Gobbledegook from Bus Company
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Paratransit Service
When you call the RTA’s paratransit service, a bus or mini-van will pick you up at the curb in front of most any address and take you to almost any other address within Orleans Parish. This service is provided for those riders whose disability in some way cannot be accommodated by the equipment on standard RTA buses and streetcars or by standard bus and streetcar routes.
The RTA provides paratransit service in accordance with the American with Disabilities Act (ADA). If you wish to use the RTA’s paratransit services, you must first go through an application process and prove your ADA eligibility.
Eligibility for Paratransit
Most of the standard buses and streetcars throughout the RTA system have equipment to serve persons with disabilities, but if you have a disability that prevents you from using the standard RTA system, you may qualify for paratransit rides. The RTA is required to provide this service under the Americans with Disabilities Act (ADA).
With the RTA’s paratransit service, a bus or mini-van will pick you up at the curb in front of most any address and take you to almost any other address within Orleans Parish. Advance reservations are required, and you will share the bus or mini-van with other paratransit riders.
If you wish to use the RTA’s paratransit services, you must first must apply for and receive an RTA Paratransit Card. Although paratransit services are for persons with disabilities, not everyone with a disability is eligible.
Who is eligible for paratransit services?
The RTA's paratransit service is meant to help those persons with disabilities that cannot use the standard buses and streetcars in the RTA system. If you have a disability but your disability does not prevent you from using standard buses and streetcars, the RTA may not find you eligible for paratransit eligibility.
You are eligible to use paratransit services if:
You cannot use the RTA buses or streetcars on your own.
You can generally use the RTA buses and streetcars on your own, but you need someone else’s assistance to use the system in certain ways.
Your disability prevents you from using particular bus or streetcar stops.
How do I apply for RTA paratransit services?
You can also pick up a form in person at the following address:
Regional Transit Authority
ADA Eligibility/ID Center
2817 Canal Street
New Orleans, LA 70119
++++++++++++++++++++++++++++++++++++++++
Certification Of ADA Paratransit Eligibility
Part 1. Applicant Information.
(Please Print. Completed by Applicant.)
Last Name_____________________ First ___________________ Middle ____
Work Phone ______________________ Home Phone ____________________
Da
te of Birth _______________Age ______Social Security # _______________
Street Address ______________________________________Apt.# _________
City __________________________________State _________Zip _________
Mailing Address ________________________State __
_______Zip _________
Do you have a RTA Lift Card?___ No ___ Yes If yes, expiration date_________
Person to contact in case of an emergency:
Name____________________________________ Relationship ____________
Street _______________________________________
___________________
City __________________________________ State __________Zip ________
Work Phone # _____________________ Home Phone # _________________
Please answer the following questions even if you do not regularly
ride RTA buses. Be sure to chec
k all that apply to you.
1. Do you need written information in a different format?
?
No
?
Yes If yes,
please indicate which format:
?
Large print
?
Braille
?
Audio type
?
Other:___________________________________________________
2. Do you
normally travel with a personal care attendant?
?
No
?
Yes. I sometimes need a personal care attendant to:
?
Yes. I always need a personal care attendant to:
Please check all that apply:
?
Get to the bus stop.
?
Get on or off the bus.
?
Help me while I ride the bus.
?
When I use The Lift or Dial A Ride.
?
Help me get where I’m going once I’m off the bus.
?
Other:______________
_______________________________________
OFFICE USE ONLY
Status ________________________Type _____________________ PCA Required
?
Date Rec’d .___________________Contact ___________________ PCA Optional
?
Office Use Only
Status _____________________________ T
ype__________________ OXY
?
PCA
?
Date Rec’d _________________________ Contact _________________ WC
?
WK
?
Reviewed __________________________ Expiration _______________ CN
?
SA
?
2
3. Using a mobility aid or on your own, how many blocks can you go on
level ground?
?
Less than 2 blocks
?
2 to 4 blocks
?
More than 4 blocks
4. How many blocks do you need to go to get to a RTA bus stop from your home?
?
Less than 2 blocks
?
2 to 4 blocks
?
