Disability Services

Adult Child Abuse Survivor Counseling

Programs that provide therapeutic interventions for adults who, as children, were subjected to a persistent pattern of violence and/or neglect that took place within the family by a parent, guardian, step-parent, sibling or other relative, or outside the home by a friend, neighbor, child care provider or teacher, and who are dealing with the trauma of that experience in their adult lives. Issues may include abandonment, emotional abuse, emotional deprivation, physical abuse, corporal punishment that led to trauma, physical neglect, inadequate supervision, or sexual abuse or exploitation. Counseling is offered in a variety of settings and may include individual, conjoint, family and group therapy sessions.

Adult Protective Services

Programs that provide assistance for adults who are unable to act on their own behalf or manage their own affairs, or who are in immediate danger due to physical or emotional abuse, unsafe or hazardous living conditions, exploitation, neglect or abandonment.

Child Abuse Counseling

Programs that provide therapeutic interventions for individuals and/or families who are experiencing child abuse including abandonment, neglect, or emotional, physical or sexual abuse by a parent, guardian, or other family or extended family member whom the child trusts and who is in a position of power over the child. Counseling is offered in a variety of settings and may include individual, conjoint, family and group therapy sessions for the child, the abusing or non-abusing parent(s) and siblings. Separate sessions may be available for young children who have been victimized and for older children in their teens.

Children's Protective Services

Programs that investigate reports of child abuse, neglect or abandonment; document substantiated cases; provide for the temporary placement of children who, for their own protection, have been removed from the custody of the adults who are responsible for their care; work with families who are experiencing a problem with child abuse with the objective of facilitating continued family unification or reunification; and provide ongoing supportive services for children in permanent placement.

Crime Victim Support

Programs whose objective is to help victims of crimes and their families recover from the trauma of their experience, get medical assistance when required, make their way through the legal system, have an opportunity to provide input to parole or clemency hearings, take appropriate steps, where relevant, to avoid becoming re-victimized, access the benefits to which they are entitled and rebuild their lives.

Domestic Violence Hotlines

Programs that provide immediate assistance for women and men who have experienced domestic abuse which may include steps to ensure the person's safety; short-term emotional support; assistance with shelter; legal information and advocacy; referrals for medical treatment; ongoing counseling and/or group support; and other related services. Hotline staff are generally available via telephone, email, chat and/or text.

Domestic Violence Shelters

Programs that provide temporary emergency shelter for individuals, primarily women, who have experienced domestic violence/abuse, and for their children. Such facilities usually provide in-house individual, group and family counseling and the full range of secondary services related to domestic violence including referral to appropriate resources. Also included are similar facilities for battered men and those that can accommodate both men and women, where they are available.

Human Trafficking Hotlines

Programs that provide immediate assistance for survivors of human trafficking (i.e., individuals who have been abducted, sold, recruited under fraud or pretense or otherwise brought under the control of another person, and forced, by means of threats, intimidation, violence or other forms of coercion, into unpaid or underpaid labor, servitude or prostitution) with the objective of defusing the crisis, ensuring the person's safety and helping the person to get the support they need. Hotline staff are generally available via telephone, email, chat and/or text.

Case/Care Management

Programs that develop plans for the evaluation, treatment and/or care of individuals who, because of age, illness, disability or other difficulties, need assistance in planning and arranging for services; which assess the individual's needs; coordinate the delivery of needed services; ensure that services are obtained in accordance with the case plan; and follow up and monitor progress to ensure that services are having a beneficial impact on the individual. Case management is a collaborative process characterized by communication, advocacy and resource management to promote high quality, cost-effective interventions and outcomes.

Centers for Independent Living

Consumer controlled, community based, cross disability, nonresidential agencies designed and operated within a local community by individuals with disabilities that provide an array of independent living services. All CILs provide five core services: information and referral, independent living skills training, peer counseling, individual and systems advocacy and transition. In addition, many CILs also offer transportation services, mobility training, personal assistance, housing and home modifications, recreation services, vocational programs, assistance in obtaining assistive technology equipment and other individualized services designed to increase and maintain independence.

