2012 Ohio Specialized Transportation

2012 OHIO SPECIALIZED TRANSPORTATION APPLICANT PROPOSAL INSTRUCTIONS

Cover On front of Proposal, enter agency’s Legal name as it appears on the Ohio Secretary of State’s web site. Section 1 APPLICANT PROPOSAL INFORMATION SECTION 1. Legal name of Agency 2.-11. Complete information as requested 12. Federal Tax ID # 13. DUNS Number (Obtained from Dunn and Bradstreet). Please check http://fedgov.dnb.com/webform to see if your agency has a DUNS Number, if not, you need to obtain a number before a grant can be awarded. 14. Ohio Charter Number from Ohio Secretary of State’s office. 15. Summary of Items Requested. Enter the quantity of vehicles requested in the appropriate column, enter the price from the vehicle worksheet page. Subtotal all vehicles columns and enter this amount in the Subtotal Vehicle Cost cell. If the request will be for other items i.e. computers, radio equipment, or other equipment, complete this section. 16. Total Project Cost : Total cost of vehicles and other items 17. Federal Share (80% of Total Project Cost (Line 15)) 18. Local Share (20% of Total Project Cost (Line 15)) Section 2 Access to Transportation and Need 1. Consult the “ODOT Status of Public Transit in Ohio July 2011” to determine if there is a transit system operating in your area: The Status of Transit is located at the indicated link. 2. If there is a Public Transit System in the county where your agency is located check this box and complete questions 2a through 2g. If there is a public transit system in your county, the Proposal must include a letter from the public transit system. The letter must state the cooperative efforts between the agency and the transit system to provide transportation in the area. If any of the items in 2a -2g are marked, the letter from the transit system should support these deficiencies in transportation. If there is no Public Transit System in the county where your agency is located go to Section 3 -Project Description. 3. Describe any other barriers to transportation that are not covered in the listed items Section 3 PROJECT DESCRIPTION Describe your organizations purpose and how the requested items will improve transportation services in the community. Limit the description to two pages. Section 4 SERVICE INFORMATION Services Area: The primary service area from where the majority of trips will originate. If you pick clients up in one county to take to a hospital or medical service in another area, the primary origin of the trip is the home county where the client is picked up. TRANSPORTATION CLIENTS SERVED: The number of transportation clients served by your agency. (Client count) Transportation Clients Served: Respond based on the demographics of your transportation clients. (Do not use trip counts) Estimated Number of Additional Clients to be served with proposed expansion project (Do not include client count from previous question) Respond based on anticipated additional clients.

1 Estimated Annual Trips: A trip is counted each time a client boards the vehicle. (Use the example below to determine the number of estimated unduplicated trips per vehicle requested.) To assist your agency in responding to the number of Transportation Clients Served and number of trips, read the following example:

During a four (4) week period John rides the bus to and from work Monday through Friday. Marie takes the bus one day per week to and from the grocery store. May takes the bus one way to see her grandchildren once a month. Once per month, Steve goes to his doctor, the pharmacy, the bank and home. (A trip is counted each time the rider gets on the bus).

Unduplicated Riders Trips

1. John (age 55) (IWD)* 2 trips per day x 5 days per week x 4 weeks = 40 trips 2. Marie (age 70) 2 trips per day x 1 day per week x 4 weeks = 8 trips

3. May**(age 75)(IWD)* 1 trip per month 1 trip 4. Steve (age 27) (IWD)* 4 trips per month 4 trips *IWD - Individual with Disability 53 trips/mo. 53 trips/22 days per month*= 2.4 trips per day 53 trips x month = 636 annual trips Assume agency operates Monday thru Friday

Information from the above example to be used in the Transportation Clients Served: 1 Number of individuals without disabilities (60 and over) 1 Number of Elderly and Disabled Individuals (60 and over with a disability) 2 Number of Individuals with Disabilities (under 60) 0 Other Clients: 0 4 Total Transportation Clients (1+1+2+0) = 4 636 Total Trips per year (53 trips x 12 months) 2.4 Passenger trips per day (53 trips ÷ 22 days)

Use the same methodology for calculating proposed service expansion. Service expansion must include the reason for the proposed expansion and supporting documentation to justify it. (New services, unable to meet client need as evidenced by study, trip denials, etc.)

