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INTRODUCTION OF AUDIENCE MEMBERS

Received introductions from the audience including: Terry Applegate, Silicon Valley Independent Living Center; Troy Hernandez, Area of Development Disability Board; Bernice Alaniz, Marketing and Public Affairs Deputy Director; Sebastien LaPlante, NovaCare Rehabilitation; Genevieve Cleveland, NovaCare Rehabilitation;
Duane Haugen, Interested Citizen; Ron Lavman, San Jose Senior Commission;
Art Hulscher, Orthopaedic Hospital Disability Services (DS); Victoria Fang, Orthopaedic Hospital Disability Services (DS); David Ledwitz, VTA Accessible Services; Baljit Pannu, VTA Human Resources; David Terrazas, VTA Marketing and Customer Services; Steve Johnstone, VTA Operations; Julia Jones, VTA Operations Planning; Mike Aro, Deputy Director of Bus and Rail Operations; Nancy Coss-Fitzwater, VTA Operations; and Matthew O. Tucker, Chief Operating Officer.

PUBLIC PRESENTATIONS

Sandra Gouveia, Interested Citizen, referenced the March 3, 2005 VTA Board of Directors Regular Meeting and expressed concern regarding public comments that were not expressed at the Board Meeting.   Ms. Gouveia stressed the importance of public comments and requested that staff place the comments in writing.  Ms. Gouveia stressed the importance of providing copies of reports to CTA Members prior to Committee Meetings.   Ms. Gouveia requested a written response regarding the policy to receive information entered into the database system regarding the applicant/client file. Ms. Gouveia stressed the importance of allowing the CTA Chairperson or an individual representing CTA to have equal time as staff to speak, provide information, and have the Committee’s recommendations considered by the Board at the Board of Directors Regular Meeting.  

Ms. Applegate spoke on behalf of a client and expressed concern regarding drivers not allowing customers with service animals to board the transit system.   Ms. Applegate noted the client’s request that VTA inform drivers of the Americans with Disabilities Act (ADA) policy regarding the use of service animals on the transit system.  Ms. Applegate requested that VTA remind drivers of the procedure regarding free rides on fixed route system to OUTREACH customers. Chairperson Julian asked Ms. Applegate if she had detail information regarding the client complaint related to the driver and incident.   Ms. Applegate responded that she did have the detail information and was assisting the customer in preparation of a complaint letter. 

Minutes of February 9, 2005

Member Gouveia noted a correction to the February 9, 2005 CTA Meeting Minutes and referenced Page 3 of 17, Paragraph 7, noting the hiring panel include individuals with disabilities with employment specialist experience.

Member Rhodes requested that the February 9, 2005 CTA Meeting Minutes be deferred.

PUBLIC PRESENTATIONS (continued)

Barbara Rhodes, Interested Citizen, expressed concern regarding incorrect information provided by staff at the March 3, 2005 VTA Board of Directors Regular Meeting where staff noted only two individual requests for personal data information entered in the database system.   Ms. Rhodes noted that more than two individuals have requested their personal data information and added that the Department of Justice is aware of the matter. 

Minutes of February 9, 2005 (continued)

Member Grant referenced the January 12, 2005 CTA Summary Minutes and
February 9, 2005 CTA Minutes, noting the Committees’ request for CTA Bylaws to be reviewed and discussed regarding modifications.   Member Grant expressed concern regarding the absence of the CTA Bylaws on the March 9, 2005 CTA Meeting Agenda.  Chairperson Julian responded that staff will address the CTA Bylaws under Committee Staff Report.  Chairperson Julian noted that the CTA Bylaws are on the
CTA Committee workplan.

Ex-Officio Member Heatley suggested deferring the February 9, 2005 CTA Meeting Minutes to the April 13, 2005 CTA Meeting.

The Committee deferred the Minutes of February 9, 2005 to the April 13, 2005 Committee for Transit Accessibility Meeting. 

