Furthermore, since these priority trips form no more than 0% to 12% of total trips they form a framework for organising schedules rather than a constraint. The call-queuing system is being g r a d u a l l y dismantled. The number of incoming booking lines has been reduced to 3 and the scheduling staff doubled to 2.

THE READIBUS EXPERIENCE

959

The overall effect has been a dramatic increase in the capacity of the service, with more passengers being carried by the same number of drivers and buses (Tables 1 , 3). The problem is by no means solved however. There is still congestion on the telephone-lines, and there is a need to increase the scheduling staff still further. However, so far, the results from this change are encouraging. 3.2.

Pre-Scheduled Services

At the same time, in June 1988, pre-scheduled services were introduced for the first time, from four origin zones to two destination zones (the Town Centre and a major Superstore) within the operating area. Passengers using the pre-scheduled service are still being offered a door-to-door service but at limited times and to limited destinations. Based on an extensive passenger survey and analysis of existing trip patterns, the pre-scheduled services were given booking priority to encourage take-up. If successful, it would clearly be beneficial to encourage passengers from similar areas to travel to similar destinations at the same time. To be successful, though, the times had to be near enough to those that were really wanted for passengers to alter their travel patterns to fit in with others. During the first 6 months of operation customers made only limited use of the pre-scheduled service (an average of 2% of trips per day of operation). Although we cannot be certain the reasons for this are assessed to be a combination of the following 1.

T h e new s e r v i c e w a s understood, partly due to terminology and partly introduction at the same booking times.

not f u l l y some of the due to its time as new

2.

The passenger survey on which the prescheduled services were based had become dated, due to the length of time it had taken to undertake and analyse it.

3.

An assumption that passengers were prepared to spend time in the town centre over the lunch period appeared false. Facilities for the disabled in

960 MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

the town centre for eating are not good, mainly due to overcrowding. A trip in the morning or afternoon is probably preferred. The same assumption for the second destination, an out-of-town superstore was correct however, as facilities there are very good. The second six months of this service will take these factors into account, as new times have been introduced from 2 January 1989. The results of these changes will be described at the conference presentation. 3

*

3.

Assessment of the recent changes

Assessment of the individual effects of each of the changes is difficult because their implementation o v e r l a p p e d on e a n o t h e r and b e c a u s e the administrative changes also had an impact on efficiency. Clearly 1 988 as a whole shows significant improvements on 1987. However, the greatest improvement in passengers/bus hour took place in March-April 1 988, before many of the changes we have discussed took full effect. It appears that this improvement was due to the combined effect of ending the social services contract and the administrative reorganisation with its improved specification of operational goals. However, we argue that the fact that this was not only sustained but also improved upon is evidence for the efficacy of the changes in booking procedures. We conclude that the change to the booking system has clearly been a success. Our experience shows that it is important to keep schedules flexible through minimising the amount of c u s t o m e r determined fixed commitments. However, we do consider that we are justified in sacrificing a little of this flexibility in the interests of reassuring potential customers that they will be able to meet their work or educational commitments. The success or failure of our attempt to fix some elements of our own service through pre-scheduling is as yet unclear. We remain hopeful that in the future it will increase bus usage and scheduling efficiency. Although we conclude that the booking procedure is an important contribution to improved efficiency

THE READIBUS EXPERIENCE

961

the apparent impact of ending the social services contract and of better management suggest that having clearly specified operational goals deriving from an appropriate ‘philosophy* about the service are even more important. This philosophy is to provide a high quality public bus service for as many people with mobility difficulties as possible. ReadiBus is aiming to provide a mass transit system, not a taxi service. 4.0.

READIBUS NOW AND IN THE FUTURE

ReadiBus currently has ten full-time paid drivers, and six minibuses, and transports over 30,000 passengers p.a. Fares revenue only accounts for 51/2% of cost, the remainder (approx. £230,000) being funded by local councils. It is a highlyrespected local service and much valued by those who need and use it. It is one of the largest dial-a-rides in Britain, and yet, it is still only large enough to serve 5% of the total people in need of it with an equivalent of less than 1 trip per week. The recent initiatives taken have improved our ability to fill our buses up, but when taken in context, it is clear that only a far larger organisation could ever be capable of consistently achieving higher loadings. REFERENCES Bowlby, S.R., Kirby, A and Swann, V. (1985) Use of Demand Responsive Transport for Disabled People; The Readibus Example, Working Paper WP 9HSFO 13, Transport and Road Research Laboratory, Department of Transport, Department of the Environment, H.M.S.O. G i 1 1 i n g w a t e r , D. (1988) Transport for a l l resourcing non-conventional and accessible public transport, in K. Orford (ed) Public Transport Options: Making Money Work, CICC Publications Ltd., Welwyn, UK.

962 MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

TABLE 1 TABLE OF PASSENGERS CARRIED PER BUS-HOUR AT 2MONTHLY INTERVALS JAN 86 - DEC 88 1986

PASS CARRIED PER BUS HOUR

% CHANGE

JAN/FEB MAR/APR

1 .86 1 .86

0

MAY/JUNE JULY/AUGUST SEPT/OCT NOV/DEC

1 .95 1 .96 2.03 2.19

4.8 0.5 3.6 7.9

COMMENTS 7-DAY PRIORITISED ADVANCE BOOKING IN OPERATION

1987 JAN/FEB MAR/APR

1 .99 2.05

MAY/JUNE 2.06 JULY/AUGUST 1 .75 SEPT/OCT NOV/DEC

1 .98 1 .88

-9.1 3.0 — j[SOCIAL SERVICES CONTRACT COMMENCES [1 MAR. 87 0.5 -15.0 — j(START OF MANAGEMENT (REORGANISATION 13.0 - 5.1

1988 JAN/FEB

2.06

MAR/APR

2.49

MAY/JUNE

2.51

JULY/AUGUST 2.52 SEPT/OCT NOV/DEC

2.66 2.81

9.6

fMANAGEMENT REORGANISATION ‘c o m p l e t e d . (SOCIAL SERVICES CONTRACT ENDS iMARCH 1ST 20.9 — j(2ND TAXI SCHEME [STARTS APRIL 1 0.8 — |(7 DAY PRIORITISED ^ADVANCE B O O K I N G 0.4 100000inhab. G= Paris suburb H= Paris

TRAVEL ACTIVITIES OF THE ELDERLY IN SWEDEN - CHANGING PATTERNS AND NEEDS B ertil

Ph. D. 1.

V ilh elm so n

INTRODUCTION

In this paper attention is paid to some effects of two main trends concerning the travel habits and needs of the population in Sweden. The first tendency is the growing number and share of elderly persons in the population. Like most industrialized countries Sweden is in a demographic transition due to reduced birthrates and increased length of life. From 1960 to 1989 the proportion of old persons (more than 65 years) increased from 12% to 18%. Now there are 1.5 million old persons in a population totaling 8.4 millions. But forecasts show that a saturation level is almost within reach. Future changes will merely reflect the short-time changes of historical birthrates and migration. In Sweden, in the decade to come, this means an increasing number of persons more than 80 years old, while the number of persons aged 65-79 in fact will decrease. Another basic trend of interest here is the long-standing transition into a highly mobile society. Since 1960 the average trip-length per capita has more than doubled, from 15 kilometers a day to almost 40 kilometers in 1985. This summarizes a dramatic transformation of the spatial organization of society as well as the time-use and access to means of transportation in the population. Up till now this growth of mobility has been concentrated to the young and middle-aged. For some years the elderly have also become active agents in this trend. Together these trends raise questions concerning issues of welfare and transportation. It is a matter of the distribution and spread of mobility resources in the population. It concerns the accessibility of transportation systems and the demands they make on the physical and mental capacity of man. It also concerns the traffic safety of different age groups. In this paper I will explore some issues of distribution related to the mobility of old people in Sweden. First I will discuss whether the elderly in general travel less than other groups. Then I explore progressing shifts in the access and use of different means of transportation. After that I analyze what factors cause the elderly to reduce their travel activities. Finally I discuss the changing mobility patterns and related needs of the elderly that are likely to occur during the next decade. 2.