Section 5 MANAGEMENT REQUIREMENTS FOR VEHICLE REQUESTS Attach a page describing how your organization will meet the bullet points listed in the Proposal. Address each bullet point in your response.

Section 6 COORDINATION EFFORTS: The “ODOT Status of Public Transit, July 2011” includes Ohio Public Transit Systems, Ohio Coordination Projects, Job Access Reverse Commute (JARC) projects, New Freedom projects, Specialized Transportation participants and Mobility Management projects. The applicant for this program should make and document contacts with all the agencies listed in their counties, in addition to any other social service organizations in the county. The Status of Transit is on line at: http://www.dot.state.oh.us/Divisions/Planning/Transit/Documents/Programs/Publication/StatusO fPublicTransitinOhio2011.pdf 2 Complete this section by listing the agencies with whom you coordinate, i.e. transporting clients of other agencies, client trips, dispatching, vehicle sharing, grant writing, scheduling, referrals to or from other agencies, personnel training (First Aid, CPR, Driver training, Passenger Assistance Techniques, Passenger sensitivity), vehicle maintenance, procurement, backup service, insurance, radio or transmitters, public transit systems (if a transit agency is operating in your area, a letter from the transit agency must be included stating how your organizations work together to provide transportation services), emergency services evacuation plans, working with first responders (police and fire) to remove intoxicated or drug impaired persons from public or private facilities, senior service organizations/housing complexes, (administrator, secretary, etc.) and other human service organizations, Job and Family Services, etc. A letter must be provided from each agency listed confirming current and ongoing coordination efforts. Provide documentation for no more than 12 coordination efforts. Each type of coordination documented in the letters submitted will receive 2.5 points, up to a maximum of 30 points. Agencies participating in Ohio Coordination projects will receive 30 points. The letters are to be submitted with the Proposal, not mailed separately to ODOT. Letters of support for your proposal do not receive points.

Example: Acceptable Demonstration of Coordination: The local hospital works with XYZ, Inc. to schedule patients so that needed transportation is provided to and from client appointments. Unacceptable: The local hospital supports ABC, Inc’s Proposal for a Specialized Transportation program vehicle.

COORDINATION Table In the rows beginning with numbers only, i.e. 1, 2, 3, 4 etc. List all agencies that work together to provide transportation service to your clients.

In the rows beginning with 1a, 2a, 3a, etc., provide a brief description of the agencies cooperation efforts, training, scheduling. (See Appendix 6 of these instructions for additional coordination considerations.)

Documentation letters must be included to support the statements made in this section from the agencies listed.

3 Section 7 ESTIMATED VEHICLE USAGE INFORMATION TABLE: Using one of the Computer Driving Directions programs (Google, MapQuest, Rand McNally, etc.) enter your agency’s address or vehicle starting point address. Using addresses of clients or expected clients, map out a proposed vehicle route. If there are several clients to be picked up, add the mileage from the vehicle starting point to the first client’s address. Map the route from the first address to the second client’s address, keep repeating until vehicle reaches its destination. (See table below). When adding passengers do not exceed the number of passengers the vehicle can accommodate for one trip. (Thirteen people cannot fit in a 12 passenger vehicle.) Adding the mileage and time between each stop will be give an approximate estimate of the daily mileage and the time required to complete the trip. Calculate this information for each vehicle trip. Include at least five minutes for boarding ambulatory and 10 minutes for nonambulatory passengers. If vehicle will return using same route but in reverse double the time and mileage. If it will be using a different route, follow the procedure above. Only include hours that your agency will be using the vehicle for this Proposal. See table below Stops Miles Time Boarding Time Clients (in minutes) time (in minutes) picked up between (LTV-16-2) stops Agency to first Stop 1st Street 45 60 60 1st to Vine Street 5 5 2 Vine Street to Berry Street 5 8 5 13 1 Berry Street to Wine Street 6 9 10 19 3 Wine Street to Grape Street 10 11 10 21 2 Grape Street to Purple Street 10 11 5 16 1 Purple Street to Agency 9 13 5 19 7 Subtotal 85 153 minutes 16 or 2.5 hours Return trip 85 153 minutes or 2.5 hours Total Daily usage 170 5 hours 32 trips miles If the agency operates 5 days per week and picks up the same people every day. The number of days per year 5 X 52 =260 -6 holidays = 254 operating days The number of trips per day: 16 people in morning + 16 people in afternoon = 32 trips per day (A trip is counted each time an individual boards the vehicle) 32 trips per day X 254 Operating days = 8,128 trips per year 170 miles per day X 254 operating days 43,180 miles per year Estimated trips to be provided per year Veh 1 Trips/day X Days/year = Trips/year 32 X 254 = 8,128 Miles/day Days /year Miles/year 170 X 254 = 43,180 Hours/day Days/year Hours/year 5 X 254 = 1,270 This information must be calculated for each vehicle requested. In the type of trips listed, check each type of trip provided by your agency

