COMMUNITY CONNECTOR
ADA COMPLEMENTARY PARATRANSIT
POLICIES AND PROCEDURES
November 25, 2016
CONTENTS
Appendices ............................................................................................... Error! Bookmark not defined.
Introduction ............................................................................................................................................4
Definitions ...............................................................................................................................................4
ADA Complementary Paratransit Service ...............................................................................................5
Service Area ........................................................................................................................................5
Response Time ....................................................................................................................................5
Hours and Days of Service ..................................................................................................................5
Fares ....................................................................................................................................................5
Trip Purpose Restrictions ....................................................................................................................6
Capacity Constraints ...........................................................................................................................6
Eligibility Standards .............................................................................................................................6
Applying for ADA Paratransit Certification .............................................................................................7
Application ..........................................................................................................................................7
Eligibility Determination .....................................................................................................................7
Eligibility Card and Renewals ..............................................................................................................8
Ineligible ..............................................................................................................................................8
Administrative Appeal Process ...........................................................................................................8
Filing a Request for an Internal Review/Appeal .................................................................................9
ADA Paratransit Review Committee ...................................................................................................9
Appeal Hearing ..................................................................................................................................10
Appeal Decisions ...............................................................................................................................10
Using ADA Paratransit Service ..............................................................................................................10
Certified.............................................................................................................................................10
Scheduling .........................................................................................................................................10
Subscription Service ..........................................................................................................................11
Trip Cancellation ...............................................................................................................................11
Traveling Companion ........................................................................................................................11
Accessibility Features of the ADA Paratransit Service ......................................................................11
Personal Care Attendant ...................................................................................................................12
Service ...............................................................................................................................................12
"No-Show" Suspension Policy .......................................................................................................... 13
Policy for Handling Subsequent Trips Following No-Shows .............................................................14
Suspension Policies for a Pattern of Excessive No-Shows and Late Cancellations...........................14
Suspension of Service .......................................................................................................................15
Suspension Process ...........................................................................................................................15
Visitor Policy ......................................................................................................................................15
Bibliography ..........................................................................................................................................16
Appendix 1 – ADA Paratrnsit Contract ..................................................................................................17
Appendix 2 – ADA Paratrnsit Service Area ...........................................................................................18
Appendix 3 – Fixed Route Schedule ......................................................................................................19
Appendix 4 – ADA Application ..............................................................................................................20
Appendix 5 – ADA Eligibility Review Form ............................................................................................26
Appendix 6 – ADA Advisory Committee Members ...............................................................................29
Appendix 7 – Capacity Constraint Definitions ......................................................................................30
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INTRODUCTION
On September 6, 1991, the U.S. Department of Transportation (USDOT) published final
regulations implementing certain provisions of the Americans with Disabilities Act of 1990.
These regulations, 49 CFR (Code of Federal Regulations) Part 37, Subpart F, require public entities
operating fixed route transportation service for the general public also to provide
complementary paratransit service to persons unable to use the fixed route service.
The Community Connector is a public transit system operated by the City of Bangor for the
communities of the Greater Bangor Urbanized Area. These include Bangor, Brewer, Veazie,
Orono, Old Town, and Hampden. The bus also provides service to Husson University, NESCOM
(New England School of Communications), Eastern Maine Community College and the University
of Maine. The City of Bangor supplies service to these communities on a contractual basis. Our
base of operation is 481 Maine Avenue, Bangor, Maine 04401. The City of Bangor has been
operating public transportation since December 1972.
The Community Connector operates within the urbanized area of the six member communities.
The routes are within walking distance of 95% of the urban population of the six communities.
The service area covers 103 miles of roadway (measured one-way only).
To provide public transportation in Bangor and the five member communities and to comply with
49 CFR Part 37, Subpart F, Community Connector operates and maintains the urban area’s public
transit system and contracts with a provider for our complementary paratransit service. (ADA
Paratransit Service Contract, Appendix 1)
The ADA Complementary Paratransit Policies and Procedures are intended to serve as a guideline
for all entities involved with complementary paratransit. The policies and procedures establish
criteria for administering complementary paratransit service in conjunction with the FTA
regulations; thereby, protecting the rights of individuals.
DEFINITIONS
Certified Health Professional – Anyone licensed by the State to provide diagnosis for
insurance purposes.