SURVEY DATA

In order to deal with these issues I will lean on empirical evidence of the travel patterns and the spread of mobility resources in the population. Two large National Surveys on Travel Patterns (NST) have been conducted in Sweden.1The first one was completed in 1978 and it was repeated after six years, in 1984/85. Data consist of two sets of separate random samples drawn from the population aged 15 to 84 years old. The 1978 NST-sample consists of 8.200 persons and the 1 The National Surveys of Travel Patterns (NST) were done by Statistics Sweden (SCB).

1019

1020

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

non-response rate is 11 percent. The 1984/85 NST-sample consists of 7.700 persons. This time the non-response rate is 15 percent. The survey includes all physical movements of more than 200 meters outside home during one day - also those done walking on foot. Any movement so defined is here called a ’’trip". The datasets also include variables covering demographic, socio-economic and geographical information about each individual. Here results from the survey will be used both to analyze cross-sectional differences over age groups and dynamic changes in the period between the two surveys. Factors influencing the travel patterns of the elderly individual will also be reported. 3.

GENERAL TRAVEL PATTERNS OF THE ELDERLY

Trips and travel are the spatial outcome of people's contacts and communications. It is commonly assumed that getting old means reduced contacts and activity. As a consequence trips and needs for travel are diminished. This depends on both internal and external restrictions affecting the old, e.g. of increasing disabilities of the individual and inaccessible environments (for instance, difficulties of boarding vehicles, or walking to bus-stops and to railway stations). Taken together this situation produces a mobility handicap. Another form of explanation emphasizes that changing travel patterns result from a voluntary withdrawal from an active life. Of course both hypotheses may be true, and merely complement each other. A look at the average trip rates of different age groups seems at a first glance to confirm the main impression of a decline in travel (fig. 1).

Figure 1 Average number of trips per person and day . Annual cohorts. Based on estimates of all trips by the Swedish population aged 15 - 84 in 1984/85.

TRAVEL ACTIVITIES OF THE ELDERLY IN SWEDEN

1021

The average rate (number of trips per day and person) decreases with age. Of course it is important to have in mind that the trip-rates are based on cross-sectional data from which one cannot strictly interpret and predict dynamic changes. For example, one cannot take for granted that the young of today will in fifty years show the same average trip frequency as the old of today. But in the short run no dramatic changes occur. The corresponding cross-section of the 1978 survey shows no statistically significant differences from the 1984/85 data. So, from an aggregate and static point of view, the hypothesis of reduced travel activity among the aging and elderly seems to be confirmed. But a somewhat closer look may change this immediate impression. A simple way to examine this question is to exclude work-related trips from the analysis. In one sense, work-trips are "forced" upon most individuals and disappear from the daily agenda when a person retires from working life; in Sweden commonly by the age of 65. Most other triprelated activities are more or less connected to the use of "free" time for reproduction (e.g.. shopping and service) and leisure (e.g. visiting friends). When work-trips are excluded from the analysis the average tendency of reduced travel by age is not so marked (see fig. 2).2 General reductions seem to occur only after 75 years of age.

5

Figure 2

15

25

35

45

55

65

75

85

A v e r a g e n u m b e r o f tr ip s p e r p e r s o n a n d d a y f o r w o r k (s h a d e d ) a n d a ll

o th e r p u r p o s e s ( b la c k ) . A n n u a l c o h o r ts . B a s e d o n e s ti m a te s o f a l l tr ip s b y th e S w e d i s h p o p u l a t i o n a g e d 1 5 - 8 4 in 1 9 8 4 / 8 5 .

So far an important conclusion may be drawn: the correlation between chronological age and factors of activity restrictions, mobility handicap and the like, a correlation which is often said to exist, is not quite manifest. Much of the change in travel behavior of the elderly seems rather to be due to changing social roles, such as the withdrawal from working life. For practical traffic planning purposes it seems natural to distinguish between at least two groups of old people, one consisting of "young old" people with an 2 A fact that has been indicated for small-scale samples in Sweden, see for instance Hansson (1977).

1022

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

almost unaffected activity- and travel pattern, and another consisting of "old old", among which travel difficulties and transportation disadvantages are more common. The first group will be in the 65-74 bracket, the second one in the 75 upwards bracket. Of course generalizations presented so far are not valid for each individual. There are important variations in trip-frequencies between individuals. In fact this variance tends to increase the older the age-group (or cohort) considered. One way to illustrate this is presented in fig. 3. In this figure the share of "non-travellers" in each annual cohort is shown. A "non-traveller" is defined as a person who does not report any trip at all during the day of investigation. It does not mean that he or she never goes out of the house. The share rather indicates the general degree of spatial inactivity in each group.

Figure 3 Proportions of daily "non-travellers" . Swedish population aged 15-84 in 1984/85. Annual cohorts. In all groups under 60 years old the proportion of non-travellers a day stays around 10 percent. After that the share grows steadily to around 80 percent in the groups above 80 years old. The number of "non-travellers" may seem to contradict the fairly high average trip levels among the elderly as shown in fig. 2. It must be a reflection of fewer but still very active persons as the years pass by. 4.

THE USE OF DIFFERENT MODES OF TRANSPORTATION

4.1

The overall picture

Though the general level of trip activity is relatively stable there are certain differences in the use of transportation modes between the age-groups. Fig. 4 shows the average trip-rates of seven different age cohorts. The trips include those done on foot, by car (as driver or passenger), by public transportation and by bicycle.

1023

Trips/person and day

TRAVEL ACTIVITIES OF THE ELDERLY IN SWEDEN

V E3 ® H ^

15-24

25-34

35-44

45-54

55-64

Walking Bicycle Car driver Car passenger Public transport

65-74

75-84

Figure 4 The propensity to use different means of transportation. Average number of trips per person and day. Swedish population in 1984185. From the perspective of the old the following observations are of interest: Today trips done on foot make up, by far, the primary mode among both the "young old" and the "old old". The average rate does not decline over the age-groups in this cross-section. In fact, the highest average propensity to walk is found in the 65-74 group. This contrasts with the common view of the correlation between chronological aging and walking difficulties. The car - the principal mode of transport among the young and middle-aged - still plays a minor role among the elderly. But the long-run tendency is clear. New generations of elderly will most likely exhibit higher proportions of car access and car use. In the overall picture, public transportation (here bus, underground railroad and tramway) is of minor importance. The average rates of use do not vary so much between the groups (except for the young relatively high-consuming groups). No decrease over the age-groups can be traced. Among the "old old" public transportation is the most common motorized mode of travelling in Sweden. The main conclusion is, as expected, that the use of the automobile is the discriminating mobility factor between young and old. It is the possibility to own and drive a car that affects both the level of mobility and differentiates the overall mode pattern. From the group perspective other modes are used to about the same extent. With new generations of elderly this factor will probably decrease in importance. Another finding is the relative significance of trips done on foot. This is often

