Application for ADA Paratransit Eligibility

This packet includes information you need to apply for Americans with Disabilities Act (ADA) paratransit service in Sacramento County. ADA paratransit service is mandated by all public transportation systems, designed as a safety net for people who cannot use regular bus or light rail by themselves, some or all the time, due to a disability or disabilities. Many individuals with disabling conditions use the regular Sacramento Regional Transit (SacRT) buses and light rail trains. All applicants for SacRT ADA paratransit service must meet the federal requirements of the Americans with Disabilities Act (ADA). An applicant’s functional ability to use accessible buses and light rail trains is the determining factor. ADA paratransit eligibility is strictly limited to those who fall into the safety net described above. The cost for ADA paratransit is $5.00 per trip (or $10 round trip) subject to change. All ADA eligible clients are required to pay fare; there are no SacRT ADA paratransit discounts based on income.

The Steps in the Eligibility Process

Read the ADA Paratransit Eligibility Requirements below. ADA Paratransit Eligibility Requirements.
Complete all questions on the ADA paratransit application. An incomplete application will be returned and will delay processing. Every question must be answered and legible.
The Professional Verification Form must be completed by your physician, or other professional. A hard copy of the form is contained in the mailed packet or select the link here to download the PDF form if you’re completing the application online.
Email, mail, or fax your signed and completed application and professional verification form to: Sacramento Regional Transit District, Accessible Services, PO Box 2110, Sacramento, CA 95812-2110. The application can also be dropped off at the Accessible Services Office at 1221 R St., Sacramento, CA 95811, Monday to Friday from 8:00 a.m. to 5:00 p.m.
If you do not receive written notice of SacRT’s decision within 21 days from the completion of the process (which may require an in-person interview), you may request ADA paratransit services until a decision has been made by calling (916) 321-2877, Option 2, then Option 1, TTY (916) 557-4686, or 711 for hearing impaired.

ADA Paratransit Eligibility Requirements

How does SacRT determine if applicants are eligible for ADA paratransit service?

On September 6, 1991, the United States Department of Transportation issued final regulations under the Americans with Disabilities Act (ADA). These regulations are quite specific in defining who is eligible for this specialized service. A person must have an actual physical, visual, or mental functional limitation which causes him or her to be unable to use accessible fixed-route transportation. The diagnosis of a potentially limiting illness or condition is not sufficient for paratransit eligibility.

The ADA law says the following factors must be considered in determining ADA paratransit eligibility:

A person’s disability and functional abilities.
Accessibility of the fixed-route system.
Architectural barriers. *
Environmental conditions. *

*A person's age, the distance to bus stops, weather, and environmental barriers do not, alone, establish eligibility.

What constitutes a disability?

The ADA defines a disability as a physical, visual, or mental impairment that substantially limits one or more of the major life activities of an individual. Major life activities include caring for oneself, performing manual tasks, walking, seeing, hearing, speaking, breathing, learning, and working.

Who can use ADA paratransit service?

You may be eligible for ADA paratransit service if, because of your specific disability or health-related condition:

You are unable to travel to or from transit stops or stations within the service area; or
You are unable to independently board, ride or exit an accessible fixed-route (bus or light rail) vehicle; without assistance (except the operator of a wheelchair lift or other boarding assistance device), to board, ride, or disembark from any vehicle on the system which is readily accessible to and usable by individuals with disabilities.

How do I apply?

If you think you are eligible, call SacRT's Accessible Services Office at (916) 321-2877, Option 2, then Option 1, TTY (916) 557-4686, or 711 for the hearing impaired and ask to be mailed or emailed an ADA Paratransit Application. Let them know if you need the application in an alternative format such as large print, audio tape, Braille, etc. If you have questions about the application form or need help filling it out, call the Accessible Services Office for assistance.