More than 4 blocks
?
don’t know
5. Do you now use the regular RTA buses?
?
Yes. How many days in one week?_____How many days in one month?___
?
No. Is there something that would help you r
ide the regular bus?
Please check all that apply:
?
A lift accessible bus.
?
A communication aid.
?
Knowing more about RTA bus routes.
?
Learning to go from home to work or school.
?
I would travel if there were accessible bus routes where I need to
go.
?
Other:
_______________________________________________________
6. Can you use the telephone to get bus information?
?
No. Please tell us why:__________________________________________
?
Yes, by myself.
?
Yes, with assistance. What type? ____
____________________________
7. Can you follow written or oral instructions to use the regular buses?
?
Yes
?
Yes, sometimes.
?
No
?
I don’t know because I’ve never tried.
Please check all that apply:
?
I get too confused and might ge
t lost.
?
I probably could with training.
?
I don’t want to ride the regular buses.
?
Other: _______________________________________________________
8. Using a mobility aid or on your own, can you make your way to or from the
bus stop nearest your ho
me?
?
Yes
?
Yes, sometimes.
?
No
?
I don’t know because I’ve never tried.
Please check all that apply:
?
I can’t go that far.
?
I don’t want to ride the regular bus.
?
I probably could with training.
?
I don’t know where the bus stop is
.
?
I can’t find a bus stop because I get confused and lost.
?
My surroundings keep me from getting there.
3
?
I can’t travel to the bus stop in bad weather.
?
I can travel to the bus stop when my health condition is good.
Other:________________________
__________________________________
9. Can you wait 30 minutes at the bus stop that doesn’t have a seat and shelter?
?
Yes
?
Yes, sometimes.
?
No
?
I don’t know because I’ve never tried.
Please check all that apply:
?
I don’t like
to wait that long.
?
I can’t stand that long.
?
I can’t wait that long in bad weather.
?
I can wait 30 minutes when my health condition is good.
?
Other:_______________________________________________________
10. Can you get on and off a regular bu
s when it has a passenger lift (either
standing or with a mobility aid)?
?
Yes
?
Yes, sometimes.
?
No
?
I don’t know because I’ve never tried.
?
I don’t need to use a lift.
Please check all that apply:
?
I don’t want to use a lift.
?
My
mobility aid won’t fit on a lift.
?
I don’t feel secure on a lift.
?
I probably could with training.
?
I can’t steady myself when a lift is moving
?
Other: ______________________________________________________
11. Can you put your money in the fare
box on the bus?
?
Yes
?
Yes, sometimes.
?
No
?
I don’t know because I’ve never tried.
Please check all that apply:
?
I don’t know where the fare box is.
?
I probably could with training.
?
I need help from an attendant or
another passenger.
?
I can’t put my money in the fare box when the bus is moving.
?
Other:_______________________________________________________
12. Can you get on and off a regular bus when it does not have a passenger
lift?
?
Yes
?
Yes, sometimes.
?
No
?
I don’t know because, I’ve never tried.
Please check all that apply:
?
I don’t want to use regular buses.
?
I need a lift.
4
?
I probably could with training.
?
Other:______________________________________________
__________
13. Can you communicate with a bus driver yourself?
?
No
?
Yes
Please check all that apply:
?
I cannot understand the driver.
?
Other people can’t understand me.
?
I need a communication aid and don’t have one. What kind is nee
ded?
________________________________________________________________
?
Other:________________________________________________________
14. Can you transfer from one regular RTA bus to another?
?
Yes
?
Yes, sometimes.
?
No
?
I don’t kn
ow because I’ve never tried.
Please check all that apply:
?
I get too confused and might get lost.
?
I don’t like to transfer.
?
I can’t hold a paper transfer.
?
I don’t want to use regular buses
?
I can transfer if it’s someplace I go all the time.
?
Other: _______________________________________________________
15. Do you know where to get off the bus or can you find out?
?
Yes
?
Yes, sometimes
?
No
?
I don’t know because I’ve never tried.
Please check all that apply:
?
I get con
fused or can’t remember where I am going.