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

1024

neglected, in travel surveys as well as in discussions of transport policy measures on all levels. 4.2

The elderly and the car

It is a well established view that the car will play a more dominating role in the mobility of the elderly in the years to come. New generations of elderly are more likely to own a car and keep a lifestyle connected to the high mobility that the car gives. In Sweden it is only during the last few decades this tendency has become evident. I will here give some basic data on the changing role of the car among the elderly. Fig. 5 shows the access to cars among different age groups in 1978 and in 1984/85. Access is defined as one or several cars being in the possession of the household to which the person belongs. It is clear that access is growing fast among the elderly. For example, in 1978 30 percent of all aged 65-74 had a car in the household. Only six years later this share had increased to 45 percent. A simple extrapolation of the trend implies that the share will reach a 70 percent level in the middle of the 1990's. % ,

Share

F ig u r e

5

T h e a c c e s s to c a r s a m o n g d if f e r e n t a g e c o h o r ts in S w e d e n in 1 9 7 8 a n d

1 9 8 4 / 8 5 ; in t e r m s o f t h e s h a r e o f i n d i v i d u a l s t h a t b o t h h a v e a d r i v e r ' s l i c e n s e a n d b e lo n g to a h o u s e h o ld o w n in g a c a r .

However, a car in the possession of the household does not mean that it is available to each person of that household. This is especially true for elderly women, who more seldom have a driver's license. It it will take another 25 years before age cohorts where both men and women are licensed drivers to the same extent reach the 65 and above age bracket.

1025

TRAVEL ACTIVITIES OF THE ELDERLY IN SWEDEN % Absolute chjav^e of shw*

1 5 -2 4

2 5 -3 4

3 5 -4 4

4 5 -5 4

5 5 -6 4

6 5 -7 4

7 5 -8 4

cohort

Figure 6 Trips of car-drivers among different age cohorts in terms of the change of the share (of all trips) between 1978 and 1984/85. Swedish population aged 1584. Survey data confirm that travelling by car is becoming more common among the elderly, fig. 6. During the period of stagnation 1978 -- 1984/85, when other groups even reduced their car-use, the growth continued among the elderly. 5.

FACTORS INFLUENCING THE TRAVEL PATTERNS

5.1

Restrictions and social roles

I will now turn to factors influencing the elderly to reduce their travel activity. In an earlier study I have explored this question by applying multivariate (multiple regression) techniques on data from the NST.3 Briefly, I found that a number of factors significantly affect the trip rates, travel distance and time spent on travel, although they still leave a considerable part of the variance unexplained.4 These factors are theoretically linked to restrictions as regards resources (e.g.. health and economy) and to the changing social roles of the aging old. Significant such factors are : Handicap Work Sex

Car availability Standard of public transportation Type of household

3 B Vilhelmson (1985), Resources and travel patterns. Activity and handicap among the elderly in transport and travel (Diss. in Swedish). 4 Note that the factors analysed can all be related to a restriction theory concerning what compels an elderly to reduce his spatial activities. No direct factors concerning the individual's own wishes were included in the analysis. No restriction theory is self-evident and immune to objection. See , for instance, Rowles (1978).

1026

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

The results may be interpreted in the following way. As expected, it appears that elderly individuals with low travel activity are often suffering from disabilities that produce handicap in inaccessible environments. The more a person is disabled, the lower will be his trip-rate, trip length and time spent on travel per day. Further, as pointed out earlier, occupational status plays an important role. Elderly persons who are still taking part in working-life tend to travel more than those who do not. Another role-aspect found is that elderly women tend to be more inactive than men living under the same conditions. Moreover, type of household has an effect. Living alone means more trips than living in a household of two people. Two persons have a chance of distributing essential tasks outside home among each other. In addition, the direct access to transportation resources has a substantial influence on the overall travel level. It is no surprise that elderly persons owning a car travel more than those without. But the access to public transportation also plays a significant role. Elderly people living near public transport systems of high standard also travel more than others. Indirectly this also indicates the type of region; urban or rural area. From a forward-looking perspective of policy and intervention two of the factors above are of primary interest - handicap and car-ownership. Handicap because it is of a dynamic character - it can be reduced by various interventions. The number of people affected by handicap in transportation can be reduced by making transportation systems more accessible for man. It can also be reduced by better health standards, rehabilitation measures and means of technical assistance of the individual. At the same time, car ownership is rapidly growing among the elderly and will probably continue to do so during the next decade. 5.2

Mobility handicap

Health and functional capability together with the accessibility standards of transportation systems, are major factors affecting spatial activity and daily travel. In the present study restricted activity due to disabilities and inaccessible environments (or systems) is referred to as handicap, which thus denotes both the disabilities of the individual and the system-related demands put on man. It is, however, problematic to operationalize this concept of handicap in a straightforward manner. For instance, in order to show how many people are affected by mobility handicap, a situation must be theoretically constructed. In the NST three such situations essential for travelling were discussed with the respondents. They were asked whether they found it difficult to walk up steps and stairs, to get into a bus and to take a quick walk for at least some minutes. Roughly, such questions help to estimate the incidence of mobility handicap (of different degrees) in a population. Another - perhaps more objective - way is to ask whether a person is entitled to the so called social transport service (STS). STS is a kind of handicap transport service subsidized by the government and local authorities. (The aim of STS is to complement the ordinary public transportation. Taxi-cabs and specially adapted mini-buses are used.) Fig. 7 shows the increasing incidence of mobility handicap by age, especially among groups over 65. An important observation is that not even among the oldest, here the 75-84 bracket, the share of handicapped exceeds 50 percent. This means

TRAVEL ACTIVITIES OF THE ELDERLY IN SWEDEN

1027

that a majority of the elderly have no severe mobility handicap. This is an essential finding in a context where aging often is viewed as a problem.

Figure 7 The incidence of mobility handicap among different age cohorts. The share of persons sufferingfrom handicap according tofour different criteria. Swedish population in 1978. Nevertheless, a large number of elderly people vigorously demand more accessible and well adapted transportation systems, table 1. In sum, about half a million persons out of a total population of 6 million aged 15-84 years, are considered to suffer from a severe mobility handicap in their daily life. The majority of the handicapped, almost 70 percent, are elderly persons over 65 years of age. Most elderly people, however, are not handicapped. Table 1

Mobility handicapped persons in Sweden. Number and share according to different measures, Swedish Travel Patterns Survey 1978 .*Population 15-84 years old.

Criterion on mobility handicap

Number

Difficulties in getting into a bus Difficulties to take a walk Difficulties in walking up stairs Entitled to use Social Transport Service (STS)

380.000 470.000 590.000 233.000 **

Total population, 15-84

6 490 000

Proportion of elderly 65-84 (percent)

* NST 1984/85 did not consider aspects of mobility handicap. ** In 1989 the number of people entitled to STS is almost 400.000.