Paratransit – means a comparable transportation service required by the ADA for
individuals with disabilities who are unable to use fixed route transportation systems.
Personal Care Attendant - means a person who performs personal care duties/services for
an individual with a disability.
Service Animal – means any guide dog, signal dog, or other animal individually trained to
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work or perform tasks for an individual with a disability, including, but not limited to, guiding
individuals with impaired vision, alerting individuals with impaired hearing to intruders or
sounds, providing minimal protection or rescue work, pulling a wheelchair, or fetching dropped
items.
Wheelchair – means a mobility aid belonging to any class of three or four-wheeled
devices, usable indoors, designed for and used by individuals with mobility impairments, whether
operated manually or powered.
ADA COMPLEMENTARY PARATRANSIT SERVICE
SERVICE AREA
Complementary paratransit service shall be provided to origins and destinations within a
three-fourths of a mile wide corridor on each side of each fixed route (see Map, Appendix 2).
RESPONSE TIME
Trips need to be scheduled up to close of business hours on the day prior to the date service is to
be rendered. Trip requests can be made during normal administrative office business hours of
8am to 4pm, or via voicemail system on those days when the office is closed. The paratransit
provider may negotiate pickup times with the individual that are no more than one hour before
or after the individual’s desired pickup time.
The paratransit provider’s vehicle will arrive within a “pickup window” that is from 15 minutes
before to 15 minutes after the scheduled pickup time. Riders should be ready to board the
vehicle at any time during that window. The driver will wait five minutes after the vehicle arrives
for the rider to board before moving on to the next stop.
HOURS AND DAYS OF SERVICE
The ADA paratransit service is provided during the normal hours of operation of fixed service
routes. Days and hours of ADA paratransit service mirror those of individual fixed routes; more
service may be available in some areas than others (see Fixed Route Schedule, Appendix 3).
FARES
The ADA paratransit service fare is twice the fixed route non-discounted fare. Individuals
accompanying ADA paratransit eligible individuals shall be charged the same fare as the ADA
paratransit eligible individual they are accompanying. A personal care attendant shall not be
charged a fare for complementary paratransit service.
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TRIP PURPOSE RESTRICTIONS
All ADA trip requests shall be treated equally. No restrictions or priorities shall be imposed based
on trip purpose.
CAPACITY CONSTRAINTS
The amount and availability of complementary paratransit service shall not be limited to ADA
paratransit eligible persons by such means as restrictions on the number of trips, waiting lists for
access to the service or any operational practice that may limit the availability of service.
Capacity constraints will be monitored and measured by the frequency of trip-denials, missed
trips, excessively long trips, and the percentage of on-time performance. See the definitions in
Appendix 7.
ELIGIBILITY STANDARDS
ADA complementary paratransit service shall be provided to all eligible individuals. The following
individuals are ADA eligible:
a. Any individual who is unable, and without the assistance of another individual, to
board, ride, or disembark from any vehicle on the system which is readily accessible and usable
to individuals with disabilities;
b. When an accessible vehicle is not being used to provide designated public
transportation on a route in which an individual with a disability needing the assistance of a
wheel chair lift or boarding device is traveling on the fixed service during its hours of operation;
c. Any individual with a disability who has a specific impairment-related condition
that prevents such individual from traveling to a boarding location or from a disembarking
location on the fixed route.
d. When the topography, accessibility of bus stops or other environmental barriers
when combined with the individual’s disability prevent them from using fixed route service some
or all of the time.
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APPLYING FOR ADA PARATRANSIT CERTIFICATION
APPLICATION
Applications to become ADA paratransit certified can be obtained from the Community
Connector, faxed, or mailed. The application is also available on the City of Bangor website at
www.bangormaine.gov. Completed applications are to be submitted to the Community
Connector for a determination of eligibility (see Application, Appendix 4). Alternative formats
are provided upon request.
ELIGIBILITY DETERMINATION
The Community Connector is responsible for determining the applicant’s ADA eligibility. The
Community Connector shall date applications upon receipt. Applicants are to be notified in
writing as to their eligibility status within 21 days after the application process is considered
complete. The application process is considered complete after the interview is completed.
The ADA specialist meets with applicants who have applied for the Community Connector’s ADA
Paratransit service. The interviews usually last about a half hour. During the interview we cover
the following;
• Review their application, abilities and limitations.