?
I probably could with training.
?
I don’t know where my bus stop is located.
?
I can if the driver calls out the stops.
?
Other:________________________________________________________
16. From where the b
us stops to let you get off, can you make your way to the
place you need to go?
?
Yes
?
No
Please check all that apply:
?
I can’t walk that far.
?
I could with training.
?
I get confused or can’t remember where I’m going.
?
I don’t want to ride th
e RTA bus.
?
The ground is too uneven for me to get there.
?
I need someone to help me get there.
?
Other:_______________________________________________________
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17. Please list your five most frequent trips, and how you get there now?
Origin
Destination
How many times do
you go there a week?
A.______________________________________________________________
How do you get there now?
?
Regular RTA bus service
?
Lift or Dial
-
A
-
Ride.
Other: ___________________________________________
______________
B.______________________________________________________________
How do you get there now?
?
Regular RTA bus service
?
Lift or Dial
-
A
-
Ride.
Other: _________________________________________________________
C.______________________________
________________________________
How do you get there now?
?
Regular RTA bus service
?
Lift or Dial
-
A
-
Ride.
Other: _________________________________________________________
D.______________________________________________________________
How do you get
there now?
?
Regular RTA bus service
?
Lift or Dial
-
A
-
Ride.
Other:_________________________________________________________
E.______________________________________________________________
How do you get there now?
?
Regular RTA bus service
?
Lift o
r Dial
-
A
-
Ride
Other:_________________________________________________________
Questions about training.
18. Have you ever had any training to learn how to use RTA buses?
?
Yes, I learned the following:
Please check all that apply:
?
General bus tra
vel.
?
How to get on or off the bus.
?
To travel to and from bus stops.
?
How to read bus destination signs.
?
How to communicate with bus drivers.
?
I started, but did not finish the training.
?
I received training, but want more so that I can tra
vel.
?
To ride on specific bus routes (please list them):
A. _______________________________ B. __________________________
C. _______________________________ D. __________________________
?
No, but I would like to get training so that I can use RTA buses
.
?
I do not want to receive training.
?
I have not had any training but I am able to use RTA buses.
19. If available, do you want training or re
-
training to use RTA buses?
?
Yes, I want the following training, if it is available:
Please check all that ap
ply:
6
?
General bus travel.
?
How to travel to and from bus stops.
?
How to read bus destination signs.
?
How to communicate with bus drivers.
?
How to ask for help or say no when offered
-
help.
?
How to ride on specific bus routes (ple
ase list them):
A. ____________________________ B. ___________________________
C. ____________________________ D. ___________________________
?
No, I do not want to receive training.
?
I do not think I can travel on RTA buses, even with training.
?
I trained myself but would like an update on training.
Applicant Signature
I certify that the information I have given in this application is true
and correct. I understand that falsification of information may result in
denial of service. I und
erstand all information will be kept confidential
and only the information required to provide the services I request will be
disclosed to those who perform the services.
I also authorize my health care professional to release any and all
information req
uired by the RTA Paratransit Program to determine my
eligibility. I understand that RTA may contact the health care professional
who completed the verification attached to this application, in order to
confirm this information.
Applicant Signature______
______________________ Date ______________
(Required)
If you are not the applicant, but you assisted the applicant with this form, you
must provide the following information: (Please print)
Name__________________________________________________________
A
ddress ________________________________________________________
City____________________________________ST_________Zip__________
Day Phone# _____________________________________________________
Relationship to applicant ____________________________________
_______
I also certify that the information given in this application is correct.
Signature_______________________________Date _____________________
7
+++++++++++++++++++++++++++++++++++++
Part 2. Request For Professional Verification
Dear Health Care Professional:
You are being as
ked to complete and sign the attached application to provide
information regarding the applicant’s disability and its impact upon his/her ability to
utilize our transit services. Federal law requires that the Regional Transit
Authority provide paratransi
t (Lift/Dial
-
A
-
Ride) services to persons who cannot
utilize our regular bus services. Health care professionals must be licensed by the
State of Louisiana and include their professional license numbers on the
application.