71 72 66 78

1028

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

Partly, these estimates are indicators of hidden problems and of the latent demand for travel. As such they can be used to describe the need for adapted and accessible transportation systems. But one further question is how discriminating the handicap factor is in the actual choice and use of different modes of transportation of the elderly. I pointed out above that, for instance, trips done on foot were as frequent among elderly people in general as among young and middle-aged persons. A somewhat more differentiated picture is given in fig. 8. Here three subgroups of elderly people are defined with respect to the severity of their mobility handicap. The first group v e r y s e v e r e l y m o b i l i t y h a n d i c a p p e d - consists of those entitled to STS. The second group - s e v e r e l y m o b i l i t y h a n d i c a p p e d - are persons having pronounced difficulties to walk or walk up stairs but n o t entitled to STS. The third group - n o t m o b i l i t y h a n d i c a p p e d - are those with no pronounced mobility problems.

Very severely mobility handicapped Severely

mobility

handicapped

Not mobility

handicapped

Trips/person and day

Figure 8

T h e p r o p e n s i t y to u s e d if f e r e n t m e a n s o f t r a n s p o r t a t i o n a m o n g th r e e

g r o u p s o f e ld e r ly a g e d 6 5 -8 4 . A v e r a g e n u m b e r o f tr ip s p e r p e r s o n a n d d a y a m o n g th e g r o u p o f v e r y s e v e r e l y m o b i lit y h a n d ic a p p e d , th e g r o u p o f s e v e r e l y m o b i lit y h a n d i c a p p e d a n d th e g r o u p o f m o b i l i t y h a n d i c a p p e d in 1 9 7 8 .

First to be noted are the wide differences in the general level of trip-activity between the three mobility groups. By and large this can be attributed to differences in the propensity to walk and to travel by car (as driver and passenger). Second, and contrary to this, public transportation is used to roughly the same extent among all groups. Trips done by STS are here included in the public transportation category. In fact STS correspond to 65 percent of the public transportation among the group of severely mobility handicapped. This means that STS almost compensates for failing possibilities to travel by ordinary means of public transportation. Other studies show, however, great variations in the individual use of STS.5

TRAVEL ACTIVITIES OF THE ELDERLY IN SWEDEN

6.

1029

DISCUSSION: THE NEXT DECADE AS SEEN FROM THE PERSPECTIVE OF THE TRANSPORT NEEDS OF THE ELDERLY

Demography is of vital importance for understanding the possible future development of needs and demands in the transport sector. In Sweden the number and share of elderly persons is beginning to stabilize on a high level, almost a fifth of the entire population. Hence the absolute number of elderly people is not a dynamic factor during the decade to come. Rather, the need for transportation will be affected by general shifts in life-styles, health, household economy and mobility resources on the part of the old. Also important will be the distribution between ’’young old” and ’’old old”. Accordingly the need for public intervention and adaption measures in the transportation system in favor of the mobility handicapped will change in relative strength. There will be a widening gap between those who have and those who have not. The disparities in mobility resources between different groups of elderly (e.g.. handicapped and non-handicapped) will be more pronounced. Most important is the increased mobility of a large number of the old. The share of elderly persons (over 65 years) possessing a driver's license and having access to a car will be more than 2/3 in the middle of the 1990’s. In 1980 only 1/3 of the old had that mobility status. The dominating effect will be that more of the elderly will satisfy their transportation needs on their own. This is not a problem per se but it will certainly have some side effects. One such side effect will be a substantial reduction of the demand for local public transportation. The elderly are at present together with the young proportionately high-consuming groups of public transportation, in particular during times of the day (off peak-hours) which are of vital economic importance for the transportation companies. Other side effects will occur on the individual level. Most households of elderly people in the 1990's will be adapted to the mobile lifestyle of car-owners. When the car suddenly becomes inaccessible, due to driving problems, illness or death of spouse, the whole way of life will be affected. Then public transportation becomes more important. The Swedish strategy of adapting public transportation to the elderly and disabled will be affected by the changes discussed above. This strategy leans heavily on the Social Transportation Service, which implies subsided transportation by taxi or, for wheelchair users or others with severe difficulties, by mini-bus. In addition, a law concerning the adaption of ordinary public transportation systems to the needs of the disabled has led to systematic, but fairly modest, measures of adaptation. From this a very large number of slightly disabled can benefit. However, during the 1990's there will be a relatively increased demand on STS or on more far reaching adaption measures in the ordinary systems, something which is a natural result of the fact that the number of very old, more than 80 years, will rapidly increase during this decade. * ^ B Vilhelmson & B Kihlman (1986), The development and future of the Social Transport Service. (In Sw ed ish ).

1030

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

References Hanson, P. The activity patterns of elderly households. Geografiska Annaler, Series B, vol 59 B, 2, 229-248, 1980. Rowles, G.D. Prisoner of space? Exploring the geographical experience of older people. Boulder, Colorado, 1978. Vilhelmson, B. Resurser och resor. Äldres aktivitet och handikapp i trafiken. Medd. fr. Göteborgs universitets Geografiska institutioner. Serie B Nr 77, 1985. Vilhelmson, B & Kihlman, B. Färdtjänstens utveckling ochframtid. Kunskapsöversikt och problemanalys. Transportforskningsberedningen, Stockholm 1986.

CAR OWNERSHIP AND TRAVEL PATTERNS AMONG ELDERLY PEOPLE 01nes, S0nneve/Haukeland, Jan Vidar Researchers 1. INTRODUCTION

Firstly, we should like to thank the Swedish Board of transport and Lund University of Technology for arranging this well-organized conference. Both the choice of conference theme and the breadth of participation here in Stockholm show that the demand for better standards of transport for the handicapped and elderly carries weight in the profession internationally. This is of course in itself necessary for changes to be possible, and for the goal of better integration of groups with a weak transport position to be possible to achieve. 2. PRESENTATION OF THE INSTITUTE

The two responsible for this paper are: S0nneve 01nes, an economist, and Jan Vidar Haukeland, a sociologist. We both belong to the Institute of Transport Economics in Oslo and work in the Department of Regional Analysis - one of the institute's k departments.

The Institute of Transport Economics is the national institute for transport research and development in Norway. 3. GENERAL COMMENTS ON THE FIELD OF RESEARCH

In this paper, we shall present some results from an investigation of the transport situation for elderly people. At our Institute we have also previously been working with questions concerning the relationship between transport and welfare. For vulnerable groups, transport problems will be a decisive obstacle to doing necessary daily tasks, and such difficulties can often be a barrier to social contact with others. Ordinary participation in social life is thus based on the individual’s purely physical mobility. Transport therefore becomes a critical factor in interactions between the individual and the surrounding social environment. If the prerequisites for individual mobility fail, the result for the individual is often increasing dependency, isolation, passiveness and unhappiness. In this perspective the motto of this conference - Mobility as a Human Right - becomes particularly relevant .

A complicating factor today is of course the explosive increase in mobility which characterizes our society. The majority of us travel far more than before bacause of radical improvements in means of transport and communication systems. Our activity zones become more and more extensive in the physical sense. But as the points of activity becomes more and more scattered as a result of this process, society also becomes structured in a new way. If we wish to have an active and out-going lifestyle, it is presupposed that the invididual capacity for mobility satisfies the demands set by the transport system. 1031

1032

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

The growth of motoring is naturally the dominant factor in the picture of change we have sketched. The rapidly increasing use of cars is important not only for the location of social activities, but also for the earning power of public transport. A shrinking traffic base results in curtailment of transport services and increases in fares, and in the 1980s this has been reinforced by the new-liberalistic wave. The reduction of public expenses and demands for "real” competition between transort services have speeded up this trend towards progressively poorer services for those who are dependent on public transport because they cannot use private cars. The forces behind the impoverishment of the public transport services are thus both many-sided and very influential social forces, where those who are particularly dependent on a well-developed public transport system have gradually become the great losers. 4.