Assistive Technology Equipment Loan

Programs that enable individuals who have physical or sensory limitations to borrow the assistive technology products they require at no charge. Loans may be long or short-term in nature and the devices are returned once the agreed-upon period of time has elapsed.

Assistive Technology Expense Assistance

Programs that pay all or a portion of the costs associated with acquiring assistive technology products and/or obtaining support services such as customization, fit/modification services or repairs.

Assistive Technology Information

Programs that provide information about cognitive/learning aids, control and signaling aids, daily living aids, hearing augmentation aids, mobility aids, prosthetic/orthotic/seating devices, recreational aids, speech aids, and/or visual/reading aids which enables potential users to evaluate their alternatives and make informed choices.

Assistive Technology Software

Programs that pay for or provide software or applications (Apps) including word prediction, grammar and spell checkers, font size changes, text to speech and reading comprehension programs which enable adults and children with disabilities to do word processing or access content or use other computer programs.

Comprehensive Disability Related Employment Programs

Programs broadly available to individuals with disabilities in general (rather than focusing on special groups within the disability population) that provide vocational assessment, job development, job training, job placement, specialized job situations and/or other supportive services that help people with disabilities prepare for, find and retain paid employment.

Disability Related Center Based Employment

Programs that provide opportunities for individuals with disabilities to learn and practice work skills in a separate and supported environment. Participants may be involved in the program on a transitional or ongoing basis, and are paid for their work, generally under a piecework arrangement. The nature of the work and the types of disabilities represented in the workforce vary widely by program and by the area in which the organization is located. Individuals participate in center-based employment for a variety of reasons including severity of disability, need for additional training or experience, need for a protected environment and/or lack of availability of community-based employment.

Job Development

Programs that seek out and create employment opportunities in various fields for people who need work. Activities may include collecting and distributing information about job opportunities and/or prospective changes in the demand for specific occupations, encouraging potential employers to create jobs, informing employers of available personnel and other comprehensive or targeted efforts to generate new job prospects.

Job Finding Assistance

Programs that help people identify and secure paid employment opportunities that match their aptitude, qualifications, experience and interests.

Supported Employment

Programs that find paid, meaningful work in a variety of community-based settings for people who have disabilities and which assign a "job coach" to work side-by-side with each client to interface with the employer and other employees, and provide training in basic job skills and work-related behaviors, assistance with specific tasks as needed and whatever other initial or ongoing support is required to ensure that the individual retains competitive employment. Included are individual placement models in which a job coach works on-the-job with a single individual and group models such as enclaves (which are self-contained work units of people needing support) and mobile work crews, in which a group of workers with disabilities receives continuous support and supervision from supported employment personnel. In the enclave model, groups of people with disabilities are trained to work as a team alongside employees in the host business supported by a specially trained on-site supervisor, who may work either for the host company or the placement agency. A variation of the enclave approach is called the "dispersed enclave" and is used in service industries (e.g., restaurants and hotels). Each person works on a separate job, and the group is dispersed throughout the company. In the mobile work crew model, a small team of people with disabilities works as a self-contained business and undertakes contract work such as landscaping and gardening projects. The crew works at various locations in a variety of settings within the community under the supervision of a job coach.

Vocational Rehabilitation

Programs that enable individuals with disabilities, people who abuse drugs or alcohol, or people who have emotional problems to obtain the training and employment experiences they need to achieve economic self-sufficiency. Services may include vocational evaluation, work adjustment, work experience, training in marketable skills and placement in competitive employment or a sheltered work environment.

Home Barrier Evaluation/Removal Services

Programs that provide assistance in the form of labor and supplies for people with disabilities who need to install ramps, elevators, stair glides or lifts; widen doorways; install grab bars in showers and bathrooms; lower kitchen and other cabinets; or make other modifications in their homes or apartments to make them accessible. Also included are programs that assess the accessibility of homes and apartments of people who have disabilities and make recommendations regarding necessary modifications.