• Applicant’s knowledge of the Community Connectors public transit system.
• Offer travel training with one our Bus Ambassador’s if applicant interested in learning
how to use the regular fixed route system.
• Determine what barriers prevent them from using our system.
• Explain the ADA Paratransit service and how it operates.
• Determine if any reasonable modifications are needed.
Applicants who have not received an eligibility determination within 21 days of a completed
application process are automatically presumed ADA paratransit eligible until a determination is
made. Community Connector will contact applicants in these cases.
Eligibility shall be determined from the application and completion of the required sections of
the standard ADA Interview Summary Form completed by Community Connector (see Form,
Appendix 5).
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All information is confidential, unless an appeal is filed by the applicant. See Administrative
Appeals Process below. If an appeal is filed, the application, the application eligibility review
form and the request for an appeal shall be presented to the Eligibility Review Committee. At
such time, a hearing shall be scheduled by the Eligibility Review Committee to review the appeal
and to give the appellant the opportunity to be heard in person (Confidentiality does not end
when there is a hearing).
ELIGIBILITY CARD AND RENEWALS
Applicants eligible for ADA paratransit certification shall receive their card via mail or pick it up at
the Community Connector office.
ADA certification is renewed every three years except for temporary eligibility. Recertification
maybe be subject to random interviews.
INELIGIBLE
Applicants that are determined ineligible shall be notified by the Community Connector.
• Incomplete applications will be returned to the applicant and notified of the deficiency in
writing. A determination cannot be made until an applicant has submitted a complete
application.
• Applicants who are functionally able to use the fixed route service are ineligible.
Applicants that are determined conditionally eligible or temporarily eligible shall be notified in
writing stating the reason(s) for their ADA paratransit certification status.
Applicants denied certification due to their inability to qualify for eligibility certification under
ADA guidelines shall receive a letter in writing stating the reason(s) for their ADA paratransit
certification status.
Applicants given temporary or conditional eligibility certification shall receive a letter in writing
stating the reason(s) for their ADA paratransit certification status and their conditions of
eligibility.
ADMINISTRATIVE APPEAL PROCESS
The Administrative Appeal Process is for those individuals who have been denied ADA eligibility,
given only conditional or temporary eligibility status, or has had their ADA service suspended. All
individuals must have an opportunity to be heard in person and to present additional
information and arguments regarding their disability and ability to use the fixed route service.
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FILING A REQUEST FOR AN INTERNAL REVIEW/APPEAL
Step 1
Individuals requesting an internal review of the initial eligibility decision must do so within 60
days from the date eligibility was denied. The request is to be in writing and sent to the
Community Connector. Individuals may request assistance in filing an internal review/appeal if
needed by calling 207-992-4670. The Superintendent is not involved in the initial determination.
The Superintendent shall review the application and the applicant’s letter requesting an internal
review to verify the initial determination.
If the applicant is given ADA paratransit certification resulting from an internal review of the
application, a letter of eligibility is to be sent to the applicant.
If, after internal review, the Community Connector still cannot certify the applicant due to the
information presented on the application, the Community Connector is to make a written
statement as to why the individual was denied paratransit certification.
Step 2
Individual can then request to appeal to the ADA Paratransit Eligibility Review Committee. The
statement, along with the application and the individual’s written request for an appeal are to be
sent to the ADA Paratransit Eligibility Review Committee. The statement is to include all
pertinent dates and support documentation related to the applicants ADA paratransit
certification request.
A hearing will be set by the ADA Paratransit Eligibility Review Committee within 30 days of the
applicants request for an appeal.
ADA PARATRANSIT ELIGIBILITY REVIEW COMMITTEE
There will be a "separation of function" between those involved with the initial eligibility
determination, the internal review determination and those selected to hear the appeal. The
ADA Paratransit Eligibility Review Committee shall be comprised of a minimum of three (3) to a
maximum of (5) members currently serving on the Advisory Committee (Appendix 6). The Review
Committee will include at a minimum one (1) individual with a disability certified for ADA
Complementary Paratransit.