ADA Paratransit Eligibility Certification

You are required to fill out an application and describe your disability or condition that prevents you from using fixed-route service. Your disability or condition must meet ADA requirements for certification. When SacRT receives your completed application, it will be evaluated, and eligibility will be determined based on your functional ability to use SacRT's fixed-route transit system. You may be asked to attend an in-person interview. Your eligibility will be determined within 21 days from the date you complete your interview and possible functional assessment. You will be notified by letter as to your eligibility status, which will be one of the following:

Unconditional – Due to a disability or health condition, you are always prevented from independently using the fixed-route buses or light rail trains. This level of eligibility allows you to use ADA paratransit services for any trip in SacRT’s defined service area.
Conditional – You are only prevented from using the fixed-route bus or light rail at times when certain disabling or extreme environmental conditions exist. ADA paratransit service is available to you at these times only. (Example: A person who uses a manual wheelchair and who cannot negotiate steep terrain would be eligible for paratransit on a conditional basis when using fixed-route service for a particular trip requires crossing a hilly area.)
SacRT does limit services to conditionally eligible persons on a trip-by-trip basis. For example, a person with a developmental disability who is travel-trained to use regular bus service solely between home and work may only be eligible for paratransit service for trips to other destinations.
Temporary – You have a health condition or disability that temporarily prevents you from using the fixed-route service (can be either conditional or unconditional). (Example: An individual's condition may improve over time or may be aided by travel training.)
Ineligible for ADA paratransit service.

If you are determined eligible for ADA paratransit services, you will receive, in the mail, your eligibility letter and a Rider’s Guide. If it is determined that you are not eligible for services, you will be notified in writing of the exact reasons for this decision and given information on the appeals process.

Please complete ALL sections of this form. An incomplete application will be returned. The information you provide will help determine what type of transportation service is the right service for you. All information will remain confidential.

Download PDF Form

Applicant Information

First Name(Required)

Middle Initial

Last Name(Required)

Mailing Address(Required)

Apt#

City(Required)

State(Required)

Zip Code(Required)

Country(Required)

Phone

Cell

TTY for hearing impaired

If different from mailing address

Home Address(Required)

City(Required)

State(Required)

Zip(Required)

Cross Street

Name of Facility/Apartments

Gate Code

Email(Required)

Date of Birth(Required)

Sex

Male

Female

Please send me written information in an alternate format.

Large Print

Audio Tape

Braille

Other

Español(Spanish)

中文(Chinese)

Русский(Russian)

tiêng Việt(Vietnamese)

Please provide the name of a LOCAL relative/friend in case of an emergency:

Name(Required)

Relationship

Phone (home)(Required)

Cell(Required)

The Sacramento Regional Transit District’s Service Area

SacRT GO ADA paratransit service area is designed to be “comparable” to SacRT’s fixed-route bus and light rail service, providing service to locations within a ¾ mile radius of SacRT’s bus routes or light rail stations during regular service hours. This includes areas within Antelope, Elverta, Carmichael, Citrus Heights, Fair Oaks, Folsom, North Highlands, Orangevale, Rancho Cordova, Rio Linda, Sacramento and unincorporated areas of Sacramento County. SacRT E-van paratransit service goes to Elk Grove. SacRT GO paratransit service does not go to West Sacramento or Roseville with the following exceptions:

Roseville: SacRT GO is able to transport passengers who live in Citrus Heights to the Kaiser Permanente Roseville facilities located at Riverside and at Eureka, and to the Sutter Roseville Medical facilities if you are unable to transfer to a Roseville ADA paratransit vehicle.

There are also transfer points, which can connect passengers to other ADA paratransit services provided in adjacent jurisdictions. Reservationists will provide assistance in arranging your trip to connect at a transfer point, if needed. Reservationists will provide assistance in arranging your trip to connect at a transfer point, if needed.

1. How did you hear about ADA paratransit?(Required)

2. Why are you applying for ADA paratransit service?(Required)

3. What is the main disability or health condition that prevents you from being able to use SacRT’s regular bus or light rail trains? Please be specific (for example: stroke, visual impairment, cognitive impairment, emphysema, schizophrenia, etc.).(Required)

4. Do you have other physical, cognitive, visual or mental health disabilities or conditions that limit your ability to use SacRT’s regular bus or light rail trains?(Required)

Yes

If yes, please explain:(Required)

5. When did you first experience the conditions you described above?(Required)

0-1 year ago

1-5 years ago

Longer than 5 years

6. Is your disability temporary?

Yes, I expect it to last _______months.

No, it is permanent

I don’t know

Enter amount of months(Required)

7. ADA paratransit drivers are unable to perform the duties of a Personal Care Attendant (PCA). Do you need to bring someone to assist you when you travel outside your home? (For example, to push your wheelchair, carry oxygen, etc.)? We do not provide a PCA to riders. If you need assistance beyond what the ADA paratransit driver can provide, please bring someone with you.