Home Barrier Removal Grants

Programs that provide cash assistance for qualified people with disabilities who want to install ramps or elevators, widen doorways, install grab bars in showers and bathrooms, lower kitchen and other cabinets or make other modifications in their homes in order to make them more accessible.

Home Barrier Removal Loans

Programs that provide loans to qualified people with disabilities who want to install ramps or elevators, widen doorways, install grab bars in showers and bathrooms, lower kitchen and other cabinets or make other modifications in their homes in order to make them more accessible.

Older Adult/Disability Related Supportive Housing

Residential facilities for older adults and/or people with disabilities who are unable to function in an independent living environment because they need assistance with toileting, bathing, dressing, medication management and administration, meals and housekeeping and other activities of daily living, but do not require nursing care on a regular basis. Living options range from state institutions for individuals with the most severe disabilities who require intensive services to settings that enable individuals with disabilities to live with their own families or in their own homes or apartments with supportive services from community-based supported living providers. Alternatives in between include health care facilities for people with a primary need for developmental services in combination with an intermittent need for skilled nursing care; community care facilities (residential care homes or group homes) for people who require varying levels of supervision and assistance in the activities of daily living; assisted living facilities; continuing care retirement communities; life care communities; foster family placements for adults who will benefit from interaction in a family environment; and semi-independent living facilities for individuals with disabilities who need minimal levels of support to live and work in the community. Some of these facilities are licensed by the state.

Residential Placement Services for People With Disabilities

Programs that maintain information about residential living options for people with disabilities including group homes, foster care, intermediate care, or semi-independent living residences, and link people who are looking for alternative living options with appropriate residential facilities.

Supported Living Services for Adults With Disabilities

Programs for adults with developmental disabilities, sensory impairments, physical disabilities, emotional problems or multiple disabilities who do not require 24-hour supervision that provide a highly individualized, coordinated system of services and supports which facilitates their ability to live in their own homes or apartments, to hire and supervise paid caregivers, to work in the community, to participate in community activities and to interact with nondisabled neighbors. A supported living agency may help the individual hire and supervise an attendant; develop a budget and pay bills on time; learn to shop and cook or hire someone to prepare meals for them; remember to take necessary medication; schedule medical appointments and get to the doctor's office; advertise for and select a roommate; make their living space barrier-free; learn about relationships, sexuality and parenting; select recreational pursuits that are personally satisfying; and accomplish other similar activities of daily living.

Activities of Daily Living Assessment

Programs that evaluate an individual's capacity for self-care and his or her ability to function independently in the context of everyday living and which, where necessary, may recommend rehabilitative services (e.g., independent living skills instruction), supportive services (e.g., attendant care, personal care or home health care), or an alternative residential setting (e.g., an assisted living center or nursing facility). Activities of daily living include bathing, eating, dressing, mobility, transferring from bed to chair and using the toilet. Most assessments also include instrumental activities of daily living such as using the telephone, taking medication, money management, housework, meal preparation, laundry and grocery shopping. Evaluation services are generally provided for individuals who have physical and/or mental limitations or for people whose age may constitute a temporary (children) or developing (elderly) limitation.

Attendant Subsidies

Programs that provide financial assistance for individuals who have physical disabilities to enable them to obtain the services of an attendant to help them in the activities of daily living.

In Home Supportive Services Subsidies

A program administered by the county that provides financial assistance which enables people who are aged, blind or have a disability, are limited in their ability to care for themselves and cannot live safely at home without assistance to obtain homemakers or chore workers to help them in their homes. To be eligible, recipients must meet income and resource guidelines which in some states are tied to Supplemental Security Income (SSI/SSP) eligibility. People who receive SSI/SSP automatically meet the program's financial need requirement. Those whose income is higher than the limits for SSI/SSP may still be eligible, but may be required to pay for part of the services they receive. In addition to the monthly income limits, there are also limits on the amount of resources a person can own and still receive these benefits. Resources include items such as savings, investments, and certain types of property and personal possessions. Eligibility requirements vary by state as do the types of services that can be authorized.