BUSINESS REFERRED TO COMMITTEE BY THE BOARD OF DIRECTORS/GENERAL MANAGER

Disability Services at Orthopaedic Hospital

Art Hulscher, Orthopaedic Hospital Disability Services (DS), provided an overview on the history of Disability Services at Orthopaedic Hospital.    Mr. Hulscher noted his intention in presenting to the Committee today is to keep the lines of communication open with the public and to represent Orthopaedic Hospital DS.  Mr. Hulscher commented on how Orthopaedic Hospital became involved with Paratransit Eligibility; however, noted regulations stating that eligibility is a transportation decision not a medical decision.  Mr. Hulscher continued that Orthopaedic Hospital has been in existence since 1922 and that Orthopaedic Hospital works with Orthopedics,
Chronic Illnesses, Mental Health, Visual, Cognitive, and Physical Disabilities and management of these conditions. 

Mr. Hulscher noted that Access Services approached Orthopaedic Hospital to conduct interview assessments, which assisted in the development of the Eligibility Training Program.   Mr. Hulscher noted that Orthopaedic Hospital staff was provided with training in accessible services and accessible fixed route service with the assistance of Metropolitan Transportation Authority in Los Angeles.

Vice Chairperson Morrow queried on the absence of a power point presentation regarding the overview on Disability Services at Orthopaedic Hospital.   Chairperson Julian added that it would have been helpful to have a list of the training received by Disability Services at Orthopaedic Hospital staff and other pertinent information related to Orthopaedic Hospital provided and distributed to Committee Members.  Chairperson Julian added that it would be beneficial for Orthopaedic Hospital to become familiar with VTA and Santa Clara County’s transportation needs as well as concerns raised at the Board of Directors Regular Meetings.  Mr. Hulscher responded that if the approach was to provide information regarding Disability Services at Orthopaedic Hospital eligibility training then he could present that information to the Committee.  

Member Stahl queried about sensitivity issues and if Disability Services at Orthopaedic Hospital staff has experience participating in different types of disability situations and conditions.  Mr. Hulscher responded yes and noted that part of the training module involves getting into three types of mobility devices and access fixed routes to understand the challenges involved.  Mr. Hulscher noted that in terms of visual impairments staff wears a blindfold and has a set of guide rules related to limited field of vision.

Vice Chairperson Morrow queried on the type of presentation Orthopaedic Hospital was asked to present to the Committee.   Mr. Hulscher responded that he was asked to keep the lines of communication open and represent Orthopaedic Hospital Disability Services. 

Edna Pampy, Acting Accessible Services Manager, responded that Orthopaedic Hospital was invited to respond to Committee questions and provide background information on how Orthopaedic Hospital became on expert in the field for assessing and determining Paratransit Eligibility.  Ms. Pampy added that Orthopaedic Hospital could speak about their training process, years of experience, and current local staff then respond to Committee questions.

Member Eljas noted concern regarding the lack of sensitivity and customer service and added that these elements are missing in the training module. Mr. Hulscher responded that he appreciated the feedback regarding sensitivity and customer service issues. Mr. Hulscher added that sensitivity training is on-going training as part of the training module. 

Chairperson Julian stressed the importance of having a power point presentation or other information regarding the training and other relevant information.  Mr. Hulscher responded that at the last CTA Meeting he did provide that information in a power point presentation to the Committee; however, the training information is featured in mass transit magazines as well as recent articles covering Paratransit Eligibility training.  Mr. Hulscher noted Orthopaedic Hospital’s goal is to make the interview assessments 100 percent accessible, available, and sensitive.  He added that Orthopaedic Hospital is one of the country’s only Paratransit Eligibility training and extended an invitation for individuals to attend monthly staff meetings regarding sensitivity and customer service issues.  Chairperson Julian suggested contacting appropriate organizations, such as, Silicon Valley Independent Living Center (SVILC), National Multiple Sclerosis (MS) Society, Silicon Valley Council of the Blind, Peninsula Center for the Blind and Visually Impaired, Lions Blind Center, senior centers, and senior groups.

Member Rhodes expressed her concern regarding items not presented to the Committee in writing.  Member Rhodes noted concern regarding the questions being asked at the interview as well as information entered into the database system regarding the client.  Member Rhodes expressed concern regarding the lack of good customer service provided at the in-person interview and stressed the importance to open the lines of communication and begin working cohesively with one another to make the program an easier process that is user friendly.

M/S/C (Rhodes/Julian) to recommend any presentation provided to CTA include a written report and be distributed to the Committee in an appropriate amount of time to review the information.