GENERAL REMARKS PEOPLE IN NORWAY

ON

THE

TRANSPORT

RESOURCES OF ELDERLY

The transport resources of the elderly are very unevenly distributed, and many are in a relatively unfavourable position. The process of ageing is characterized by an increasing loss of resources which are important in the context of transport. ”Family resources” decrease as the household to which one belongs shrinks, and central resource components such as economy and health are vulnerable areas. In addition, vital transport resources such as a private car and a driving licence are lacking in most cases. Let ut start by looking at the general situation in Norway:

As the figure shows (fig. 1), one characteristic of household structure is that about every fifth man over 65 years lives alone, while every other woman in the age groups is in the same situation. Household structure varies with the degree of urbanization; the higher the degree of urbanization, the more people are living alone. The proportion of people living alone has doubled in the last 20 years.

Elderly people have a considerably lower personal consumption than younger (fig. 2), and single elderly people are in a particularly unfavourable position. On average, the personal consumption of a single old-age pensioner is only half that of a single person younger than 40. Many fixed expenses mean that transport often becomes a balancing item. Younger single people have transport expenses which are nearly five times as large as those of elderly single people. This pattern is also found among married couples, but the difference is somewhat smaller.

Physiological changes take place as one grows older: movements are hampered, and the senses are impaired. As one ages, it becomes more difficult to get from one place to another by one’s own efforts (e.g. walking and cycling) and one is also less able to use public means of transport. These physiological changes take place more rapidly among women than among men. 14 % of men between 60 and 7^ years experience problems related to health in different transport situations. The equi-

CAR OWNERSHIP AMONG ELDERLY PEOPLE

1033

valent figures for women are nearly three times as high. As early as the beginning of their sixties, women start to experience more health problems (1/3) than men between 70 and 74 years (1/4).

Access to a means of transport (private cars) and driving skills (driving licence) is also substantially poorer among elderly people than in the rest of the population. This is also the result of a cohort phenomenon; today’s elderly people belong to a generation who lived most of their lives before the age of the car. In Norway car sales were derestricted as late as I960, i.e. at a time when the youngest of today’s pensioners were about 40 years old. Access to cars is therefore still very modest compared with the widespread car ownership which characterizes younger age groups. Elderly people are therefore very dependent on public transport services.

We have extracted some figures which indicate the resource situation for elderly people in Norway. The figures are derived from a nationwide analysis of travel habits which was made in 1984-85. In total, for the whole country, 3/4 of those in the age group 60-74 years have a car in the household, while somewhat more than halv have a driving licence. These average figures hide differences which may be considerable, as shown by the table (table 1).

The proportion who have a car and/or driving licence decreases wiht age. Nevertheless, sex is the factor which divides most strongly, especially in relation to the possession of a driving licence. After the age of 70, only l4 % of the women have a driving licence.

There are marked differences in access to a car among the different types of households. 83 % of all households including several persons have a car, while the proportion for singleperson households is 36 % . 5. OUR INVESTIGATION

The investigation we made took place in Western Norway (fig. 3), in a large town and in a smaller municipality. We will show some typical puctures from the area - unfortunately we have no winter photograps. As you will understand, transport problems are aggravated by winter conditions. 5 .1 Description of the areas investigated:

Bergen is Norway’s second largest city, with rather more than 200 000 inhabitants. We chose two districts here, one of which, Sandviken, is near the centre and is one of the oldest parts of the city. The buildings spread up the hillside, and steep hills can be difficult to manage. Relatively narrow streets with cars parked on the pavements make it difficult for pedestrians to get around. A typical urban feature is also that the green intervals at traffic lights are too short, so that people do not manage to cross before the lights change to red.

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

1034

Ytre Arna was the other district we chose in Bergen. Ytre Arna was formely an industrial area which grew up around what used to be the country’s largest textile factory. It takes about a half to three-quarters of an hour to drive to the centre of Bergen. It is not all that easy to be a pedestrian here either. Vags0y, the other municipality, is a coastal municipality where the sea has been the most important transport route until now. The municipality has 6 500 inhabitants, and two centres - Mal0y and Raudeberg. The settlements are typically western Norwegian, and are built up the hillsides. The rest of the population is scattered in small communities, some of which are very isolated. To manage to provide a profitable public transport service can, as I am sure you understand, present problems. We devided VAgs0y into the centre and the district. 5.2 Results of the questionnaire:

We 65

sent

%.

out

1 200

questionnaires and received answers from

As in the national figures we presented at the beginning, we found a general decrease in the access to transport resources with increasing age in our investigation, and also found that women, especially women living alone, are in a much worse position than men both in relation to health, income and access to a car. High correlation among the different resource dimensions made it natural to construct a resource index which expresses the individual’s total resource situation (table 2). From the table, we can see that very few of those who live in households of several people are in a very difficult resource situation. About half have a relatively favourable or quite uncomplicated situation. Men and women have very different access to resources. Almost all those in our material who had no problems are men. The resource profile for women leant towards the more difficult side. Most of those living alone are women, and almost 90 % in this category have what we have called an entirely or mainly difficult resource situation. The equivalent percentage for men living on their own is 57* 5-3 Travel activity and level activity

Our analyses showed a strong correlation between access to resources and the extent of travel activity. How does this travel activity affect elderly people’s pattern of activities?

Time only permits us to present one example:

If we look at the necessary errand such as shopping for groceries, we find a strong positive correlation for women between travel activity and the frequency of purchases (fig. 4). For men, this relationship is somewhat different (fig. 5)* Men’s shopping habits are fairly constant - the exception here is those who travel least of all (and have least resources). The

CAR OWNERSHIP AMONG ELDERLY PEOPLE

1035

frequency of purchases is lower for this group. In total, women shop more often than men - despite fewer resources and lower travel activity. In general, however, we find that men have a higher level of activity outside the home than women which can be ascribed to a more favourable resource situation and higher travel activity. 5.4 Public transport services

Very few elderly people travel daily by public transport. About one quarter travel at least once a week, and half more seldom than once a month. About 1/3 of the sample have problems in getting to and from the bus stop, getting on and off, in using public transport because of lack of space and crowding, or in keeping themselves informed about timetables. Every fifth person in the sample feels discomfort during travelling. Our results also suggest that the elderly have great problems in understanding the information which is given whether such information needs to be heard or read. The fares are perceived as high. This was also emphasized in interviews. Other factors which were often mentioned were hindrances such as car traffic, lack of space at the edge of the road for pedestrians, bank of snow, and slippery roads. The elderly are afraid of falling and of being run over, and this fear reduces their activities outside the home.