The ADA Paratransit Eligibility Review Committee will possess, either individually or collectively,
certain skills and knowledge. Among these are:
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* a working knowledge of the ADA complementary paratransit regulations, particularly the
regulatory definition of ADA paratransit eligibility and the appeal process;
* an understanding of different types of disabilities and the functional capabilities characteristic
of each;
* a knowledge of the fixed route system and the skills needed to understand and use it; and
* an understanding of the complementary paratransit service and the policies and procedures
related to the service.
APPEAL HEARING
A hearing shall be set by the ADA Paratransit Eligibility Review Committee within 30 days of the
applicants request for an appeal. The appeal hearing shall be scheduled between all parties
involved, the appellant, the Community Connector, and the ADA Paratransit Eligibility Review
Committee. The hearing date shall be confirmed in writing and sent by certified mail to the
appellant to ensure receipt.
The hearing shall be more than an administrative review of the initial determination. The ADA
Paratransit Eligibility Review Committee is responsible for ensuring that the approved policy was
followed, reviewing the judgment made regarding the individual's eligibility in the initial
determination, and is to consider any additional information provided prior to or during the
hearing, in an effort to provide a fair and reasonable determination.
APPEAL DECISIONS
Applicants will receive written notification stating the reasons why certification was denied
within 30 days of the completion of the appeal process. If a decision cannot be made within the
30 days, presumptive eligibility is to be granted to the individual until otherwise notified.
Community Connector will contact an individual in these circumstances.
USING ADA PARATRANSIT SERVICE
CERTIFIED
Only those individuals that have been certified through Community Connector may use the
complementary paratransit service. Certified individuals must present their ID card to the driver
when boarding the vehicle.
SCHEDULING
ADA eligible individuals shall make trip requests during normal business hours of the Community
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Connector’s administrative offices, weekdays from 8:00AM to 4:00 PM. Trip requests can be
made after 4:00 PM by calling 207-992-4673 via voicemail, however, the trip is not guaranteed
for next day service. Requests will be taken via our voicemail system on Sundays and holidays
when the Community Connector’s administrative offices are not open before a day of service.
Any trip left on the voicemail will be provided at the requested time.
Trip requests may be made up to 30 days in advance of an ADA paratransit eligible individual's
desired trip.
SUBSCRIPTION SERVICE
Subscription service is limited to riders traveling to the same place at the same time at least once
a week for a minimum period of 90 days. Community Connector reserves the right to restrict
and/or prioritize Subscription Service to maintain a maximum level of fifty percent (50%) as
required by the ADA, when there is no excess demand capacity available.
TRIP CANCELLATION
Scheduled trips shall be canceled no less than two (2) hours prior to the scheduled pick-up time,
unless the trip is scheduled to pick-up between 6 a.m. to 8 a.m., in which case the individual shall
cancel the request by leaving a message on the paratransit provider’s answering machine prior to
normal administrative business hours. In the event that a customer is able to attempt to cancel
the trip with less than a two hour notice, a no-show may be avoided if the vehicle is not on the
way. The date and time of the cancellation shall be documented in the individual’s file by the
paratransit provider.
TRAVELING COMPANION
Complementary paratransit service shall be provided to one other individual accompanying a
certified ADA paratransit individual. Additional individuals accompanying the certified ADA
paratransit individual shall be provided service, provided that space is available for them on the
paratransit vehicle carrying the ADA paratransit individual. Transportation of additional
individuals accompanying ADA paratransit eligible individuals shall not result in a denial of service
to other ADA paratransit eligible individuals.
Traveling companions shall be charged the same fare as for the ADA eligible individual they are
accompanying.
ACCESSIBILITY FEATURES OF THE ADA PARATRANSIT SERVICE
• Service animals are allowed on all vehicles. Pets are allowed in paratransit vehicles as long
as pet is in a pet carrier.
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• Wheelchair equipped vans will be dispatched for customers that have wheelchairs or
scooters.
• All customers traveling with respirators or O2 tanks will be accommodated. Tanks must
be secured, preferably in an upright position.
• A reasonable modification is a change, exception or adjustment that Community
Connector can make to its rules, policies, practices, and procedures to provide a customer with a
disability an equal opportunity to utilize Community Connector services. In compliance with the
Americans with Disabilities Act, Community Connector allows requests for reasonable
accommodations to customers with disabilities. The request should be as specific as possible and
include information on why the requested modification is needed in order to allow the individual
to use Community Connector services. Requests may be sent to
[email protected] or called in to 992-4670.
