The document discusses ideas generated at a brainstorming session on how to start and expand paratransit services for people with disabilities in less wealthy regions. Some key ideas included using smaller, more affordable vehicles like cycle rickshaws; promoting better planning and accessibility of vehicles; and exploring funding sources as well as sustainable service models including community-based and microfinancing approaches. Over 140 comments and ideas were discussed on topics like vehicle options, operational concerns, funding, and creating customer-focused service models.

1. Paratransit for All: Thinking outside the box
In most countries, door-to-door transport services
are not available to persons with disabilities and
others who most need them. On January 17, 2013,
24 transport specialists from the Americas, Asia,
and Europe met together in Washington, DC, to
brainstorm how to start up and scale up paratransit
for mobility-impaired persons in less-wealthy
regions. Here are some of their ideas.
Photo by Tom Rickert, AEI
Participants in the brainstorming session are shown during a break in the
proceedings, held in facilities donated by the American Public Transportation
Association. The session was co-sponsored by Access Exchange International
(San Francisco) and the Intl. Centre for Accessible Transportation (Montreal), and
was part of a series of annual roundtables on accessible transport in developing
regions. A list of participants is attached at the rear.

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Introduction
85% of the world's people live in the 127 countries that have ratified the United Nations
Convention on the Rights of Persons with Disabilities. These countries have agreed to "take
appropriate measures to ensure to persons with disabilities access, on an equal basis with
others, to the physical environment (and) to transportation . . "1 While many countries have
laws and regulations in place promoting or requiring access for persons with disabilities, one of
the biggest needs is to go beyond laws on paper to actually take action! In the world's growing
cities, concrete actions are needed in three main categories: (1) access to sidewalks, street
crossings, and other public space; (2) access to buses, trains, and other "fixed route"
transportation; and (3) access to smaller paratransit vehicles. Many earlier roundtables in this
series have focused on the first two areas, while the purpose of our meeting this year was to
discuss practical methods to promote access to door-to-door paratransit services provided by
vans, taxis, auto- and cycle-rickshaws, and similar small vehicles.
Although the situation varies sharply from country to country, the access and affordability of
door-to-door services for those unable to get to bus stops or train stations is
especially problematic. This situation has led Access Exchange
International to publish our new guide, Paratransit for mobility-impaired
persons in developing regions: Starting up and scaling up, available to
www.globalride-sf.org/paratransit/Guide.pdf. The preparation of this guide
revealed the need for fresh ideas – especially for the sustainable financing of
paratransit services affordable to disabled persons – which in turn led us to
use a brainstorming method which encourages all ideas by "thinking outside
the box" in a non-judgmental environment. The result was an outpouring of
nearly 140 comments and ideas in a session moderated by Tom Rickert of AEI, who also
recorded the comments. This report attempts to organize the main themes developed during
our meeting together, arbitrarily beginning with issues of use of smaller vehicles and practical
operational concerns in order to provide a background for the themes that provoked the most
comments: how to create sustainable service models and funding for paratransit services. The
themes are so inter-connected that the reader will quickly notice that the ideas tend to overlap.
Some comments contradict others, which is natural in a brainstorming session. Readers may
sharply disagree with some ideas while supporting others. By all means let us know your own
comments!2
Comments and ideas, grouped and edited by themes and topics
Theme # 1: Explore smaller less-expensive vehicles, not forgetting new technologies
• Participants from India noted the potential of cycle-rickshaws and auto-rickshaws to expand
inexpensive paratransit for disabled passengers. This theme was a followup to similar ideas in
the new guide to paratransit services noted above. . . . A central agency is needed to mandate
safety features and place limits on the number of auto-rickshaws to avoid congestion. . . . Cities
may lack local autonomy to regulate smaller vehicles due to national transport policies.
Problems include harassment of auto-rickshaw drivers by police, who often demand bribes from
the drivers. Other comments also focused on corruption and varying attitudes toward corruption.
1
Article 9 of the UNCRPD
2
Comments may be directed to AEI's Executive Director, Tom Rickert, at tom@globalride-sf.org