Seen collectively these difficulties are also strongly linked to the individuals* functional capacity in relation to health. A collective indicator of problems in using public transport is shown in the table (table 3)*

The distribution profile for the perceived problems in using public transport vary along the same lines as the individual's general health situation. Nevertheless, we can see that 44 % of those who do not have health problems also have problems in using public transport. The problems are thus not related to a person’s state of health alone - the organization of the transport service can also cause problems for those without significant health problems. Problems in travelling very differently by women increase with age for major problems is roughly for all age groups.

by public transport are experienced and men. Even though the problems both sexes, the proportion who have twice as large for women as for men

This figure shows (fig. 6) that the problems are not randomly distributed among groups with different access to cars. It is primarily those who do not drive themselves who also have problems in using public transport. 4 of 5 of those with major problems do not have a car in the household. Transport hindrances have in other words a strong tendency to accumulate.

Both during the evenings on working days, and at weekends in general (fig. 7 and fig. 8), the timetables fit badly with the travel needs of the elderly. The transport service in the city seems to be best adapted to the travel needs of elderly people. A drastic cut in timetables seems to affect the districts particularly badly.

1036

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

5.5 Access to a car

3/4 of the informants in our material have never driven a car, 1/5 drive a car, and 5 % have stopped driving. 39 % have access to a car in the household. 50 % have never previously had a car in the household, while 11 % have stopped owning a car. This means that 22 % of those who at some time previously have had a car in the household, had stopped owning a car when the investigation was made. Two of the reasons given for no longer owning a car seems to be very important for; about one third mentioned that there is no longer anyone in the household who can drive a car, and about as many state that it has become too expensive to drive a car. In the interviews, many elderly people expressed a desire for a car, and those who had a car often gave an impression of great dependence of the car. Among those who did not have a car, lifts could be had occasionally if the younger generation lived nearby. 6. CONCLUSION

At the beginning of this talk, we called attention to some features of the development of society which contribute to the more and more difficult transport situation for the elderly. An additional aspect is what we may call the erosion of informal forms of help: the lifelong ’’social contract’’ between parents and children, which involves a commitment to give practical help when it is needed, is in retreat. Even though many elderly people can expect to be driven by younger members of the family, there were also a number who expressed that they did not wish ”to be a nuisance”. ’’Everyone has enough with their own affairs" was a statement we noted even in the more outlying areas. It reflects the fact that social lifestyles gradually comes to follow the urbanized pattern in all parts of the ountry.

In contrast to these tendencies which create problems, is the fact that larger and larger proportions of new cohorts of elderly people will be in a favourable resource situation. More and more of the elderly will have a better economy, improved health because of a different employment background, and to an increasing extent, access to transport resources such as a driving licence and a car at the beginning of retirement. More elderly people will thus be able to enjoy an independent and active old age. We will therefore move towards a situation where social differences are greater. Parallel with the appearance of a greater proportion of well-adjusted elderly people, those who still have an unsatisfactory resource base to start with, or who lose their resource base through ageing, will be in a steadily more difficult situation.

CAR OWNERSHIP AMONG ELDERLY PEOPLE

1037

LITTERATURE

BREVIK, Ivar Offentlig eldreomsorg fram mot ar 2000. Notat 19 DAATLAND, Svein Olav Boform og husholdsstruktur i eldre ar.

NIBR-85:1^7 NGI Rapport 2/86

GRUND, Jan Perspektivanalyse for eldreomsorgen frem til 1990* NAVF’s gruppe for helsetjenesteforskning. Rapport nr t 1978

HAUKELAND, Jan Vidar Transportproblemer for funksjonshemmede i en T01-rapport, Oslo desember 19 8 1 . STATISTISK SENTRALBYRA Forbruksunders0kelse 1983 “ 1985*

STATISTISK SENTRALBYRA Statistisk Arbok 1987 . NOS B 69O

kystkommune.

NOS B 67^.

STEEN, Terje, HOVE, Olav Terje og S0LEM, Per Erik Eldre fotgjengeres sikkerhet. Oppdragsrapport nr ^1, Institutt for samferdselsteknikk, NTH. Trondheim 1980. 0LNES, S0nneve Eldres transportsituasjon - reisem0nster og transportutgifter. T0I-notat av 30*^*1-985 (nr 732) CiLNe'i, PJ

% HAu.K.cUfcNp, J*A re^fciot . T#l - rapport . cU sc^lptr

Cnr

¿0 )

1038

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS HOUSEHOLD STRUCTURE

Porcoot

[

I Marri»«

I Marri*«

«lia

lalhata

f l p f l {¡»«i». liti*« f c = s i* ilk atkan

Figure

Lltla« alaaa

1

CONSUMPTION EXPENDITURES PER H0USEH0L0 PER TEAR IN NON < 40

SINGLES

4 0-87 Ytir

> 6 7 Year

(In avarice 70.700 NOK)

Rant,fuel and Powar Other goods and Saraices Food and bevorago Transport Figure 2 Tha Pra« arila* al Ma* a*« W a « « */ I* ■Iflaraal a«a«r«apa aiara tkaa It Tears ka»l*« a Car I* Ika Hoasakal« a*« kart«« a Oriti«« Licaaca.

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10 35 72 20 1 no 74 20 (1421 17011 •

CAR OWNERSHIP AMONG ELDERLY PEOPLE

1039

SCORE FOR RESOURCE IR D E I. PERCENT la llra ly PraMaaiallc Oat Parsaa HaatahalA

Mas Waaiaa

la t t i M alli Parsaa HaaaakalA

Talal

Maa Warnan

7 27 21 1 4 2

Vary PraMaaiallc

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as

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io a

i

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3 100 101 1 17

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13441

Table 2 Shopping Frequencies Related to Travel Frequencies in General Women

Vary « U n

f""] Always

Olla»

HUH

»aliasi ____

H

Figure 5

Table 3

Vafy «aliati

l i m i * far lai al PapaUtlaa, Wawaa

1040

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

PERCEIVED PROBLEMS IN USING PUBLIC TRANSPORT RELATED TO CAR ACCESSIBILITY. PERCENT

li

□

ca r la tha Hacsefeeld

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HABITS

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HANDICAPPED

BELISLE Jean-Pierre, M.Sc. / Assistant-Professor, Ecole des Hautes Etudes Commerciales de Montréal. 1. INTRODUCTION The specialized door-to-door transportation service of the Société de Transport de la Communauté Urbaine de Montréal (S.T.C.U.M.) was created following the adoption in 1978 of the law protecting the rights of handicapped persons (Bill 9) by the Quebec National Assembly. It began its operations in 1980 and since then it has never ceased to increase its supply of transportation. The aim of this article is to analyze the degree to which this service is successful in meeting the transportation needs of handicapped people residing in the Montreal Urban Community and to present some preliminary results from a study of the travel habits of these people. Our presentation is based essentially on various documents produced by the S.T.C.U.M. (see bibliography), interviews of persons with reduced mobility conducted by us during the summer of 1987 and a preliminary analysis of all the trips made by the clients of this service during the week of September 21 1987. 2. THE SPECIALIZED SERVICE OFFERED BY THE S.T.C.U.M. The specialized door-to-door transportation service of the S.T.C.U.M. (called Service du Transport Adapté) serves the entire territory of the Montreal Urban Community. This area of approximately 500 sq. km. is made up mostly of the Island of Montreal. It also includes 4 smaller islands: lie Bizard, Ile des Soeurs, H e Sainte- Hélène, and H e Notre Dame, of which only the first two are inhabited. The City of Montreal itself covers 36* of the territory and contains 58$ of the 1 752 582 inhabitants of the Urban Community (1986 Census). The service is offered to handicapped persons residing in the M.U.C.(Montreal Urban Community) whose eligibility has been established by the Eligibility Committee of the Service du Transport Adapté. To date more than 10 000 people have been given access to this service and the number is growing at an annual rate of 1500-1800. The fares are the same as those of the regular public transportation system and the hours of operation are comparable (from 6:30 a.m. to 1:00 a.m. weekdays, from 8:00 a.m. to 1:30 a.m. on Saturday, and from 8:00 a.m. to 1:00 a.m. on Sunday and holidays). In the beginning the service was offered exclusively by minibus. However experiments using taxis for those able to use this type of transport were begun in 1984 and were extended in 1985 and 1041