NOTE:    M/S/C MEANS MOTION SECONDED AND CARRIED AND, UNLESS OTHERWISE INDICATED, THE MOTION PASSED UNANIMOUSLY.

Member Marcillet queried about the cost per year to provide the Paratransit Eligibility Certification Program Process assessment for VTA.  Ms. Pampy responded that the amount is around $500,000 per year for the assessment interview services. 
Member Marcillet queried about the percentage of applicants determined ineligible. 
Mr. Hulscher responded 3.1 percent of the applicants interviewed were determined ineligible.  Member Marcillet queried about a time foreseen regarding the ending or phasing out of the assessment interview process.  Mr. Hulscher responded that the service will be conducted for a while and noted that Orthopaedic Hospital came on doing the recertification knowing that it would take about three years to get through the entire ridership.  Member Marcillet noted the extensive amount of money spent for the Paratransit Eligibility Certification Program considering 97 percent of the people are determined eligible for the program services.

Member Jensen queried if Orthopaedic Hospital considered Occupational Therapist conducting the in-person interview assessment since they have a background working with mental and physical disabilities.   Member Jensen queried on the credentials of the individuals conducting the interviews in Santa Clara County and what is used to determine functional ability.  Mr. Hulscher responded that Orthopaedic Hospital does not have an Occupational Therapist in Santa Clara County; however, Orthopaedic Hospital is not opposed to having one on staff.  Mr. Hulscher added that Orthopaedic Hospital has staff that represents 40-years combined experience in working with individuals with disabilities, social work, and public health in conducting the assessments. 

Mr. Hulscher commented that criteria used to determine the functional ability are questions, answers, and observations. 

Member Jensen requested that Orthopaedic Hospital Disability Services provide the in-person interview functional assessment questions and observations to Committee Members.   Mr. Hulscher responded yes that staff will provide the information to Committee Members; however, noted that contractually they are unable to release the eligibility files; therefore, the request for the information must go through VTA.  

Member Rhodes left her seat at 1:55 p.m. and a Committee of the Whole was declared.

Member Bruntz queried on the observation assessment and the objective criterion for the observation assessment.   Mr. Hulscher responded that observation assessment is usually based in notations to comment on the ambulation speed since Orthopaedic Hospital Disability Services does not measure the speed but made an observation.

Member Rhodes took her seat at 2:05 p.m. and a quorum was declared.

Member Bruntz queried if the client receives copies of the observations and knows how they were evaluated.   Mr. Hulscher responded yes that the information is placed in the client’s files. 

Member Bruntz queried if the information is given to the client.   Mr. Hulscher responded that if the client requests a copy of their file then it is provided; however, there is no one skill set that makes an applicant eligible and added that eligibility is always based on an individual case-by-case basis. 

Member Stahl requested that Orthopaedic Hospital Disability Services provide her personal data information entered in the database system.   Mr. Hulscher responded that the request would have to go through VTA since they are not allowed to release information and added that as soon as Orthopaedic Hospital Disability Services receives the request from VTA a copy of the file is sent to VTA.  Ms. Pampy responded and acknowledged the request from Member Stahl for the information and noted that the information will be mailed.  Member Stahl noted appreciation to staff regarding the request for the data information.

Member Rhodes queried if Orthopaedic Hospital factors in changes in the timing of the traffic lights and stressed the importance of factoring in the timing of traffic lights. 
Mr. Hulscher responded that Orthopaedic Hospital has a standard that the decision is based on and stressed the importance of the applicant informing the interviewer of the challenges an applicant may experience.   Member Rhodes queried if staff was aware that undergoing any test or eligibility is stressful for people and especially elderly individuals. 

Member Gouveia queried if balance had anything to do with people being certified for eligibility.   Mr. Hulscher responded that balance is factored into the assessment and there is a measured test. 

Member Gouveia noted that she is talking about people noting that their medication makes them off balance not if they are tested for balance.   Mr. Hulscher responded that a pharmacist meets with the group regarding medication with reference information obtained from the Nurse’s Drug Reference Handbook.  Mr. Hulscher noted the reason for the pharmacy training is to be familiar with categories since categories carry certain functions and features common amongst side effects, such as, dizziness and nausea; therefore, staff would have a sense of what is going on with the individual.  However, in every assessment staff has a question that asks about medication side effects because assessment is based on an individual case-by-case basis.  