Section 8 VEHICLE FISCAL REQUIREMENTS: Calculations: 4 1. Salaries should be calculated for drivers, dispatchers, administrative functions related to the operation of the vehicle or vehicles requested: If two employees work 20 hours each and their employment is transportation related, their salaries should be calculated as one Full Time Employee. If the Dispatcher, secretary or administrator has other responsibilities in addition to this program, only the time spent on this program should be included in the vehicle fiscal expenses. Positions (Driver, Dispatcher, Secretary, Administrator) Ex: Driver: Hours*(Hourly wage + Fringe Benefits) = Salary Dispatcher: Hours*(Hourly wage + Fringe Benefits) = Salary Administrative Salaries Secretary: Hours*(Hourly wage + Fringe Benefits) = Salary Administrator: Hours*(Hourly wage + Fringe Benefits) = Salary $Total Salaries Required *If administrator only spends 10% of her time on the transportation program, then only 10% of their salary expenses should be included. 2. Expenses related to personnel training expenses: First Aid $ Drive $ CPR $ Defensive Driving $ Securement Training $ Passenger Assist Techniques $ Bloodborne Pathogens $ Drug and Alcohol Training $ Additional Training required by your agency $ Estimated Training Cost $ 3. Fuel Cost: Calculate for each vehicle requested. SMV, MMV 20 mpg DMV, CV, LTN, LTV = 12 mpg Formula for calculating year fuel expense: (Estimated Mileage per Vehicle ÷ Miles per gallon) × Cost of Fuel ($3.50) = Yearly fuel expense 4. Vehicle insurance cost: Obtained estimate from your insurance agent for each vehicle requested. 5. Vehicle Maintenance Cost per year: $200 per vehicle requested 6. Administrative costs related to the operation of this vehicle: telephone, utilities, rent, etc. If transportation is 10% of your organizations function, then 10% of the cost of these items may be attributed to the transportation costs. 7. Vehicle Storage Facility Expense 8. Other Costs. Include description of costs 9. Total items 1 through 9 to obtain total operational cost for vehicle(s) requested. 10. Funds your organization is going to commit to the operation of vehicle(s)? Do not include local share funds committed to vehicle purchase associated with this proposal. 11. Does the amount in 10 equal or exceed the amount in 9? If so, please explain.

5 Section 9 VEHICLE REQUEST FORM Vehicle Types, consult Vehicle Selection Guide to determine appropriate vehicle. SMV Standard Minivan LTN Light Transit Narrow Body MMV Modified Minivan LTV 22’ Light Transit Wide Body CV Converted Van LTV 25’ Light Transit Wide Body DMV Dedicated Mobility Vehicle