• ADA Paratransit Information is available in accessible formats. Please call 992-4670 to
request accessible formats.
• Filing a Complaint - Complaints can be filed by email to
community.connector@bangormaine.gov, online at
www.bangormaine.gov/communityconnector, or by calling 207-992-4670 to speak with a
Supervisor.
PERSONAL CARE ATTENDANT
ADA paratransit individuals requiring a personal care attendant shall be identified upon applying
for ADA paratransit certification. ADA paratransit individuals shall notify the Paratransit Office at
the time trip is scheduled that their PCA will accompany them.
Personal care attendants shall not be charged a fare for complementary paratransit service.
Traveling companions and personal care attendants accompanying ADA paratransit individuals
must have the same origin and destination as that of the paratransit individual they are
accompanying.
SERVICE
Paratransit service is not required to be provided for those individuals appealing their initial
eligibility determination; unless the person has been through the appeal process and a decision is
not made within 30 days of the hearing.
Paratransit service is to be provided for individuals who have filed an appeal due to a suspension
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of service.
All correspondence with applicants shall be done in an accessible format if requested.
"NO-SHOW" SUSPENSION POLICY
Community Connector understands that because our complementary ADA paratransit service
requires trips to be scheduled in advance, riders may sometimes miss scheduled rides or forget
to cancel rides they no longer need. Community Connector also understands that riders may
sometimes miss scheduled trips or be unable to cancel trips in a timely way for reasons that are
beyond their control. However, repeatedly missing scheduled trips or failing to cancel trips in a
timely way can lead to suspension of service. The following information explains Community
Connector’s no-show policy.
Definitions: No Show, Pickup Window, and Late Cancellation
A no-show occurs when a rider fails to appear to board the vehicle for a scheduled trip. This
presumes the vehicle arrives at the scheduled pickup location within the pickup window and the
driver waits at least 5 minutes. The pickup window is defined as from 15 minutes before the
scheduled pickup time to 15 minutes after the scheduled pickup time. Riders must be ready to
board a vehicle that arrives within the pickup window. The driver will wait for a maximum of 5
minutes within the pickup window for the rider to appear. A late cancellation is defined as
follows: a cancellation made less than 2 hours before the scheduled pickup time, as a
cancellation made at the door, or a refusal to board a vehicle that has arrived within the pickup
window.
Definition: No-Shows Due to Operator Error or to Circumstances Beyond a Rider’s Control
Community Connector does not count missed trips as no-shows.
Community Connector does not count as no-shows or late cancellations situations beyond a
rider’s control that prevent the rider from notifying us that the trip cannot be taken, such as:
Medical emergency
Family emergency
Sudden illness or change in condition
Appointment that runs unexpectedly late without sufficient notice
Riders should contact the Community Connector’s ADA complementary paratransit service office
(207-992-4670) when experiencing no-shows or late cancellations due to circumstances beyond
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their control.
POLICY FOR HANDLING SUBSEQUENT TRIPS FOLLOWING NO-SHOWS
When a rider is a no-show for one trip, all subsequent trips on that day remain on the schedule
unless the rider specifically cancels the trips.
To avoid multiple no-shows on the same day, riders are strongly encouraged to cancel any
subsequent trips they no longer need that day.
SUSPENSION POLICIES FOR A PATTERN OF EXCESSIVE NO-SHOWS AND
LATE CANCELLATIONS
Community Connector reviews all recorded no-shows and late cancellations to ensure accuracy
before recording them in a rider’s account. Each verified no-show or late cancellation consistent
with the above definitions counts as 1 penalty point. Riders will be subject to suspension after
they meet all of the following conditions:
Accumulate 3 penalty points in three calendar month period
Have booked at least 30 trips during that three month period
Have “no-showed or “late cancelled” at least 20% of those trips.
A rider will be subject to suspension only if both the minimum number of trips booked and the
minimum number of penalty points are reached during the three-month period. Community
Connector will notify riders by telephone after they have accumulated 2 penalty points and
would be subject to suspension should they accumulate 1 additional penalty point with that
period consistent with the criteria listed in this section of the policy above.