Member Gouveia requested that staff provide Committee Members with the written process to request personal data information entered in the database system.   Ms. Pampy responded that staff will provide the information to Committee Members.

Ex-Officio Member Heatley noted the confusion regarding the process for clients to request and receive their personal data information and suggested that staff clarify the process.   Ex-Officio Member Heatley suggested that Disability Services at Orthopaedic Hospital staff at the in-person interview assessment read back the information obtained in the interview assessment to ensure that the client is aware of the information being entered into the database system regarding their case file.  Mr. Hulscher responded that the standard assessment Disability Services at Orthopaedic Hospital uses does not really include the observations and added that the observations are merely used in the notations.

Ex-Officio Member Heatley noted as the Paratransit Provider the comments remain confidential and noted concern regarding legal action being brought about by various groups.    Ex-Officio Member Heatley noted for the record that people in this community have gone to the Office of Civil Rights regarding this issue; however, added that we have the opportunity to resolve these issues through procedures and techniques. Mr. Hulscher responded that the goal is to continue to keep the lines of communication open and welcomed the opportunity to participate and define a process that is fair and equal. 

Ms. Applegate expressed concern regarding the in-person interview assessment conducted by Disability Services at Orthopaedic Hospital staff regarding their lack of sensitivity and customer service.   Ms. Applegate noted concern regarding the process to request and receive personal data information entered in the database system. Ms. Applegate noted concern regarding trip-by-trip eligibility determination.

Mr. Haugen expressed concern regarding the in-person interview assessment and queried why the complete list of criteria is not sent to the client before the appointment; therefore, the person is aware of what the interviewer will be looking at and if the person will require an attendant at the interview assessment. 

Mr. Hulscher responded that complaints related to sensitivity issues and customer service will be addressed and noted that staff will provide the personal data information to an individual when they request the information.   Mr. Hulscher noted that trip-by-trip is self identified usually by the individual; however, that trip-by-trip is not enforced.

Ms. Pampy responded that staff will work with Disability Services at Orthopaedic Hospital to address the issues discussed and provide the information in writing to the Committee.   Mr. Tucker responded that staff is looking for specific direction from CTA regarding specific issues to be addressed and staff will respond accordingly and provide the information.  Mr. Tucker suggested a task force to have a comprehensive system to evaluate everything at one time to address concerns raised by the Committee.

Chairperson Julian proposed a Committee task force to address the concerns raised by the Committee.

Member Jensen requested that the questions and observations used in the in-person interview assessment be distributed to CTA Members.   Member Jensen stressed concern regarding the interviewer not allowing family members or Personal Care Attendants (PCA) to attend or provide answers for the client during the in-person interview assessment.  Mr. Hulscher responded that information should be primarily obtained from the applicant then the interviewer may request feedback from the caregiver.

Chairperson Julian requested volunteers to participate in a task force to address concerns raised by the Committee.  Members Eljas, Jensen, Rhodes, Stahl, Ex-Officio Member Heatley, Vice Chairperson Morrow, and Chairperson Julian volunteered to participate in the task force.   

Member Grant queried about trip-by-trip eligibility.  Mr. Hulscher responded that Disability Services at Orthopaedic Hospital does grant trip-by-trip eligibility; however, trip-by-trip eligibility is not enforced.

Member Eljas stressed the importance of the issues and suggested that the task force be a subcommittee to address the concerns raised by the Committee since a subcommittee will have more impact and be more effective. 

Chairperson Julian agreed that the task force would be more effective as a subcommittee to address concerns raised by the Committee.  Member Gouveia volunteered to serve on the subcommittee.  Chairperson Julian queried if the task force volunteers would be willing to serve on a subcommittee.  Members Eljas, Gouveia, Jensen, Rhodes, Stahl, Ex-Officio Member Heatley, Vice Chairperson Morrow, and Chairperson Julian agreed to serve as volunteers to participate in the subcommittee.   

Vice Chairperson Morrow requested that Orthopaedic Hospital Disability Services provide their training module material to Committee Members.  Vice Chairperson Morrow noted concern regarding his recertification interview and added that the
in-person interview assessment conducted by Disability Services at Orthopaedic Hospital is lacking in customer service.