Complete one form for each vehicle selected Mark if vehicle is a replacement or expansion vehicle. If replacement, indicate which vehicle in Section 10 (Vehicle Inventory) is being replaced by entering the line number. Project priority number, mark most important vehicle to replace as 1, next 2…. Name of Agency as it is to appear on vehicle title. 4-10 Complete information as requested for delivery information. Vehicle selection (using the 2011-2012 Vehicle Selection Guide choose the appropriate size vehicle for your agency) Vehicle selected i.e. CV-12 -0 or LTN-8-2 or XLTV-14-1. The Dedicated Mobility Vehicle is not included in the current Selection Guide. Please use $47,000 for the Base Vehicle Price. Mark the Base Vehicle Price $XX,XXX Obtain the base vehicle price from Appendix C, page C-7, includes base vehicle and seating Select lift manufacturer for LTNs and LTVs (Braun, Ricon, or Maxon). This selection should be determined based on the closet repair facility, the current lifts in your fleet, and driver preferences. Restraint System: Mark the Q-Straint or Sure-Lok. Again review current restraint system in vehicles and talk to your drivers. 15. Webbing loops, used to assist in securing scooters and other hard to secure mobility aid devices. Accessories If the agency does not want jump seats, mark reference no jump seats and deduct amount listed by type of vehicle (LTV-14-1 -$238), (LTV-12-3 -$238). Integrated child seat, mark single or double (This option is not available on LTV-0-6 or MMVs). Converted vans can only use single child seats. Flat Floor – LTV-0-6 and LTV-12-2 have flat floor included in base price, for all other floor plans they must be added. Only available on LTNs and LTVs. 19-22 Add unit cost if item is requested 23-24 Add the additional items and unit cost for any items not listed above but contained in the vehicle catalog selection price list. 25. Total Project Cost – Add items 12 through 24. 26. Federal Share – Multiply the Total Vehicle Cost by 80% (Round to nearest dollar). 27. Local share – Multiply the Total Project cost by 20% (Round to nearest dollar).

6 Section 10 CURRENT VEHICLE INVENTORY:

Complete as shown in the example for all vehicles your agency uses to provide people transportation (do not include service vehicles). Use calculation at bottom of page to determine the percentage of your fleet that is currently accessible. If 50% of you fleet is not accessible you must order an accessible vehicle (MMV, MV-1, CV with lift, LTN or LTV).

Section 11 PROPOSAL FOR COMPUTER(S) (Hardware or Software): Computer hardware and software requests are limited to current participants with 5 or more vehicles to schedule. 1. List the computer equipment requested, quantity requested, unit cost and the total cost. 2. Add all equipment listed under one to determine Total Project Cost 3. Determine the federal share by multiplying the Total Project Cost by 80% 4. Determine the local share by multiplying the Total Project Cost by 20%. 5. Check the items in the list the computer will be tracking. 6. How many vehicles will the computer be used to schedule? 7. Explain how the requested computers will be used to support or improve transportation services. 8. Include two cost estimates for requested computer equipment.

Section 12 PROPOSAL FOR COMMUNICATION EQUIPMENT:

Communications equipment requests are limited to current participants with 5 or more vehicles. Complete the Proposal with the following information:

1. Describe the communications equipment requested and quantity needed 2. Total Project Cost 3. Federal Share (80% of Communications Equipment Cost) 4. Local Share (20% of Communications Equipment Cost) 5. Explanation of how the requested computer equipment will be to support or improve transportation services. 6. Include two cost estimates for requested communications equipment. The following Proposal documents must be completed: Section 13 Local Match Certification (20% of Total Project Cost) Section 14 Public Private Section Participation and Involvement Deadline February 2, 2012 Section 15 Authorizing Resolution Section 16 Certification of Project Derived from Locally Developed Coordinated Public Transit-Human Services Transportation Plan Section 17 Title VI General Reporting Requirements Section 18 Title VI Compliance Form Section 19 Ohio Ambulette Exemption Requirements Section 20 Resolution for Certification of a Public Body (City, County or governmental entity only) Section 21 FY 2011 Federal and State Certifications and Assurances for the Specialized Transportation Program Section 22 Documentation Required

7 For additional information, see the 2012 Proposal Instruction Appendixes

Appendix 1: Content for Public Notice Appendix 2: Procedure for Responding to Service Proposals for Coordination and Private Sector Initiatives Appendix 3: Metropolitan Planning Organizations with Specialized Transportation Program Contacts Appendix 4: Coordination Efforts – (This worksheet is to assist you in identifying coordinating opportunities with other agencies.)

8 APPENDIX 1

CONTENT FOR PUBLIC NOTICE

The (name of agency exactly as it appears in the Articles of Incorporation) which is a (private nonprofit corporation or public body) intends to submit a Proposal for a capital grant under the provision of 49 USC Section 5310 of the Federal Transit Act to provide transportation service for the elderly and disabled within (describe agency service area and specific routes.) The grant Proposal will request (describe the eligible item(s) requested).