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SUSPENSION OF SERVICE
Offense Action Action taken by
First Letter Mailed by the fixed route ADA Paratransit
Coordinator
Second 1 Week Suspension of
Service
ADA Paratransit Coordinator
Third in 1 Year 2 Weeks
Suspension of Service
ADA Paratransit Coordinator
SUSPENSION PROCESS
Upon determining sufficient cause to suspend an individual’s service, the following steps must be
taken prior to suspending service:
1. The individual must be notified in writing by the fixed route ADA Paratransit
Coordinator of its intent to suspend service, citing with specificity the basis of the proposed
suspension and the proposed course of action.
a. Notice shall be sent certified mail (or similar) to document receipt by the
individual.
2. The individual has 14 days to appeal in writing the suspension of service.
3. The individual shall be notified as to what course of action will be carried out.
- If the ADA Paratransit Coordinator does not receive a written appeal within the
designated time, service will be suspended;
- If the ADA Paratransit Coordinator does receive a valid written appeal, the
provider can a) accept the individuals appeal and continue service or b) reject the appeal and
proceed with suspending service.
VISITOR POLICY
Complementary paratransit service shall be provided to visitors. A "visitor" is an individual with
disabilities who does not reside in one of the communities served by the fixed route transit.
Individuals presenting documentation that they are ADA paratransit eligible in the jurisdiction in
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which they reside shall be eligible.
Visitors are eligible for paratransit service for (up to) 21 days of service within 12 months from
the date of the first paratransit trip. To receive service beyond this time, individuals shall be
required to apply for eligibility.
BIBLIOGRAPHY
ADA Paratransit Handbook: Implementing the Complementary Paratransit Service Requirements
of the Americans with Disabilities Act of 1990, U.S. Department of Transportation, Urban Mass
Transportation Administration, September 1991.
Americans with Disabilities Act (ADA) Paratransit Eligibility Manual, U.S. Department of
Transportation, Federal Transit Administration, September 1993.
"Paratransit as a Complement to Fixed Route Service", 49 CFR 37, Subpart F, Vol. 56, No. 173,
September 6, 1991.
FTA C 4710.1 Circular, November 4, 2015
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APPENDIX 1 – ADA PARATRNSIT CONTRACT
Contract to be included in 2018.
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APPENDIX 2 – ADA PARATRNSIT SERVICE AREA
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APPENDIX 3 – FIXED ROUTE SCHEDULE
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APPENDIX 4 – ADA APPLICATION
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Community Connector Complementary ADA Paratransit
Application Professional Verification Form
Please complete this professional verification form as thoroughly as possible. Should you have any additional
questions, please do not hesitate to call 207-992-4670 to speak with ADA Coordinator.
Forms can be mailed to Community Connector, 475 Maine Ave, Bangor, Me 04401 or faxed to 207-945-4992.
Applicant’s Name:____________________________________Date of Birth_______________________
Address______________________________________________________________________________
1. a. In what capacity have you known this individual?_______________________________
_______________________________________________________________________
b. How long have you known this individual?_____________________________________
2. What is the last date of face to face contact (by you or your agency) with this individual?______
______________________________________________________________________________
3. What is the individual’s diagnosis? (DSM-IV)__________________________________________
4. Date of onset?__________________________________________________________________
5. What is the prognosis?___________________________________________________________
6. Is person taking psychotropic, antidepressant, or other medication? _________Yes_______No
If yes, answer a, b, and c.
a. Did you prescribe this medication? _______Yes _______No
b. List of Medication Dosage/Frequency Date Prescribed
_______________ ________________ ______________
_______________ ________________ ______________
_______________ ________________ ______________
_______________ ________________ ______________
c. Do you deem individual to be compliant in taking medications? _______Yes_______No
d. How does above medication affect individual’s functional ability to travel independently within the
community? (drowsiness, confusion etc.)______________________________
________________________________________________________________________
________________________________________________________________________
7. Has the individual’s functional ability changed temporarily due to adjustment to medication?
______Yes ______No
If yes, please explain and give expected duration________________________________
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_______________________________________________________________________
8. When taking medication compliantly, will the individual be able to travel independently in the community?
_______Yes ______No
9. Does the individual drive? _______Yes _______No
10. Does the individual currently experience either auditory or visual hallucinations?
_______Yes _______No
If yes, would s/he be likely to experience auditory or visual misperceptions due to hallucinations?