The Committee thanked Mr. Hulscher for the Disability Services at Orthopaedic Hospital presentation.   Mr. Hulscher thanked the Committee for the opportunity to continue to keep the lines of communication open and welcomed feedback of the Committee. 

The Committee received the Disability Services at Orthopaedic Hospital presentation.

NovaCare Rehabilitation

Sebastien LaPlante, NovaCare Rehabilitation Physical Therapist (PT) and Project Manager, provided a brief overview on NovaCare Rehabilitation.  Mr. LaPlante introduced Genevieve Cleveland, NovaCare Rehabilitation Physical Therapist, to the Committee Members.   Mr. LaPlante commented that VTA contacted NovaCare Rehabilitation to provide a brief overview on the company and history to Committee Members.  Mr. LaPlante continued that NovaCare Rehabilitation is a division of Select Medical Corporation a private company headquartered in Pennsylvania with a background in Long-Term Acute Care Hospitals.  NovaCare Rehabilitation is a division of Select Medical, a specialty Outpatient Physical Therapy provider, with 550 centers across the country in 25-30 states with 15 local clinics in the overall Bay Area and 35 clinics in the entire state.  NovaCare Rehabilitation has been providing objective appeal functional assessment evaluation testing since the summer of 2003 at the Los Gatos clinic facility. 

Mr. LaPlante noted that Ms. Cleveland’s background is quite extensive in physical therapy and added that Ms. Cleveland completed training in functional capacity evaluations 14-years ago.   Mr. LaPlante added that NovaCare Rehabilitation’s goal is to be fair, consistent, professional, and respectful to all of the individuals evaluated by NovaCare Rehabilitation.  Mr. LaPlante commented on the process and noted that NovaCare Rehabilitation sends a letter to the appeal applicant to schedule an appointment with the applicant within 10-15 days of the appeal request.  NovaCare Rehabilitation will verify the appointment within 48-hours of the set appointment, at the appointment the applicant is greeted, and asked a few questions before being taken out for the functional assessment evaluation test.   The applicant goes for a walk for approximately 1300 feet, which is equivalent to ¼ mile and the coarse is in the community simulating a real life course with real life barriers, such as cracks in the sidewalks.  Mr. LaPlante noted that street crossing speed is determined based on the contract with Las Vegas through the Regional Transit Commission at three feet per second or the ability to walk 100 feet in 33 seconds.  The assessment evaluation examines the applicant on curves, ability to negotiate curves, and an informal balance assessment.

Chairperson Julian queried about the duties performed by Orthopaedic Hospital DS and NovaCare Rehabilitation regarding the Paratransit Eligibility Certification Process Program.   Ms. Pampy responded that Orthopaedic Hospital DS performs the in-person interview assessment certification process regarding the Paratransit Eligibility Certification Program and NovaCare Rehabilitation conducts the function assessment evaluation in the denial appeals process regarding the Paratransit Eligibility Certification Program.  Ms. Pampy continued that the information is provided from the in-person interview assessment and bus stop information acquired through VTA to examine accessibility issues and terrain issues then the information is passed along in picture format to the functional assessment evaluation to provide an idea of barriers and issues with the intent of determining eligibility.

Member Stahl queried on eligibility for OUTREACH dependent on the weather. 
Ms. Cleveland responded that if the applicant was determined eligible on weather conditions it meant that the applicant was able to walk the 1300 feet distance in
16-minutes or less.

Member Gouveia queried about how blind and visually impaired client assessments are handled.   Ms. Cleveland responded that visually impaired clients have issues regarding the inability to read street signs; therefore, granted the ability to use OUTREACH. 

Member Jensen queried about how individuals with variable function skills are assessed related to how they function better on a good day versus a bad day.   Ms. Cleveland responded that Physical Therapists see this quite common with MS patients and the information obtained from the applicant and or caregiver is placed in the report that is sent to VTA Accessible Services staff and note in the report that the applicant may have difficulties during different types of weather conditions. 

Member Jensen asked if the client may be given eligibility based on the word of the client.   Ms. Cleveland responded yes.  