It is projected that (number and type of persons to be transported) will use the service (number of days/weeks) for various activities, including transportation to (types of activities).

The (name of agency) invites comments and proposals from all interested public, private and paratransit operators including taxi operators, for the provision of transportation service to the elderly and disabled within our service area.

Operators who are interested in offering proposals to provide service should contact (name of person, title) at (agency name and address) to obtain full details of the type of transportation service that is needed prior to preparing a proposal.

Written comments or proposals must be submitted within 30 days to the agency at the above address with a copy to the Ohio Department of Transportation, Office of Transit, 1980 West Broad Street, Columbus, Ohio 43223; Attention: Administrator.

The above information should be provided to all Public Transit Systems in your area, see Appendix 1 Ohio’s Public Transit Systems.

Public bodies must include the date, time and location and state location of the scheduled public meeting. The public meeting notice must be held at an accessible location and the notice must state that other accommodations will be made as requested.

9 APPENDIX 2

Procedure for Responding to Service Proposals for Coordination and Private Sector Initiatives

Should another agency submit a proposal to provide the transportation service proposed in the Proposal, the Applicant must:

Provide the interested party with all pertinent information such as: - number and characteristics of clientele to be served - number of nonambulatory clients - origins and destinations of clients and routes to be served - schedules of desired service (e.g. time, days, and special handling of clients required) - number of wheelchair positions on vehicle - radio base station power output/watts - frequencies at which you operate - insurance requirements - other information as appropriate

2) Review any resulting proposals and consider: - full cost of service (including vehicle depreciation) - quality of service - passenger satisfaction - comfort and safety (including driver competence and training) - degree of protection to the public (including liability insurance) - reliability of service, including vehicle maintenance - amount of Applicant's agency staff time (excluding drivers') that must be devoted to transportation activities - any other times that the Applicant feels are pertinent

3) Analyze the proposal, considering the above criteria, and make a recommendation.

4) Provide ODOT or the MPO a copy of the proposal, the proposed recommendation, and adequate documentation supporting the Applicant's decision.

5) Include a copy of the proposal and any resulting contracts or correspondence in the Proposal.

ODOT or the MPO will review the proposal and the Applicant's recommendation. While the Applicant's comments and recommendations are taken into consideration, ODOT and the MPOs reserve the right to make final decisions on the acceptance or rejection of any proposal.

10 APPENDIX 3 METROPOLITAN PLANNING ORGANIZATIONS

1 AKRON URBANIZED AREA Jeff Gardner Akron Metropolitan Area Transportation Study Citicenter Building 146 South High Street, Room 806 Akron, OH 44308-1423 (330)375-2436 Summit County

2 CANTON URBANIZED AREA Rick Keyes Stark County Area Transportation Study 201 3rd Street, N.E., Suite 201 Canton, OH 44702-2298 (330)451-7406 Stark County

3 CINCINNATI URBANIZED AREA Thomas M. Mazur Clark County-Springfield Mark Paine Lima-Allen County Regional Planning Transportation Study OKI Regional Council of Governments Commission 3130 East Main Street, Suite 2A 720 E. Pete Rose Way, Suite 420 130 W. North Street Springfield, OH 45505-1522 Cincinnati, OH 45202-3576 Lima, OH 45801 (937)521-2131 (513)621-6300 (419)228-1836 Clark County Hamilton, Butler & Clermont Co. Allen County