1042

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

1986 with the result that in 1988 almost 70% of all trips were made with this mode of transport. The table which follows describes the evolution of demand between 1980 and 1988. Number minibus

Year 1980 1981 1982 1983 1984 1985 1986 1987 1988

70 135 179 210 204 203 170 139 199

734 541 398 079 654 928 507 975 629

of taxi

trips total

_ -

29 70 171 295 457

-

933 437 189 061 080

70 135 179 210 234 274 341 435 656

annual increase

734 541 398 079 587 365 696 036 709

_

91,6 % 32,4% 17,1% 11,7% 17,0% 24,5% 27,3% 51,0%

TABLE 1: Evolution of demand The introduction of taxis as the principal mode of transportation for those capable of using them has allowed the S.T.C.U.M. to increase its supply of transportation considerably. As well, since the average cost of a trip by taxi (about 17 $CN in 1987) is substantially less than that of a trip by minibus (about 42 $CN in 1987) theincrease in the supply of transportation has been made possible without a proportional increase in the total costs. The table which follows describes the evolution of the total operating expenses between 1980 and 1987 (calculations for the 1988 figures were not completed at the time of writing). Year 1980 1981 1982 1983 1984 1985 1986 1987

Total costs (millions of $ CN) 0,92 3,29 5,50 6,48 7,51 8,67 10,15 12,00

annual increase

_

356,7% 67,2% 17,8% 15,9% 15,4% 17,0% 18,3%

TABLE 2: Total annual expenses In Montreal we find two types of transportation requests: Regular and occasional requests. Regular requests are for trips that are repeated at regular intervals and have the same characteristics from one time to another, such as traveling from home to the office every morning at 9:00 a.m. . This type of request must be made at least 7 days ahead of time and its acceptance guarantees transportation for each of the times it is needed, without having to make any new reservation. Most regular transportation requests are for travel to work or to school and they generally take place during rush hours.

TRANSPORTATION HANDICAPPED IN MONTREAL

1043

Occasional transportation requests can be made up to 48 hours ahead of time. While there is no minimum time limit for requesting transportation by minibus, acceptance of these requests depends on the availability of vehicles, and it is therefore imprudent to make a last-minute request. The same rules apply for taxi users, except that a four-hour minimum notice is required. This four-hour time delay allows the S.T.C.U.M. to process the request and to transmit it to one of the taxi companies under contract. In the case of a medical appointment, a court appearance, or for wheelchair repairs, the client can call for his return trip when ready for it. This must be done however before 7:00 p.m. . 3.

THE USERS' VIEW OF THE SERVICE

In order to better familiarize ourselves with the public transportation needs and expectations of handicapped persons, our research team carried out a series of 25 interviews with persons with reduced mobility during the summer of 1987 in Montreal. Sixteen of the people questioned were users of the specialized transportation system. While these 16 clients were in general relatively satisfied with the service offered, 13 of them were severely critical of the service's personnel. They complained particularly of the lack of training and courtesy on the part of taxi drivers and telephone reservation agents. The other criticism common to most of the clients interviewed concerned the rigidity of the reservation rules which forced them to plan their travel in advance, not allowing them to decide on a trip spontaneously like the users of the regular public transportation system can do. The other principle criticisms of the system concerned the inability to travel outside of the M.U.C., the lack of assistance by taxi drivers between the residence and the vehicle (the rules provide that a taxi user must be able to reach the vehicle un-aided, and drivers are therefore not required to offer any assistance), and the fact that the rules prohibit making two trips in a short space of time. Thirteen of the clients questioned also accepted to classify by order of importance five aspects of a good quality of service which we proposed to them. From their classifications the five aspects from most important to less important are: Convenience of the reservation system, reliability and on-time performance of the service, duration of reservation calls, driver characteristics, and responsiveness to the individual. When questioned about what was the most important attribute of reliability and on-time performance of the service all were much more concerned with the waiting time for departures rather than the travel time in the vehicle itself. In April 1988 the S.T.C.U.M. organized a two-day symposium on the transportation of handicapped persons. This symposium allowed numerous representatives of the users to make the S.T.C.U.M. authorities aware of the reasons for some of their 35

1044

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

This event as well allowed the dissatisfaction. representatives of the S.T.C.U.M. to discuss frankly with the users the administrative constraints inherent to this type of service. A series of concrete proposals to improve the quality of service came out of this symposium. 4. THE SITUATION OF THE NON-USERS At present a little more than 10 000 people have been accepted for the S.T.C.U.N.'s specialized transportation service. This is a very small number considering the total population of the Montreal Urban Community. While there is no precise study which would allow us to properly evaluate the number of persons who would be technically eligible for this service, information from other sources indicates that the specialized transportation service in Montreal is not reaching the number of people that it should. A study undertaken by Statistics Canada in 1983, the results of which were presented at the Orlando Conference [MC LAREN and FLEMING (1986)], established in effect that in urban areas of Quebec 2,44% of the population over the age of 15 and not institutionalized could be considered as being "transportation disabled". According to the 1986 Census there were 1 475 920 people over the age of 15 residing in the Montreal Urban Community. Since this figure also includes those individuals living in institutions, we could conservatively apply the 2,44% factor to a minimum population of 1 400 000, which would give an approximate total of 34 000 "transportation disabled" people in Montreal. This is more than triple the number of clients who have been admitted to the service to date. Another way of showing the low penetration rate of the specialized transportation system in Montreal is by establishing comparisons with other large Canadian cities. At the Vancouver Conference HERRERO-VAN ECK and HAFFENDEN (1987) presented fairly precise figures for Calgary. In this city with a population of about 36% that of the Montreal Urban Community 10 495 people had been admitted to their Special Needs Taxi and Handi-Bus Services by 1986. By simple multiplication we obtain an estimated equivalent of 29 000 people who should have been technically eligible for comparable services in Montreal by 1986! We must therefore ask ourselves how is it that so few handicapped persons have so far taken advantage of their right to specialized transportation services. Is it that information about this fundamental right has not been publicized well enough, or is it the eligibility policy that is at fault? At present, to be accepted for the S.T.C.U.M.'s specialized transportation service one must first fill out a special form, part of which must also be filled out by a health-care professional. The request is then studied by the