Vice Chairperson Morrow queried about cost of the appeals process and amount charged for one appeal evaluation.   Ms. Cleveland responded $155 for one appeal evaluation.  Vice Chairperson Morrow noted the appeal evaluation cost is expensive. 
Vice Chairperson Morrow queried about trip-by-trip basis eligibility.  Ms. Cleveland responded that she could not comment on trip-by-trip eligibility. 

Member Grant queried and requested information regarding the denial and appeals process for the Paratransit Eligibility Program.   Ms. Pampy responded that staff will provide the information to Committee Members.  Ms. Pampy noted a denial rate of
3.1 percent and added that 50 percent of the applicants denied eligibility appeal. 
Ms. Pampy noted that about 75 percent of the applicants who appeal are determined eligible by having a functional assessment evaluation. 

Member Grant queried if appeals are conducted in-house or only with NovaCare Rehabilitation.   Ms. Pampy responded that staff reviews every appeal document received and noted one case involving a visually impaired individual where staff administratively overturned the denial.  Ms. Pampy added that the functional assessment evaluation tests conducted by NovaCare Rehabilitation provide additional information to determine eligibility.

Ms. Applegate expressed concern regarding public comments made at the Friday, November 5, 2004 VTA Board of Directors Workshop Meeting.   Ms. Applegate queried about how NovaCare Rehabilitation assesses power chairs in the functional assessment evaluation.  Ms. Applegate queried about the ability and training of Physical Therapist to evaluate cognitive assessment.  Ms. Applegate noted concern regarding leaving appeal clients unattended outside the assessment evaluation facility in hot weather.  Ms. Cleveland responded that every applicant is asked if they would like to go back in the facility to wait for OUTREACH; however, some applicants decline and wait outside the facility for OUTREACH.  Ms. Cleveland added that every applicant is taken back in the facility unless otherwise requested.  Ms. Cleveland responded that NovaCare Rehabilitation assesses all applicants with the same parameters; however, added that the assessment is taken further with wheelchair applicants to ensure the applicant can maneuver around and access in the community.  Ms. Cleveland noted that Physical Therapist are not trained in cognitive assessments but the interviewer asks as many real life situation open-ended questions to the applicant; therefore, noted the importance of having the applicant speak for themselves.  Ms. Cleveland noted that staff is aware that the assessment evaluation is a stressful situation for the applicant.

Member Bruntz queried about the functional assessment evaluation and if observation of the applicant maneuvering through the facility is part of the formal evaluation. Ms. Cleveland responded that the observation of the applicant maneuvering through the facility is part of the formal evaluation process.   Ms. Cleveland continued that when the applicant arrives at the facility they are greeted, asked to sign one form then accompanied outside of the office, down the elevator where the route functional assessment begins. 

Member Bruntz queried if the applicant is aware that the elevator and walking outside of the office is part of the assessment evaluation.   Ms. Cleveland responded that the applicant is given the information that the interviewer will examine how the applicant responds in the community and barriers the client may encounter. 

Member Bruntz stressed the importance to ensure that the applicant is aware that the entire visit at the facility is considered part of the functional assessment evaluation test.   Ms. Cleveland responded that the applicant should understand that the entire visit is part of the functional assessment evaluation test since the interviewer states that they will examine how the applicant interacts in the community.

Member Jensen left the meeting at 3:05 p.m. and a Committee of the Whole was declared.

Member Rhodes expressed appreciation and thanked Orthopaedic Hospital and NovaCare Rehabilitation for their attendance and presentation to the Committee.  Member Rhodes noted the importance to have an open line of communication as well as a continuation of updated report presentations with written reports and accessible media provided to the Committee.

Member Eljas expressed appreciation and thanked Chairperson Julian for his efforts to conduct committee business. 

The Committee of the Whole received the NovaCare Rehabilitation presentation.

CTA Transit System Ridership Report

The CTA Transit System Ridership Report was deferred.

Legislative Updates

The Legislative Updates was deferred.

Committee Staff Report

The Committee Staff Report was deferred.

Chairperson’s Report

The Chairperson’s Report was deferred.

Announcements

Member Rhodes expressed appreciation for the opportunity to work with Information Technology Systems (ITS) staff and Ms. Pampy regarding efforts to make VTA Take-One and VTA website more accessible and added these efforts are a step in the right direction.

Chairperson Julian expressed appreciation and thanked Orthopaedic Hospital and NovaCare for their attendance and presentation to the Committee.