Yes; always

Yes; sometimes

No; never

8. How does that person help you complete the purpose of your trip?(Required)

9. Are you able to wait for a regular SacRT bus or light rail train?(Required)

Yes

10. If you checked no, you must explain in the space below, how you are prevented from waiting for a bus or light rail train.(Required)

11. How far can you walk on level ground?

_____feet

Less than 1 block

1 block

2 block

3 or more block

Enter amount of feet(Required)

12. If using a mobility aid, how far are you able to go without help from someone else?

_____feet

Less than 1 block

1 block

2 block

3 or more block

Enter amount of feet(Required)

MOBILITY AID AND/OR EQUIPMENT INFORMATION

If you use a power wheelchair, or scooter, SacRT will need to verify what you and your wheelchair weigh together. Many power wheelchairs and scooters are very heavy. (SacRT ADA paratransit vehicle lifts are designed to lift 600 to 800 pounds, depending on the ADA paratransit vehicle type.) Which of these mobility aids do you currently use when traveling? Please check all that apply to you.

DO NOT SELECT A DEVICE THAT YOU ARE WAITING ON FOR APPROVAL OR PRESCRIPTION

* The ADA defines a “Wheelchair” as a mobility aid belonging to any class of three- or more-wheeled devices, usable indoors, designed or modified for and used by individuals with mobility impairments, whether operated manually or powered.

If you checked manual wheelchair, power wheelchair, or powered scooter/cart, please provide the following information:

Are you able to propel and /or control your wheelchair or scooter without help

Yes

Do you and your wheelchair weigh more than 600 pounds combined?

Yes

What is the make/model of your wheelchair or scooter?

Make

Model

HOW DO YOU TRAVEL NOW?

Please check all that apply to you.(Required)

walk

drive a car

ride in someone’s ca

taxi

bicycle

ADA paratransit

SacRT bus

SacRT light rail train

Other

Do you use SacRT's regular buses and/or light rail trains by yourself?

Yes

If yes, how often?(Required)

Which routes do you use?(Required)

When did you last use SacRT on your own(Required)

Have you ever had training on how to travel around the community or how to use SacRT’s accessible regular buses or light rail trains?

Yes

Never ridden bus/light rail

I am interested in travel training

Never want to ride bus/light rail

If you checked “yes”, please note when and where you received this training.

FUNCTIONAL ABILITIES: USING REGULAR BUSES AND LIGHT RAIL TRAINS

What best describes your functional ability to use the regular buses and light rail trains on your own?

(CHECK ALL THAT APPLY)(Required)

I can get to and from bus stops/stations if the distance is not too far

Because of my disability or medical condition, I have difficulty understanding or remembering all the things I would have to do to use the regular buses and light rail trains.

I can use the regular buses and light rail trains if it is some place I go all the time

I have a visual impairment that causes me to be unable to use the regular buses or light rail trains at times. If checked, please explain how and when your visual impairment prevents you from using fixed route service independently:

I am not able to use the regular buses and light rail trains by myself for other reasons.

Reasons. Please explain(Required)

checkbox6

I would be able to use the regular buses or light rail trains on my own IF:

resons(Required)

CERTIFICATION OF APPLICANT

I understand the information I provided on this application is true and correct to the best of my knowledge. The purpose of this application is to determine if I am eligible to use ADA paratransit services, or if at times I can ride the SacRT regular buses and light rail trains. I understand that falsification of information could result in a loss of ADA paratransit services as well as a penalty under the law. I also understand that, at no expense to me the Sacramento Regional Transit District may require that I participate in an in-person functional evaluation of my travel skills and agree to such a functional evaluation, if one is necessary. I agree to notify SacRT if my condition changes, if my mobility device has been replaced, if I have a new mobility device, or if I no longer need to use ADA paratransit service

(Signature of Applicant)(Required)

Date(Required)

Person Completing Application If Not the Applicant (REQUIRED)

Printed Name(Required)

Relationship to Applicant(Required)

Signature

Date(Required)

Daytime Phone #(Required)

Evening Phone #(Required)

Agency Name (if applicable(Required)