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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 w 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. C:\WINDOWS\TEMP\GRAPEV12.doc01/1 1/01 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 -------- ..I IN gel 0.11■.ol SPECIAL NEEDS STAFF INITIALS REQUEST / RESPONSE LOG USER NAME REQUEST DRIVER TRIP TRIP NO SHOW DATE CONFIRMED COMPLETED CANCELLED