Personal Care

Programs that offer the services of paraprofessional aides who provide assistance with personal hygiene (bathing, grooming and mouth care), clothing care, ambulation, seating, toileting, housekeeping (changing bed linens or other chores that are essential to the individual's health and comfort), food preparation and nutritional and environmental support for recently discharged hospital patients, elderly people and people with disabilities in their own homes or other settings. Personal care may also include supervision which involves cueing, reminding, prompting or directing daily activities, as needed, but does not include medical services.

State Medicaid Waiver Programs

Medicaid programs offered by states that have been authorized by the Secretary of the U.S. Department of Health and Human Services (HHS) to waive certain Medicaid statutory requirements giving them more flexibility in Medicaid program operation. Included are home and community care based (HCBC) waiver programs operated under Section 1915(c) of the Social Security Act that allow long-term care services to be delivered in community settings; managed care/freedom of choice waiver programs operated under Section 1915(b) of the Social Security Act which allow states to implement managed care delivery systems or otherwise limit individuals' choice of provider under Medicaid; and research and demonstration project waiver programs operated under Section 1115 of the Social Security Act to projects that test policy innovations likely to further the objectives of the Medicaid program. Each of the states has developed waivers to meet their needs; and while every state's waiver programs have their own unique characteristics, there may also be common threads.

Centers for Independent Living

Consumer controlled, community based, cross disability, nonresidential agencies designed and operated within a local community by individuals with disabilities that provide an array of independent living services. All CILs provide five core services: information and referral, independent living skills training, peer counseling, individual and systems advocacy and transition. In addition, many CILs also offer transportation services, mobility training, personal assistance, housing and home modifications, recreation services, vocational programs, assistance in obtaining assistive technology equipment and other individualized services designed to increase and maintain independence.

Early Identification Programs

Programs that develop and implement organized plans for locating and identifying children who may be experiencing developmental delays or be in need of special education, and connect them with programs that provide evaluation and assessment services and/or school systems that offer the educational assistance they need.

Early Intervention for Children With Disabilities/Delays

Programs that identify infants, toddlers and in some cases, preschoolers who show evidence of or are at risk for lags in physical development, cognitive development, language and speech development, psychosocial development or self-help skills, and provide or coordinate the delivery of an enrichment program in order to minimize the potential for a developmental delay and to meet their current developmental needs. The program may include early identification activities (child find); a developmental evaluation; a review of family concerns, priorities and resources; meetings with the family to develop an individualized family service plan; service coordination to ensure that the individual and his or her family receive needed services which may include but are not limited to physical therapy, occupational therapy, audiology, health/medical services, nursing services, nutrition services, psychological services including specialized play groups or therapy sessions, counseling, speech and language assistance, special instructional services, transportation, and parenting skills development; and ongoing evaluation of the child's progress and his or her changing enrichment needs. Included are "birth to three" programs and federal, state or local programs that address the needs of slightly older children or children not otherwise eligible for "birth to three" programs.

Special Education Classes/Centers

Programs that enroll exceptional learners for the majority of the school day in special classes or centers that are located on regular school sites and which group pupils who have similar instructional needs. Special classes and centers serve pupils who have intensive needs that cannot be met in a less restrictive learning environment.

Vocational Rehabilitation

Programs that enable individuals with disabilities, people who abuse drugs or alcohol, or people who have emotional problems to obtain the training and employment experiences they need to achieve economic self-sufficiency. Services may include vocational evaluation, work adjustment, work experience, training in marketable skills and placement in competitive employment or a sheltered work environment.