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Paratransit drivers need to be sensitized to the needs of passengers with disabilities. Incentives
for drivers need to be developed for this purpose.
• More neighborhoods in cities may need to be opened up for rickshaws. . . . Cycle-rickshaws
and other vehicles need to be further developed to handle all terrains. . . . On-call centrally
dispatched auto-rickshaw services are needed, not only for passengers, but also to run errands
for disabled persons and others. An advantage of small cycle-rickshaw operations may be that
the drivers are known to the community and more likely to be trusted by disabled passengers.
Planners and officials need customer service training, with a hands-on approach requiring them
to experience driving an auto-rickshaw. . . . What would be the role of NGOs in carrying out
these ideas?
• Paratransit in rural areas may need to be combined with postal, ambulance, and school bus
services. Packages could be delivered by such vehicles as they ply to and from medical
facilities and other stops.
• Technology is opening up new options. Call centers, GPS-powered apps, and swipe cards
and other electronic fare payment technologies can ultimately make small vehicles such as
three-wheelers more available to disabled passengers. Social media will play an increasing role
for both paratransit providers and their customers.
Theme # 2: Promote better planning, vehicle design, and operation of paratransit vehicles
and services
• Younger urban planners need to be educated concerning disability. . . . Planners in India need
to be educated to incorporate paratransit feeder services to BRT and other bus and rail
transport, including the use of auto- and cycle-rickshaws with accessibility features to connect
with accessible Bus Rapid Transit routes. . . . Planners need to include paratransit options in
their work on future infrastructure and development, with more emphasis on intermodal
connections (cycle-rickshaw to BRT, etc.). . . . Planners should consider exclusive rights-of-way
for auto-rickshaws and for cycle-rickshaws and other non-motorized vehicles: For example,
rickshaw lanes already exit in Bangalore. . . . There are many stakeholders: Unions, if any, or
informal associations of paratransit drivers or owners, need to work cooperatively.
• Let's make sure we ask the people who operate paratransit services what they want and not
assume we know the answers. Operators need incentives to serve customers with disabilities.
We also need more feedback from passengers: this will help establish standards for on-time
reliability and safety. . . . Legislation is needed in many countries to require more accessible
paratransit vehicles and funding is needed to provide incentives.
• Maintenance and operation costs need to be contained. These and other functions could be
pooled to provide economies of scale for service providers. . . . Stakeholders need to
understand what markets are served, select service areas, and look at paratransit feeder
services to bus and rail lines. They need to learn how to schedule different categories of trips
and the technical issues of handling trip requests, including when and how to use dispatching
software or real time dispatching with cell phones. Local sources could provide maintenance,
and the manufacturing of simple vehicles such as cycle-rickshaws could occur locally. . . .
Written standards are needed for vehicle maintenance. . . . Fuel economies and global

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warming/pollution issues need to be addressed. . . . Wheelchair manufacturers need to make
their equipment usable on transport systems.
• Attention must be paid to eligibility criteria for subsidized systems, which gets into thorny
issues of prioritizing rides by trip purpose. . . . Paratransit services might best start small and
develop political support before growing too fast.
• Recruiting and training drivers is important. Service providers need to understand issues of
hiring, training drivers, firing drivers when necessary, and drug and alcohol and safety issues. . .
Incentives are needed to hire persons with disabilities as workers within the system. . . . More
women should be considered as drivers: they would probably create a greater degree of
community trust in systems that serve vulnerable populations, including persons with disabilities.
• Stakeholders need to understand the use of attendants. . . . Dog guides and service animals
may be needed. Some passengers may have behavior issues and this needs to be thought
through. . . . Women and older persons can be vulnerable to predatory drivers.
• Prospective passengers need travel information that is usable by those with cognitive issues.
Users need to be taught how to use the service. . . . Color and format is important. . . . There
may be cultural impacts in regard to the sense of time. . . . Best practices need to be collected
and promoted.
• Rural access is especially needed. Existing experience should be considered: For example,
Canada has vast rural areas and their experience with paratransit services can be taken into
consideration. . . . Vehicles could be better designed to cope with weather, terrain, and poor
roads.
Theme #3: Take full advantage of potential funding sources
Many comments concerned taking full advantage of funding sources which may be available in
different countries. . . . Champions are needed to advocate for long-term commitments to
sustainable funding for paratransit services for disabled passengers.
• Several comments focused on the need for small startup capital grants or loans to assist
NGOs or entrepreneurs needing to get over the hurdle of the original cost of vehicles but able to
sustain ongoing regular operating costs. In the USA, federal funding often covers 80% of the
initial cost of accessible paratransit vehicles to serve disabled passengers, helping to produce
47 million door-to-door trips per year at a federal subsidy of only US$2.80 per trip. . . .
Governments could also assist with tax breaks for paratransit agencies that demonstrate good
service for disabled patrons. . . . Development banks (the World Bank, the Asian Development
Bank, etc.) need to look at ways to encourage private sector and NGO startups to provide
paratransit services for vulnerable populations and connect them with bus and rail lines. These
and other funding sources could take into account the increased revenues for businesses when
more people have access to their services and products.
• Tax monies to subsidize paratransit may come from taxes on fuel, a sales tax, hotel tax, or
licensing fees. Taxes could also come from road pricing (tolls or other types of direct payments
by road users could go to defray paratransit costs for disabled passengers). Tax cuts could be
provided to manufacturers of vehicles with improved access features. . . . Government funding is

