HomeMy WebLinkAboutWS Item 01 - Senior Transportation Program(V � ITEM 0 1 --- --
MEMO TO: HONORABLE MAYOR AND MEMBERS OF THE CITY COUNCIL
FROM: ROGER NELSON, CITY MANAGER
MEETING DATE: JANUARY 16, 2001
SUBJECT: WORKSHOP - SENIOR TRANSPORTATION PROGRAM
(GRAPEVINE SENIOR MOVERS)
Attached is a summary sheet and draft program documents detailing the senior
transportation program discussed at the December 5, 2000 City Council work session.
There was concern at the work session regarding the exact parameters of service that
would be available to the program users, specifically, the use of the service for personal
care appointments. The attached documents more clearly define for what type of
transportation the service may be used. The policy guidelines clearly state that medical
and dental appointments will always have priority. However, transportation to personal
care appointments will be considered based on volunteer availability. The program
users will be encouraged to use the transportation services provided by the Senior
Activities Center whenever possible.
Once this program meets your approval, Staff is ready to move forward.
JCH
January 10, 2001 (10:58AM)
Grapevine Senior Movers
Basic Facts
Program Summary
The Grapevine Senior Mover program is a volunteer service coordinated through
the Grapevine Senior Activities Center that provides transportation for Grapevine
seniors to medical and dental appointments. The program coordinator matches
volunteers with eligible users. Transportation to personal care appointments such
as beauty shops, will be considered based on volunteer availability (the attached
user guidelines make clear the intent of the program). However, Medical and
dental appointments will always have first priority.
Rider Eligibility Guidelines
All Grapevine residents 55 and over who are ambulatory will be eligible for the
service.
Parameters of Service
This program will provide transportation to medical appointments within a 25 mile
radius of the Grapevine Senior Activities Center. Appointments for personal care
will be provided within the City limits of Grapevine. Users are asked to utilize the
services of the Senior Activities Center for grocery shopping and other available
services.
Rider Safety
Because of the vulnerability of some riders, volunteer drivers are asked to
consent to a criminal history and driving record check. Volunteers may be
disqualified based on this data.
Volunteer Liability and Safety
Volunteers are required to show proof of liability insurance coverage. In the event
of an accident, if the senior is in the vehicle, the City's umbrella policy will
supplement the volunteer driver's own coverage up to $1 million. In addition, the
City will reimburse the driver for his/her deductible up to $1,000 per occurrence
should that apply. The City reserves the right to refuse service to any rider for
any reason.
GRAPEVINE SENIOR MOVERS
TRANSPORTATION COORDINATOR
DUTIES/RESPONSIBILITIES
• Manage Program
• Advertise Program and need for Volunteer Drivers
• Accept applications and interview Volunteer Drivers
• Accept applications and interview Users
• Manage background information
• Establish and maintain data bases
• Match Users with available Drivers
• Confirm assignments
• Provide transportation as needed
• Prepare monthly reports
• Report to Senior Activities Center Director
• Manage telephone calls and general office duties pertaining to Program
• Maintain records, including reports of Program abuses, incidents, etc.
• Place follow up calls as necessary
Policy Statement
Motor Vehicle Record/Criminal History/ Social Security # Verification
STATEMENT
In an effort to protect senior participants using the Grapevine Senior Mover
Program with the CITY OF GRAPEVINE, criminal background checks, motor
vehicle record history, and social security number verification will be mandatory
for all volunteer drivers.
Volunteer driver applicants must sign a Consent form. This will give the CITY OF
GRAPEVINE the right to check criminal history records, driving records, and
verify social security numbers. Any applicant who has lived in a state other than
Texas within the last 7 years is subject to a nationwide search. Background
checks will be performed by a private screening company and may take up to 3
days to complete. Reasons for being declined the opportunity to volunteer
follow. In some instances, factors of time may be taken into account when
considering volunteer driver eligibility.