Autism Therapy

Programs that offer any of a variety of therapeutic interventions, which may be used singly or in combination, to address the range of social, language, sensory and behavioral difficulties experienced by children and adults with autism and related disorders. Because of the spectrum nature of autism and the many behavior combinations that can occur, treatment approaches must be tailored to meet the individual needs of each person. Included are behavioral and communication development approaches such as Applied Behavioral Analysis, TEACCH (Treatment and Education of Autistic and Related Communication Handicapped Children), PECS (Picture Exchange Communication Systems), Floor Time, Pivotal Response Treatment (PRT), Social Stories and sensory integration; biomedical and dietary treatments including psychiatric medications, vitamins and minerals (such as Vitamin B6, magnesium and essential fatty acids), treatment using the hormone secretin and special diets; and various complementary therapies such as music, art or equestrian therapy which may be used on an individual basis or integrated into an educational program.

Brain Injury Assessment

Programs that conduct medical tests to determine the extent of brain injuries and the type of treatment and rehabilitation that are needed. Brain injuries may be hereditary, congenital, degenerative or acquired. Acquired brain injuries include central nervous system injury from physical trauma (traumatic brain injuries), anoxia or hypoxic episodes and allergic conditions, toxic substances, and other acute medical/clinical incidents.

Disability Rights Groups

Organizations that support the passage and enforcement of laws or other social measures that protect the rights of people who have physical, mental, developmental or learning disabilities and maximize their ability to enjoy the same opportunities, resources and privileges as the mainstream population.

Health/Disability Related Counseling

Programs that provide emotional support, information and guidance in a variety of settings for individuals who have a disability; who are concerned about or have any of a variety of illnesses, including those that may ultimately be fatal; or who have experienced the disabling or disfiguring effects of an illness, injury or surgery. The counseling may deal with the realities of having a disability or being ill, coping with their illness/disability, life adjustments required by their situation, and helping them evaluate their alternatives and make personal choices that will maximize their ability to function independently. Included are programs that provide counseling for individuals who have a family history of a particular health condition or disability and need assistance in coping with the emotional problems that are associated with having or being at risk for developing the condition.

Health/Disability Related Support Groups

Mutual support groups whose members are people who have specific disabilities, illnesses or other health conditions, their families and friends. The groups meet in-person, by telephone or via the Internet; and provide an opportunity for participants to share information, resources, practical tips for daily living and encouragement about issues related to the disability or health problem.

Home/Community Based Developmental Disabilities Programs

Programs for individuals with developmental disabilities that focus on enabling the individual to attain his or her maximum functional level and which may serve to reinforce skills or lessons taught in school, therapy or other settings. Services may be provided in the individual's home or outside the home in community-based settings.

Life Skills Education

Programs that offer training which focuses on the knowledge and skills an individual may need to live independently or make a successful transition to independent living. Participants may include runaway youth who are living on their own, youth who because of age can no longer be maintained in foster care, new widows, victims of domestic abuse, people who have previously been homeless, and others who have lived in an environment in which decision making and responsibilities of daily living have been handled by another as well as people currently living independently who want to be more effective. Training may address job search and retention, money management, insurance, taxes, rental agreements, vehicle purchase, nutrition, home management, health care, legal emancipation for teens and other similar topics.

Occupational Therapy

Programs that evaluate the task performance skills of individuals who may be having difficulty engaging in self-care, work, play or leisure time activities and help people across the lifespan participate in the things they want and need to do through the therapeutic use of everyday activities (occupations). Occupational therapy services typically include an individualized evaluation, during which the individual/family and occupational therapist agree on the person's goals; customized intervention to improve the person's ability to perform daily activities and reach their goals; and an outcomes evaluation to ensure that the goals are being met. Common occupational therapy interventions include helping children with disabilities to participate fully in school and social situations, helping people recovering from injury to regain skills, and providing supports for older adults experiencing physical and cognitive changes.

