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Alternative FACT

Innovative Regional Brokerage Fills Mobility Gaps With Curb-to-Curb Service

By Stephanie Jordan
Managing Editor
Transit California

There’s no place like home. But for many seniors and disabled people, going out and returning home isn’t always easy.

Enter Facilitating Access to Coordinated Transportation – or FACT – a regional brokerage of transportation services based in San Diego County that provides affordable rides to medical offices, grocery stores, or anywhere else seniors and persons with disabilities need to go. Central to FACT’s mission is helping its customers to remain in their homes, as opposed to living in institutions or relocating closer to amenities and medical facilities.

Once a dream of several innovative-thinking community leaders, FACT’s RideFACT program’s success has been hard won. Established as the region’s Consolidated Transportation Services Agency (CTSA) in 2006, FACT began partnering with the San Diego Association of Governments (SANDAG) and local non-profits to establish a coordinated transportation delivery system for seniors and persons with disabilities. As fewer non-profit transportation service providers were available back then, FACT began adding for-profit partners to establish an effective transportation brokerage. FACT continues to work to improve access to transportation for seniors, persons with disabilities, veterans, and the income disadvantaged and to fill gaps in existing services, all of which contributed to RideFACT service reaching its 100,000th ride in June.

Through its innovative brokerage model, FACT launched RideFACT as a pilot project in January 2012 to serve Rancho Bernardo, Poway and Escondido. Rides were purchased in bulk at reduced rates from private and non-profit taxi-type providers. The costs of the curb-to-curb services were significantly below private taxicab rates. The success of the brokerage enabled FACT to launch RideFACT countywide just six months later in July 2012.

The Federal Transportation Administration in August 2016 awarded $200,000 to FACT. Working in partnership with SANDAG, FACT is one of 19 transportation agencies in the nation to have been awarded the 18-month grant, which is part of the federal agency’s “Rides to Wellness” medical transportation initiative. Patients can gain access to the service upon their discharge from the hospital and for follow-up visits.

“The stress and hardship of hospitalization should not include worrying about a ride home,” stated then county Supervisor Dave Roberts, chairman of FACT’s Board of Directors at the time of the grant. “The Rides to Wellness grant helps patients get affordable, dependable rides and also cuts healthcare costs by reducing the likelihood of hospital readmissions.”

Today, RideFACT has grown into a dial-a-ride service that operates in all 18 cities in San Diego County and serves residents 60+ years of age, people with disabilities, and others with mobility challenges. It is a unique subsidized service that takes San Diego residents across the county, or within and between any of the cities in San Diego, for a low fare. To ensure effective utilization of all mobility options in the County, FACT provides referrals to other public, community and private transportation resources prior to offering rides.

Meet Jack and Rose

For Chula Vista residents Jack and Rose, it was an uneventful trip to the grocery store, but during that June 9 outing FACT celebrated its 100,000th ride. Jack, who is 94 years old, and Rose, who is 76, learned about RideFACT because their daughter was searching for local transportation options for her elderly parents. These days, the couple uses the service at least once a week to get to medical appointments, grocery shopping, and church.

According to Jack, before they discovered RideFACT, they did not use other transportation services because they could not afford them or they had difficulty accessing them.

“Without RideFACT we would be stuck here in the house. Because of RideFACT I can go see my doctor so I can get better,” states Jack.

Shedding Car Keys

With 10,000 baby boomers retiring each day in the United States, Jack and Rose are in good company. In July 2017, The American Association of Retired Persons (AARP) reported that the demand for senior transportation will likely increase as “our country’s 78 million boomers, now ages 49-67, shed their car keys. Men typically outlive their driving days by seven years and women outlive theirs by 10.” Forecast data in the SANDAG Coordinated Plan indicates that seniors aged 85 and older will increase by 60 percent by 2050. For its part, FACT is ready to manage the continued demand for services by boomer seniors.

“We communicate with the vendors regularly about trends in demand and help them prepare for growth by projecting the demand for them,” says Arun Prem, executive director for FACT. “The change in demographics is going to require assisting with more seniors who are more advanced in age. This will require specialized vehicles and equipment, which are challenging for private sector brokerage partners. FACT is working on procuring grant funded accessible vehicles that can be shared with the vendors.”

When asked about how the deployment of autonomous vehicles might play into services to support the forecasted demand of boomer seniors, Prem sees a future where self-driving cars will be useful.

“I imagine that when autonomous vehicles become ready for paratransit services they will fit into this service model seamlessly – for those individuals who need assistance in boarding, a rider would be able to bring someone along. The model does not preclude someone remaining on board for that purpose for certain rides – but in our brokerage model today there are always options to use a sedan with a driver for this scenario without incurring extra expense.”

Coordinated Access

In addition to the RideFACT service, which is available directly to riders, FACT offers low-cost rides through contracts with the City of Oceanside, ElderHelp (a local non-profit) and the Tri-City Medical Center. FACT also works with local transit provider, North County Transit District (NCTD) as a sub-contractor of the agency’s contractor for LIFT (Paratransit) service. Because FACT acts as a mobility manager for individuals who are looking for transportation by referring them to the most appropriate mode for them, Prem sees FACT as an important contributor to maximizing the public transit network.

“Curb-to-curb transportation is the only option for a certain segment of the population consisting of people who are frail and cannot negotiate their way through other modes. Given that, the model used by FACT utilizes existing capacity and equipment/vehicles by brokering rides to vendors who already have vehicles and are trying to optimize their capacity by fitting in FACT’s rides. This model requires no new infrastructure or investment in vehicles -- in addition to better utilization of what is already in place.”

Transportation referrals are provided in person, via telephone, and through the web-based trip planner, Find-A-Ride. A strength of FACT’s approach is that it can expand or contract as required. In an era of increasing interest in transportation network companies, could FACT expand beyond seniors and those with mobility issues? Couldn’t FACT’s services be a first-mile/last-mile option? Arun believes so.

“The model used by FACT has been scaled up and down during its history and it’s feasible to do both. When additional demand is expected, we work with vendors who are interested in additional business and will invest in expanding infrastructure at their own expense to have access to the additional business,” said Arun. “Our service is currently being utilized for senior dial-a ride services due to the limitation placed on the use of the service by funding source; operationally it would be simple to offer this cost-effective transportation to others – low income riders and those who need first mile/last mile solutions – it’s a matter of regional planning and funding priorities aligning with the capacity of this system.”