A committee consisting of the Senior Activities Center Director, Recreation
�- Superintendent, and the Director of Parks and Recreation and/or his designee,
and the City's attorney, as needed, will review background check information to
determine eligibility. All information is strictly confidential to the extent
allowed by law. The decision of this committee is final and may not be
appealed. All criminal history record information will be promptly destroyed
following determination of the suitability of the candidate for a volunteer driving
position.
Any volunteer driver, who while driving Seniors for the CITY OF GRAPEVINE, is
arrested for committing an offense per the attached list, will immediately forfeit
his/her eligibility until disposition by the courts. A conviction on an offense as
listed will result in termination of volunteer driving eligibility as stated in this
policy. Volunteer Drivers are required to notify the CITY OF GRAPEVINE if
arrested or convicted of a listed offense at anytime during their volunteer driving
term.
Page 2
TIME FRAME
All Volunteer Driver candidates will be checked one time annually, to coincide
with the City's operating year, October 1 — September 31.
The following is a list of offenses that would prohibit qualification of a volunteer
driver candidate.
Arson
Assault (including aggravated and sexual)
Aggravated Kidnapping
Aggravated Robbery
Crimes against Children
(Including abandonment, abuse, endangerment, pornography, possession
or promotion of pornography, enticement, solicitation, sales or purchase
of, injury to, indecency)
Criminal Nonsupport
Criminally Negligent Homicide
Deadly Conduct
Delivery or possession of Marijuana
Incest
Manufacture of or Delivery of a controlled substance or dangerous drug
Any violation of a law intended to control the possession or distribution of any
Controlled substance or illegal drug
Indecent Exposure
Injury to elderly or disabled
Intoxication Manslaughter
Kidnapping
Manslaughter (involuntary or voluntary)
Murder (including capital murder)
Obscenity
Prohibited Sexual Conduct
Prostitution (including promotion of, aggravated promotion of)
Public Lewdness
Rape
Sexual abuse
DWI/DUI
Theft
GRAPEVINE SENIOR MOVERS — VOLUNTEER CHAUFFEUR GUIDELINES
This program has been organized to assist our City's Senior Citizens with the
transportation needs that are not currently provided by Senior Activities Center
transportation, or by NETS (Northeast Transportation System).
Each Volunteer Chauffeur driving their personal vehicle on behalf of the
Grapevine Senior Movers program will receive insurance coverage for excess
over any valid and collectible liability coverage that is in force through the vehicle
owner's policy, while a Senior is being transported. This coverage is under the
Hired and non -owned portion of the City's comprehensive automobile insurance
policy with Hartford Insurance Company. The provision is for $1,000,000.
combined single limit, per accident. The CITY OF GRAPEVINE is also prepared
to re-imburse the volunteer up to $1,000.00 for related deductible charges, while
transporting a Senior within the Program.
1.
Each Volunteer must complete an application, and provide proof of insurance,
as well as information for Motor Vehicle Record History checks, and criminal
background checks to be conducted by the CITY OF GRAPEVINE.
2.
Each Volunteer will provide vehicle maintenance, fuel, and safety inspections.
3.
For your protection,. please do not enter a Rider's home, or share your
personal information with the Rider.
<'4.
Volunteers will call in advance of the trip to introduce themselves, to reassure
the Senior Rider they will be taken care of, and confirm transportation
information.
5.
Volunteers will not be required to remain with the Rider for appointments, but
should not forget to make arrangements for a timely pick-up.
,6.
Notification should be made as early as possible if you are unable to provide
the transportation assistance for a Rider that you have been assigned to.
7.
It is strongly recommended that no Volunteer feel obligated to do any lifting
that could cause injury to themselves, or the Rider.
8.
Special Needs Riders will be referred to NETS (Northeast Transportation
System).
9.
Requests or demands for a particular Volunteer may not be approved.
10.
The Volunteer will be asked to only provide the transportation reserved from
Point A to Point B, and return. Please do not allow unscheduled stops.
11.
Rider guidelines are provided for your benefit, and your protection. It will be
very important they be followed. Basic consistency and integrity of the
program must be maintained.