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needed that can survive political changes. For example, when Mexico changes governments
every six years, the new administration may not sustain efforts of the previous administration.
• Other creative approaches are needed. . . . Advertising could gain exposure for businesses to
help sponsor vehicle costs. . . . Funds may be available for specific groups (e.g., special
transportation for veterans noted in Houston, USA). . . . Some subsidies could come from
employers that provide credits if employees use commuter vans: Cape Town is considering this.
• A change in thinking is required: paratransit is part of all public transit and deserves the
favorable treatment provided in some cases to bus and rail systems, especially in the funding of
initial capital costs such as designated rights-of-way and stations. . . . Mobility is a right, a social
freedom, and everyone should pay
Theme #4: Create more sustainable service models
• Many comments focused on exploration of government, NGO, and entrepreneurial models,
with special emphasis on encouraging small private operators and fostering ways to help make
their services profitable. Investors need a legal environment within which they can understand
the risks and have reason to expect a return on their investments. . . . Existing paratransit
companies may wish to start up new enterprises for specific markets such as persons with
disabilities.
• Many comments encouraged customer-driven service models, stating that local communities,
not governments, should ideally decide who provides service. . . . "Empowering activism" needs
to be a key theme. . . . One comment spoke of "the efficiency of the system vs. the efficiency of
the market.". . . Traditional "medical models" for paratransit service need to be expanded to
cover other needs. Service models should be market driven, not planner driven. . . . Western
models often do not apply to less-wealthy countries. For example, highly subsidized paratransit
services will not be available in India, and communities need to think creatively about how to
meet their own needs.
• Some kind of paratransit broker or mobility manager may be needed to put it all together,
fostering a variety of services, but with local governments serving all providers in non-
controversial ways, such as fostering economies of scale when it comes to fuel, maintenance,
driver training, or insurance, or helping to recruit volunteer staff: The good experience of the
USA and United Kingdom in the use of volunteers can serve as a model. . . .
• One or more city employees could be tasked to find out which NGOs and which commercial
taxi and van companies offer services for at least some residents with mobility, sensory, or
cognitive impairments. . . . This might be the time to publish (or have someone else publish) a
directory of how to access these services. Who is already offering these services? Can a city
convene stakeholders to work together to create less expensive driver training, fuel,
maintenance, or insurance?
• Relationships need to be built with customers. Local communities should ideally drive service
decisions. . . . For example, when services are subsidized, vouchers could be given to those
needing services, letting them choose among paratransit providers.
• This implies a close look at regulations. Some comments questioned how much licensing,
regulation, inspection, enforcement, accountability, and reporting on the use of funds is