TRANSPORTATION HANDICAPPED IN MONTREAL

1045

eligibility committee which is composed of eight members (4 representatives of the S.T.C.U.M. and 4 representatives of the users), which must decide if the candidate meets the definition of an eligible person as established by the Admissibility Policy issued by the Quebec Ministry of Transport in 1983. This committee meets twice monthly and the time between an application and a response is usually about six weeks. During the round of interviews that we conducted during the summer of 1987 we found that three of the nine non-users had already submitted applications for the service. Of these only one had been accepted, and even then only on a temporary basis. One of the people interviewed was a diabetic woman, 62 years old and visually handicapped. She was on her third try, having been refused on two previous occasions. This even though her application included a doctor's certificate stating that she was not able to travel alone, and could not therefore use the regular public transportation system. The committee told her that she should be able to use the regular system when accompanied by someone else, and that she would certainly be able to do it alone once she had taken a mobility training course! Other persons with reduced mobility not able to use the regular public transportation system, but who are not considered to be handicapped under the legal definition are not taken into account in the Quebec Ministry of Transport's admissibility policy. In June 1987 the Senior Citizen's Forum of Montreal published a manifesto which denounced this situation. In this manifesto it is estimated that at least 10% of the population over the age of 65 is not able to use the regular transportation system, while at the same time being ineligible for specialized transportation services. When applied to the total population of the M.U.C. over the age of 65 in 1986, i.e. 224 350 inhabitants, this estimate gives a minimum of 22 000 elderly persons who have no access to a public transportation service. A large proportion of these people could of course become users of the regular* public transportation system if there were improved access. As early as 1983 the Senior Citizens' Forum of Montreal published a report which included numerous recommendations to facilitate access to public transportation for elderly persons [FORUM DES CIT0YENS AGES DE MONTREAL (1983)]. Since that time, the S.T.C.U.M. has made numerous efforts to improve the situation, and the Senior Citizens' Forum of Montreal has just begun a new study to verify the changes in this area 6 years later. 5.

PRELIMINARY RESULTS ON TRAVEL HABITS

Every five years the S.T.C.U.M. carries out a large origindestination survey in order to study the travel habits of the whole of the population and to be able to determine how the public transportation system is being used. Unfortunately this type of survey does not permit us to analyze the travel

1046

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

habits of persons with reduced mobility because they form too small a part of the total population, and as a consequence of the survey sample as well. The last origin-destination survey was carried out during the month of September 1987. At that time and with the agreement of the S.T.C.U.M., our research team was able to gather information on all of the trips made by users of the specialized door-to-door transportation service for a full week of operation. The week studied was from Monday, September 21 until Sunday, September 27 1987. The data was taken directly from the S.T.C.U.M.'s management information system for 3 categories of trips: Occasional trips by taxi, occasional trips by minibus, and regular trips by minibus. Because regular trips by taxi were still handled manually at the time of our study we were given copies of the dispatch sheets. Unfortunately the information they contained was not compatible with that which we received directly from the computerized information system. We are now in the process of finding and validating the missing information. The following table gives an indication of the size of the data base we are now completing. Number Day

occasional

trips

of regular

taxi

mbus

total

taxi

Mon Tue Wed Thu Fri Sat Sun

561 551 678 573 536 219 202

285 276 354 303 299 246 160

846 827 1032 876 835 465 362

788 772 683 708 754 167 12

TOT

3320

1923

5243

* * * * * * *

trips

mbus

total

250 290 212 258 224 40 23

1038 1062 895 966 978 207 35

3884 * 1297

TOTAL * * * * » * *

1884 1889 1927 1842 1813 672 397

* * * * * * *

5181 * 10424 *

* figures currently under validation TABLE 3: Description of the data

It is interesting to note that during the week under study 69,1* of the trips were carried out by taxi. This is slightly higher than the 67,8* proportion that can be deduced from Table 1 for 1987, but it is within the upward trend that can be seen for 1988 (69,6*). In January 1989 we began the analysis of the 5243 occasional trips made during the week studied. These trips were made by 1423 distinct individuals. Table 4, which follows, gives a breakdown of the number of occasional trips made during the week studied by these clients as well as the relative contribution of each of the trip frequencies within the total of the trips made.

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TRANSPORTATION HANDICAPPED IN MONTREAL

number of clients

trip frequency 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 19

Total :

1

146 603 90 234 57 113 26 54 18 38 10 17 3 7 2 2 2 1

1423

% of clients 10,3 42,4 6,3 16,4 4,0 7,9 1,8 3,8 1,3 2,7 0,7 1,2 0,2 0,5 0,1 0,1 0,1 0,1

100,0

number of trips

1

146 1206 270 936 285 678 182 432 162 380 110 204 39 98 30 32 34 19

5243

% of trips 2,8 23,0 5,1 17,9 5,4 12,9 3,5 8,2 3,1 7,2 2,1 3,9 0,7 1,9 0,6 0,6 0,6 0,4

100,0

TABLE 4: Distribution of trip frequency among active occasional clients during the studied week.

Although on average 3,68 trips were made, the preceding table shows that the median was 2 occasional trips per week. It can be noted in effect that 52,7% of the active occasional clients made 1 or 2 trips during the week. These trips however only make up 25,8% of the total trips made. It would be interesting therefore to better identify the characteristics of those clients making more than two occasional trips per week. This leads to an analysis of the travel habits of the active occasional clients where trip frequencies are studied in conjunction with age and home location. Age Group 0-17 18 - 25 26 - 35 36 - 45 46 - 55 56 - 64 65 - 74 75 - 84 85 - + (1) (2) (3)

% eligible clients (1) 3,0 7,7 11,4 9,8 9,0 12,9 18,3 17,6 10,2

% active clients (2) 1,7 13,3 25,8 20,1 12,0 12,0 8,0 5,0 0,9

% active occasional clients (3) 2,7 12,5 20,3 15,4 13,9 13,5 12,8 7,7 1,3

: 8155 eligible clients at the end of 1987. : 4318 active clients during 1987. : 1423 active occasional clients for the week studied.

TABLE 5; Age distribution of the clients

MOBILITY AND TRANSPORT FOR ELDERLY AND DISABLED PERSONS

1048

Table 5, which precedes, gives an age distribution of the specialized transportation service clients calculated in three ways. The first column gives the age distribution of the 8155 clients admitted to the service at the end of 1987. The second column gives the age distribution of the 4318 clients who used the service at least once during 1987. Finally the third column gives the age distribution on the 1423 clients who made at least one occasional trip during the week under study. This table shows a surprising phenomenon: Only 52,9* of the eligible clients used the service in 1987. This shows very well why, in undertaking any planning study, we should limit our attention to the active users. Thus, even though persons aged 65 and over made up 46,1* of the clients admitted to the service at the end of 1987 they made up only 13,9* of those who were active. This percentage falls quite close to the fraction of the total population that people aged 65 and over represent in the Montreal Urban Community (12,8* , 1986 Census). From the statistics taken from the week of September 21 however we noted that this age group makes up a bigger part of the active occasional users (they represented 21,8* of the clients having made occasional trips). Age is therefore an important factor affecting travel habits.

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FIGURE 1: Distribution of home locations The map given by Figure 1 shows the home locations for the clients who made occasional trips during the week of September 21, 1987. It illustrates well how the density of places of residence varies enormously from one part of the territory to another. A high concentration of the clientele can be observed in the east-central part of the island, which

TRANSPORTATION HANDICAPPED IN MONTREAL

1049

corresponds to the most densely populated areas of the City of Montreal. It is obviously in these same areas, or at least close to them that one finds the highest concentration of work places and public institutions (the downtown core of the city, where business and commercial activities are concentrated, is situated to the south-west of the most densely populated areas). The following map in Figure 2 shows the distribution of the 10 486 points visited during the 5 243 occasional trips made during the week under study.

—

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