12.
We will reserve the right to refuse service to any rider found to be abusing the
Volunteers generosity, or the Program itself.
H:\GRAPEVINE SENIOR MOVERS.doc12/22/00
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GRAPEVINE SENIOR MOVERS
The following information is required to become a volunteer driver for the
Grapevine Senior Movers program. information is considered confidential to the
extent allowed by law. By signing this application, you are agreeing to follow the
guidelines that have been set forth for your protection, as well as that of the rider.
Name Driver's License #
(copy attached)
Address State Exp. Date
City
Phone H} ------------
Zip Code,
Availability Monday
AM
PM
For Destinations
Tuesday
AM
PM
Grapevine
Wednesday
AM
PM
Mid -cities
Thursday
AM
PM
Dallas
Friday
AM
PM
Fort Worth
Vehicle
Information #1. Make Model
#2. Make
Insurance Company
Policy #
LIG. #
Exp. Date,
Page 2
Would you have difficulty dealing with a special needs rider?
Wheelchair
Yes
No
Cane
Yes
No
Walker
Yes
No
Crutches
Yes
No
Scooter
Yes
No
Pet Assistant
Yes
No
Oxygen Equipment
Yes
No
Other
Personal Information
Emergency Contact
Hospital Preference
Physician Name
Physician Number—
SIGNATURE
Phone
STAFF INITIALS
CITY OF GRAPEVINE
RELEASE FORM FOR CRIMINAL HISTORY BACKGROUND CHECKS
In connection with my application for a volunteer driver position with the CITY OF
GRAPEVINE, I understand that an investigative report which may contain public
record information may be requested or made on me including criminal record,
driving record, and social security number verification. Further, I understand that
you may be requesting information from various federal, State, local and other
agencies regarding my past activities.
I hereby authorize without reservation, any party or agency contacted by the
CITY OF GRAPEVINE to furnish the above-mentioned information.
I understand that any information received regarding my past activities will be
destroyed once volunteer driver eligibility has been determined.
I have read, understand and agree to abide by the CITY OF GRAPEVINE
criminal history background check policy.
This authorization and consent shall be valid in original, fax, or copied form.
=0 31
Print Name
Signature,
1P,RAPRTI\ylf`j,
MOTOR VEHICLE RECORD/CRIMINAL HISTORY/
SOCIAL SECURITY NUMBER VERIFICATION INFORMATION
PLEASE PRINT
Last Name First Name Middle Initial
Driver's License # State Sex Date of Birth
Social Security #___-__--_—_
List all previous addresses for the last seven (7) years, and approximate dates
you resided there.
Address City County Zip Code Dates
Signature of Applicant Date
This information will be detached before your paperwork is reviewed. The
information on this form will only be used to check those items as specified
above.
Falsification of this document or any other document completed during this
process shall result in your removal from the selection process. Falsification of
such documents may also lead to termination of volunteer driving if found at any
time.
GRAPEVINE SENIOR MOVERS — QUALIFIED USER GUIDELINES
1. Eligibility qualifications will be Grapevine residency, age 55 and over, and
only those with physical conditions permitting them to be transported by
Volunteers, in personal vehicles. Special needs will be referred to NETS.
2. Service Hours will be limited to 8 AM — 4 PM, Monday through Friday.
3. Applications must be completed for each Rider, in advance of first request. If
at all possible, Initial interviews and paperwork should be accomplished at the
Senior Activities Center.
4. A minimum of 48 hours notification of need will be requested.
5. Requests for service will be accepted at the Grapevine Senior Activities
Center from 9:00 am to 12:00, Monday through Friday.
6. Medical and Dental trips will be limited to a 25 mile radius of the Grapevine
Senior Activities Center, while personal care needs should remain within the
Grapevine city limits.
7. Medical and Dental trips will receive top priority. Based on Volunteer
availability, personal care needs will also be considered.