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needed. How much is not needed if new services are not to be regulated to death? In countries
such as India, governments cannot be relied upon to enforce existing procedures. . . . Let's
unchain entrepreneurs to go out and invent new service models! . . . In some cases,
paratransit systems, even accessible systems, may need to evolve in a haphazard manner until
they mature: such systems should not be over-regulated. Spontaneous growth of paratransit
should be encouraged. (Yet another comment noted that excellent customer service is needed
in order to grow the systems for persons with disabilities. Checks and balances are needed,
and attention must be paid by even informal providers to matters such as making service
information available in accessible formats.) . . Some NGOs and charities have far more
experience with paratransit for their clients than do entrepreneurs: they may be able to help train
the private sector. Private for-profit services and non-profit NGOs face many of the same
problems. Peer data is needed to help entrepreneurs, especially assisting them as they plan to
start up.
• Several comments looked at the role of the community. People could organize locally for
paratransit to serve just their own district (a variation on the idea of dividing cities up into
paratransit zones in order to save money for more trips by keeping the trips shorter). If
customers want to travel outside their zone, higher fares could be required. . . . Perhaps younger
people could "buy in" to supporting a local paratransit system for use when they get older. Or
relatives or other volunteer drivers could get credit for future rides when they needed them.
More flexible paratransit services might result: delivery trucks could use any extra capacity to
carry passengers. . . . Those disabled persons who do not need to remain in wheelchairs could
take part in ride-sharing schemes or car pooling. . . . Community paratransit cooperatives could
be formed. . . . Self-forming groups could use social media, instead of being formed by an
existing company or dispatcher. Sliding scales for fares could apply to more vulnerable
paratransit passengers. . . . A "quasi-schedule" could be issued, while self-directed grouping
could modify the schedule and channel demand for trips more efficiently by using mobility-
management principles. Shuttles and flex routes could result from this self-organizing demand
("Yes, we can carry five bags of groceries OK on Thursday after 4 p.m." or "Yes, we will reserve
an inside-space for this disabled person in our jitney at x hour.") Students could be involved to
help solve community issues. . . . The community could work directly with "trip generators" such
as major institutions or shopping centers.
• When government funding is available for accessibility, communities could decide on their
priorities, for example, for pedestrian infrastructure first, then paratransit, or the opposite, as they
consider the specific factors impacting their situation.
• In the context of looking at community approaches, several comments focused on
microfinancing. . . . What about utilizing the international web-based micro-finance enterprises
which permit donors to put in small amounts to assist entrepreneurs? . . . Provide service now
and bank it as a credit vs. receiving service in the future: barter services using social media. . .
Paratransit services could be kick-started with crowd funding and micro-financing. . . . Pre-paid
subscription service could be paid by the community or by individuals. . . . How about gift
cards, donating cars, or air miles donated to charity. . . The concept of "lifetime productivity
years" should be considered in funding social mobility.

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Participants:
Dana Baldwin, National Council on Independent Living, USA
Daniel Blais, Transport Canada
Pamela Boswell, American Pubic Transportation Assn.
Robert Carlson, Community Transportation Assn. of America
Phoebe Chan, International Center for Accessible Transportation, Canada
Sonal Chaudhry, Jindal Saw, India
Todd Litman, Victoria Transport Policy Institute, Canada
Eileen Lu, Eden Welfare Foundation, Taiwan
Stein Lundebye, Consultant to the World Bank
* Abha Negi, Svayam, India
Bill Orleans, Hack, USA
Karen Peffley, Disability and Development staff, World Bank
Aleksandra Posarac, Team Leader, Disability and Development, World Bank
Tom Rickert, Access Exchange International, San Francisco
Lilian Salazar, Instituto Tecnológico de Monterrey, Mexico
John G. Schoon, University of Southampton, UK
* Richard Schultze, RLS & Associates, USA
Lalita Sen, Texas Southern University, USA
Anabela Simões, Instituto Superior de Educação e Ciencias, Portugal
Ling Suen, International Centre for Accessible Transportation, Canada
* Russell Thatcher, TranSystems, USA
Joe Wang, Eden Welfare Foundation, Taiwan
* Annette Williams, San Francisco Municipal Transportation Agency, USA
Karen Wolfe-Branigin, Easter Seals Project ACTION, USA
* These individuals also served as discussants to briefly introduce different sections of the
brainstorming session.
Access Exchange International
112 San Pablo Avenue
San Francisco, CA 94127, USA
1-415-661-6355
tom@globalride-sf.org
www.globalride-sf.org