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As can be seen, without policy changes the demand (if it continues to grow at current rates) is <br /> likely to be well in excess of any potential growth in funding. This means that either 1) additional <br /> funding will be needed, 2) demand will have to be restricted, and/or 3) the services type will need to be <br /> changed to lower per trip costs. Two options currently being considered for the short-run include: <br /> 1) Requiring a co-payment (fare) from the passenger of$1.00 or $2.50, which would possibly <br /> reduce demand somewhat but would also raise some funding; and/or <br /> 2) Capping the number of trips a particular individual could receive. This is in response to the <br /> fact that a relatively small number of persons take many of the trips, primarily for kidney <br /> dialysis or cancer treatments. However, capping the number of trips available to such <br /> individuals could seriously compromise their health care. <br /> The OPT Board will decide on one or the other of these, or both, as a short-term solution. <br /> However,the TDP should consider whether or not additional long-term options should be pursued. These <br /> could include: <br /> o Changing from Demand-Responsive Service to a More Restricted Service jpe: <br /> Rather than offering strictly demand-responsive service,this option would offer service from <br /> one section of the County to medical offices each day of the week on a set schedule, <br /> essentially a route deviation subscription route. It would be less convenient and therefore <br /> decrease demand (usage), but would increase productivity. Users would have to set their <br /> appointments up on the day the bus was serving their area, and would likely have to wait both <br /> before and after appointments. <br /> o Changing the Focus of the Program: Medical trips were identified as the priority in the last <br /> TDP and subsequently by the Board and OPT. E&DTAP could be used by other programs <br /> to serve the elderly and disabled for other purposes, and the Board might wish to revisit this <br /> issue. Clearly the medical need is there, but many more group trips (senior shopping, or <br /> nutrition routes, etc.) can be provided for a dollar of E&DTAP funding. <br /> This should be a topic of discussion for the County Transportation Advisory Board, who, in turn <br /> will make recommendations to the County Manager and the Board of County Commissioners. Compared <br /> to other counties in the state, Orange County's E&DTAP program appears to have a high cost per trip, <br /> but this is a result of policy choices favoring a high level of service (county-wide demand-response) <br /> targeted on a small group with high needs. The program could offer a lower level of service to a broader <br /> group, but this is a County policy decision. <br /> -36- <br />