8. Service will be Curb to Curb.
9. Volunteers will not be allowed to enter the user residence.
10. Volunteers will not be required to perform any lifting.
11. Volunteers should not be asked to share any personal information.
12. Transportation provided by the Senior Activities Center should be utilized for
scheduled activities, such as grocery shopping, & other outings.
13. Volunteers will be required to provide information for Driving History, and
background checks.
14. Each Rider will be asked to sign a Waiver.
15. The Volunteer will be calling the Rider in advance of the trip for confirmation
purposes.
16. Volunteers will not be required to remain with the Rider for the duration of the
appointment, but should be informed of the appropriate time to return for pick-
up.
17. Riders are not to abuse volunteer generosity by asking for additional stops.
Scheduled reservations are to be adhered to.
18. This service is for transportation only. Please do not ask volunteers to run
errands, or provide any type of assistance, other than transporting from Point
A to Point B, and return.
19. We reserve the right to refuse service to any rider for any reason.
20. It must be understood, this is a free service for the Senior Citizens of
Grapevine, but will be dependent on Volunteer Drivers to meet the
demand. There could conceivably be occasions when a Volunteer is
not available.
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GRAPEVINE SENIOR MOVERS
USER APPLICATION
The following information is required to become eligible for the Grapevine Senior
Movers program. Information is considered confidential and will be treated as
such, being used only as necessary to accomplish the ultimate goal. By signing
this application/waiver, you are agreeing to follow the guidelines that have been
set forth for your protection, as well as that of the volunteer driver.
Last Name
First Name MI
Address
Phone
Birthdate Month _ _ Day__ Year____
a Special Needs
Wheelchair
Cane
Walker
Crutches
Scooter
Pet Assistant
Oxygen Equipment
Other
�- AR
EMERGENCY INFORMATION
Hospital Preference
Primary Care Physician
Phone Number
Emergency Contact Information
#1 Name Relationship
Phone H)------ ----
C)---"---"----
P)---"---"----
WAIVER: I/WE DO HEREBY RELEASE, ABSOLVE, INDEMNIFY, AND HOLD HARMLESS THE CITY OF GRAPEVINE
AND ITS EMPLOYEES, AND VOLUNTEER DRIVERS, ANY AND ALL OF THEM IN THE EVENT OF ANY ACCIDENT,
INJURY, OR DEATH SUSTAINED BY THE ABOVE NAMED PARTICIPANT WHILE BEING TRANSPORTED, FROM
ANY LIABILITY OF ANY KIND WHATSOEVER. VWE ALSO GIVE PERMISSION FOR ANY PHOTOGRAPHS TAKEN
TO BE UTILIZED FOR PROMOTIONAL USE BY THE CITY OF GRAPEVINE NOW AND IN THE FUTURE. ANY
OFFENSIVE CONDUCT, DISCRIMINATION, HARASSMENT, OR SEXUAL HARASSMENT OR OTHER CONDUCT
OFFENSIVE TO A PERSON, REGARDLESS OF GENDER, RACE, COLOR, RELIGION, OR NATIONAL ORIGIN,
COMMITTED BY THE PARTICIPANT TOWARDS ANOTHER PARTICIPANT, CITY STAFF, OR VOLUNTEER DRIVER
SHALL BE PROHIBITED AND SHALL RESULT IN IMMEDIATE REMOVAL OF SAID PARTICIPANT FROM THE
PROGRAM.
SIGNATURE
DATE STAFF INITIALS
REQUEST DATE
USER NAME
GRAPEVINE SENIOR MOVERS
TRIP REQUEST
REQUEST TIME
USER PHONE NUMBER------------
PICK
UMBER--PICK UP ADDRESS
DRIVER PHONE H) --------
PICK UPTIME a
DESTINATION ADDRESS
DESTINATION PHONE NUMBER --------
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SPECIAL NEEDS
STAFF INITIALS
REQUEST / RESPONSE LOG
USER NAME
REQUEST DRIVER TRIP TRIP NO SHOW
DATE CONFIRMED COMPLETED CANCELLED