9 MANSFIELD URBANIZED AREA 14 STEUBENVILLE URBANIZED AREA Kathy Adams Mike Paprocki 4 CLEVELAND URBANIZED AREA Richland County Regional Planning Brooke-Hancock-Jefferson Transportation Sara Byrnes Maier Commission Study Northeast Ohio Areawide Coordinating nd 35 North Park Street 124 N. Fourth Street, 2 Floor Agency Steubenville, OH 43952 Mansfield, OH 44902 1299 Superior Avenue (740)282-3685 (419)774-6396 Cleveland, OH 44114-3204 Jefferson County (216)241-2414 ext. 308 Richland County Cuyahoga, Lake & Lorain Co. 15 TOLEDO URBANIZED AREA 10 NEWARK-HEATH URBANIZED AREA Dave Gedeon Sandra Mapel, P.E. 5 COLUMBUS URBANIZED AREA Toledo Metropolitan Area Council of Licking County Area Transportation Mary Ann Frantz Governments Study Mid Ohio Regional Planning Commission 300 Martin Luther King Jr. Drive 20 South Second Street 111 Liberty Street, Suite 100 Toledo, OH 43604 Newark, OH 43055 Columbus, OH 43215 (419)241-9155 ext. 125 (740) 670-5190 (614)233-4156 Lucas County Franklin County Licking County 16 WHEELING-BRIDGEPORT 11 PARKERSBURG-BELPRE URBANIZED AREA URBANIZED AREA 6 DAYTON URBANIZED AREA Bob Muransky Randy Durst Bob Steinbach Bel-O-Mar Transportation Study WWW Interstate Planning Commission Miami Valley RPC 105 Bridge Street Plaza, P.O. Box 2086 531 Market Street One Dayton Center Wheeling, WV 26003 Parkersburg, WV 26101 1 South Main Street, Suite 260 (304)242-1800 (304)422-4993 Dayton, OH 45402 Belmont County Washington County (937)223-6323 Montgomery, Greene & Miami Co. 17 YOUNGSTOWN URBANIZED AREA 12 SANDUSKY URBANIZED AREA Kathy Zook Steve Poggiali 7 HUNTINGTON/ASHLAND/ Eastgate Regional Council of Erie Regional Planning Commission IRONTON URBANIZED AREA Governments 2900 Columbus Ave. Saleem Salameh City Center One Building Sandusky, OH 44870 KYOVA Interstate Planning Commission 100 East Federal Street, Suite 1000 (419)627-7792 720 Fourth Avenue Youngstown, OH 44503 Erie County Huntington, WV 25701 (330)779-3800 (304)523-7434 Mahoning & Trumbull Counties Lawrence County 13 SPRINGFIELD URBANIZED AREA 8 LIMA URBANIZED AREA Lamar Daniel

12 APPENDIX 4 COORDINATION EFFORTS WORKSHEET Coordination is cooperation in the delivery of transportation services. Coordination occurs when individuals and organizations work together to expand one or more transportation-related activities. Coordination can be as simple as referrals about transportation choices among several agencies or it can be as complex as a fully consolidated community transportation system serving human service agencies. Below is a list of activities in which your organization may participate. Please mark all appropriate categories for which your agency provides the services listed below to other agencies Backup documentation from the agencies purchasing or receiving the services must be provided. Trips Scheduling Receive Backup Training Maintenance Procurement Storage Insurance Referrals Service* Facilities Senior Transportation Services Title IIIB Older Americans Passport and Caregiver Disabled Transportation Services DD clients Mental Health Clients Other Government Entities Medicaid Transportation Job Access Reverse Commute Local Public Transit System City, County Law Enforcement Emergency Services Private Entities Senior Residential Facilities Disabled Residential Facilities Veterans Service Organizations Medical Facilities Adult Day Care Facilities Vocational Rehab Services Other Organizations

This page is a worksheet to help agencies identify coordination opportunities. Do not return with the Proposal.

13 APPENDIX 5

Proposal Scoring Criteria and Points:

Returning Agencies/Replacement Vehicles/ Expansion Vehicles Access to Transportation and Need 10 points Management Capacity 10 points Estimated Days of Service 10 points Estimated Mileage per Year 10 points Estimated Trips per Year 10 points Coordination Efforts 30 points Proposal Completeness 5 points Subtotal 85 points Replacement vehicles meet disposition standards 5 points Subtotal 90 points Points based on usage of previous program vehicles Trips (Choose the applicable statement)* a. Actual vehicle trips provided within 90% of estimates 10 points b. Actual vehicle trips provided within 80% of estimates 5 points Mileage (Choose the applicable statement)* a. Actual vehicle mileage within 90% of estimates 10 points b. Actual vehicle mileage within 80% of estimates 5 points Total Points Possible 110 points *Previous year trips and mileage data is from Six Month Report data.

New Agencies Access to Transportation and Need 10 points Management Capacity 25 points Estimated Days of Service 10 points Estimated Mileage per Year 10 points Estimated Trips 10 points Proposal Completeness 10 points Coordination Efforts 30 points Subtotal 105 points New Agency credit 5 points Total Points Possible 110 points