RTA paratransit service is provi
ded to persons unable to use regular public
transit service due to any disability. As a result of the disability, they cannot
board, ride, or disembark; or they have a specific impairment
-
related condition
that prevents them from getting to and from a bus
stop.
Please Note:
1.
RTA Paratransit is a limited special transportation service for disabled
persons who, because of a mental or physical disability, find it
impossible
to use regular public transportation.
2.
RTA fixed
-
route buses (regular bus service)
can accommodate people
using wheelchairs and persons who find it difficult to climb the steps on
a bus.
3.
Your verification should consider only the presence of a disabling
condition, not the applicant’s
age
or
economic
status.
Resources for this progr
am are limited. Your evaluation of each person must
be based solely upon the individual’s ability to use regular transit. Please exercise
care in evaluating applicants for this program. False verification could result in
travel limitation for persons l
egitimately qualified to use this program
.
RTA may
contact the certifying health care professional to verify accuracy of the information.
RTA will make the final determination as to the applicant’s eligibility.
The Professional verification
must be fill
ed out
completely and solely
by the
health care professional for processing to occur.
Please Print
. Thank you for your assistance.
8
Part 2. Professional Verification
Applicant’s Name _________________________________________________
Address _________________________________________________________
City/State/Zip _____________________________________________________
1. What is the di
agnosis of the applicant’s disability? Please describe
specifically as possible in layman’s terms. _____________________________
________________________________________________________________
_________________________________________________________
_______
2. Does the applicant’s condition prevent him/her from using regular bus service?
?
No
?
Yes If yes, tell us why _____________________________________
_________________________________________________________________
_____________________
____________________________________________
3. Is the applicant’s condition temporary?
?
Yes
?
No
If yes, expected duration is ________months.
The following information will be used to ensure the appropriate type of vehicle is used
to provide trans
portation, and an accurate analysis of the applicant’s trip request is
processed by the RTA.
4. Does the applicant use any mobility aids?
?
Yes
?
No
If yes, what type?
?
Wheelchair
?
Scooter
?
Walker
?
Crutches
?
Cane
?
Other___
____________________________________________________
5. Can the applicant be transferred from wheelchair/other mobility aid to a
passenger seat if necessary?
?
Yes
?
No
6. Does the applicant need a Personal Care Attendant (PCA) for tr
avel?
?
Yes
?
No
7. Can the applicant travel 200 feet without assistance?
?
Yes
?
No
8. Can the applicant travel one
-
quarter mile without assistance?
?
Yes
?
No
9. Can the applicant climb three twelve inch steps without assist
ance?
?
Yes
?
No
10. Can the applicant wait outside without support for thirty minutes?
?
Yes
?
No
9
11. Is applicant able to give address and phone numbers upon request?
?
Yes
?
No
12. Is applicant able to recogni
ze a destination or landmark?
?
Yes
?
No
13. Is applicant able to deal with unexpected situations or unexpected
changes in routine?
?
Yes
?
No
14. Is applicant able to ask for, understand, and follow directions?
?
Yes
?
No
15. Is applicant able to travel, safely and effectively, through crowded and/or
complex facilities?
?
Yes
?
No
16. Can applicant use regular bus service if travel training is provided?
?
Yes
?
No
Please check only one of the following
:
?
Applicant can use regular public transit buses.
?
Applicant cannot use regular public transit at all.
?
Applicant can use regular public transit only to destinations for which
applicant has been trained.
The Regional Transit Authority’s para
transit program is a federally assisted program. By
signing this document, the below
-
named licensed health care professional hereby certifies
to the truth and accuracy of the above information to the best of his/her professional
knowledge, information, an
d belief under the penalty of applicable federal, state and local
law.
Print:
Health Care Professional's Name ________________________________________
Office Street Address _________________________________________________
City __________________________
___________ State _______ Zip___________
Office Telephone # _________________ La Professional License # ____________
(
Required
)
Signature ______________________________________Date _________________
Please check the one that applies to you:
?
Physician
?
Vocational Rehabilitation Counselor
?
Other: ____________________________________________________