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.
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 REQUESTSAttach 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/StatusOfPublicTransitinOhio2011.pdf
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.
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(in minutes) between stops / Boarding time / Time
(in minutes) / Clients picked up
(LTV-16-2)
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 or 2.5 hours / 16
Return trip / 85 / 153 minutes or 2.5 hours
Total Daily usage / 170 miles / 5 hours / 32 trips
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 1Trips/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:
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.
Section 9 / VEHICLE REQUEST FORMVehicle Types, consult Vehicle Selection Guide to determine appropriate vehicle.
SMV / Standard Minivan / LTN / Light Transit Narrow BodyMMV / 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