_______Yes _______No
11. a. Is individual’s disability the same every day? _______Yes _______No
b. What is a “good” day like?__________________________________________________
________________________________________________________________________
c. What is individual able to do on a “good day”?__________________________________
________________________________________________________________________
d. What is a “bad “day like?___________________________________________________
________________________________________________________________________
e. How many good/bad days has individual had in the last month?
__________”good” days __________”bad” days
f. Does anything trigger a “bad” day? _______Yes _______No Explain_________________
________________________________________________________________________
12. Are any of the following affected by individual’s disability? Check ALL that apply:
_______ Disorientation _______ Monitoring time
_______ Problem solving _______ Judgment
_______ Short term memory _______ Communication
_______ Long term memory _______ Inconsistent performance
_______ Concentration _______ Coping skills
_______ Gait or balance _______ Inappropriate social behavior
Please explain how the above interferes with safe community travel.______________________
______________________________________________________________________________
______________________________________________________________________________
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13. Does individual demonstrate inappropriate social behavior? _______Yes _______No
If yes, please describe:____________________________________________________________
______________________________________________________________________________
14. Describe how the individual’s disability affects his/her ability to complete the following travel tasks:
• Traveling alone outside________________________________________________________
• Leaving house on time_________________________________________________________
• Seeking and acting on directions_________________________________________________
• Finding way to/from bus stop___________________________________________________
• Crossing streets______________________________________________________________
• Waiting for a bus_____________________________________________________________
• Boarding the correct bus_______________________________________________________
• Riding on a bus_______________________________________________________________
• Transferring to a second bus or exiting at the correct destination_______________________
___________________________________________________________________________
• Monitoring time______________________________________________________________
15. Would mobility training be appropriate for this individual? _______Yes _______No
If no, why?_____________________________________________________________________
______________________________________________________________________________
16. Would training tools help? (Ex. Memory cards, written route directions, photo’s, etc)
_______ Yes _______No If not, Why?________________________________________________
______________________________________________________________________________
17. Are there any other life skills that this individual lacks that would be an indication of his/her inability to use
public transportation?_______________________________________________
_____________________________________________________________________________
18. Is the goal of traveling independently (even limited travel in the neighborhood) in the context of treatment?
_______Yes _______No
I certify that this information is true and correct to the best of my knowledge.
Signature_______________________________ Title__________________________________
______________________________________ ______________________________________
Please print name Please print title
Agency _______________________________ Date__________________________________
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Address_______________________________ Phone_________________________________
_______________________________
Thank you for your time and input.
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APPENDIX 5 – ADA ELIGIBILITY REVIEW FORM
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APPENDIX 6 – ADA ADVISORY COMMITTEE MEMBERS
Title
First
Name
Job Title / Company
Mr
Michael
Asst City Manager/City of Bangor
Mr
Don
BACTS
Ms
Elaine
Bangor Public Health and Community Services
Mr
Theodore
Retired
Ms
Helen
Adoptive and Foster Family Services-Me
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APPENDIX 7 – CAPACITY CONSTRAINT DEFINITIONS
Definition
Trip denials Agency is unable to provide a next day trip for one or more
legs of the trip within one hour of the desired trip time, when
the ADA client books the ride in time. If only one leg of the
trip can be scheduled and the client turns the trip down, two
trips have been denied.
On-time performance ADA clients are picked up within the -15/+15 minute pickup
window and/or dropped off at appointments on time.
Community Connector’s standard is 93% or more trips with
on-time pickups and 93% of trips with on-time drop-offs for
appointments.
Missed trips Missed trips, i.e., trips that are requested, confirmed, and
scheduled but do not take place because of Community
Connector’s actions, not those of the customer. They include:
Vehicle does not arrive.
Customer is picked up outside of the -15/+15 minute pickup
window.
Vehicle departs prior to the beginning of the pickup window
or before the five-minute waiting period within the window.
Vehicle arrives after the end of the pickup window and
departs without the customer.
Customer takes the trip even though the vehicle arrived after
the end of the window.
Excessively long trips Length of client’s ride should be comparable to a ride on the
fixed route service. This includes walk, wait time and a stop
etc.
Community Connector’s standard is 98 % or more of trips
with ride times comparable to or less than a similar fixed
route trip.
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