Optometry

Programs that are staffed by health care professionals who are licensed to provide primary eye care services including comprehensive eye health and vision examinations; diagnosis and treatment of disease and vision disorders; and prescriptions for glasses, contact lenses, low vision rehabilitation, vision therapy and medications. Optometrists check patient vision using eye charts; measure patient nearsightedness, farsightedness, depth perception and other vision problems using optical instruments; prescribe and fit corrective lenses or other corrective treatments to conserve, improve and correct vision; prescribe training exercises to strengthen weak eye muscles; and counsel patients on contact lens use and care, visual hygiene, lighting arrangements, working distances and safety factors. They may also examine eyes for glaucoma and other diseases and refer patients to ophthalmologists or other physicians and surgeons when ocular or other diseases are found. Optometrists may specialize in fitting visual aids for people who are partially blind, fitting contact lenses or correcting special vision problems.

Physical Therapy

Programs that evaluate joint motion, muscle strength and endurance, heart and lung function and the ability of people to perform activities of daily living; and utilize the therapeutic properties of exercise, heat, cold, electricity, ultraviolet, water, manipulation and massage to improve circulation, strengthen muscles, reduce pain and restore mobility to people who have been disabled by a stroke, arthritis, back or spinal cord injuries or other debilitating conditions. Physical therapists practice in a variety of settings including hospitals, private offices, outpatient clinics, rehabilitation centers, developmental centers, home health agencies, schools and pediatric centers.

Service Animals

Programs that provide and train recipients in the use of animals who have been taught to help individuals who have disabilities increase their mobility and independence and/or maximize their ability to communicate effectively.

Vocational Rehabilitation

Programs that enable individuals with disabilities, people who abuse drugs or alcohol, or people who have emotional problems to obtain the training and employment experiences they need to achieve economic self-sufficiency. Services may include vocational evaluation, work adjustment, work experience, training in marketable skills and placement in competitive employment or a sheltered work environment.

Caregiver Consultation and Support

Programs that provide information, guidance and assistance that supports the ability of family members and other informal caregivers to make decisions and solve problems relating to their caregiving role. The service helps the caregiver find practical solutions to concerns about the health and wellbeing of the care recipient; and may be provided via an advice line or an online chat service as well as in in-person settings.

Caregiver Counseling

Programs that provide emotional support, information and guidance in individual and/or group settings for family members, friends, significant others, non-familial caregivers or attendants who are caring for someone who has a serious illness or disability or who is elderly and increasingly unable to provide for his or her own care, and are feeling overwhelmed by their responsibilities and the effect that their caregiving role has had on their lives.

Caregiver Training

Programs that provide training for family members and other informal caregivers which focuses on care-related activities such as medication management, personal care and making the home environment safe and barrier-free as well as on stress management and other techniques to help the caregiver take care of him or herself. The focus of the training is on building the skills and capacity of the caregiver to manage their caregiving role. Some programs include a caregiver assessment, development of an individualized plan that focuses on the caregiver, setting goals and establishing a routine for ongoing support for the caregiver.

Caregiver/Care Receiver Support Groups

Mutual support groups whose members are family, friends, significant others, non-familial caregivers or attendants who are caring for someone who has a temporary, chronic, life-threatening or terminal illness or disability or who is elderly and increasingly unable to provide for his or her own care. The groups meet in-person, by telephone or via the Internet; and provide emotional support, information and resources to help participants ensure their own well-being while remaining involved in the intense care of a loved one. Also included are care receiver support groups that help people who have a caregiver cope with the fact that they require care. Care receiver support groups are often offered in conjunction with caregiver support groups and are structured to allow care receivers to participate in their own group while their caregiver attends another.

Family Caregiver Subsidies

Programs that use federal, state, local and/or other funding to provide financial assistance for family members (or other persons such as neighbors) who are serving as informal primary caregivers for frail elderly individuals or, in some cases, for adults with disabilities; for grandparents caring for grandchildren; or, in some jurisdictions, for families caring for children with severe disabilities. Age and other eligibility criteria may vary by area. Assistance may be provided in the form of cash to the consumer/caregiver, vouchers which can be redeemed with approved service providers or through pro bono services donated by local service providers to a service bank for family caregivers. The objective of the program is to make it possible for primary caregivers to obtain the assistance they need in order to continue in their caregiving role which, in turn, enables the frail elderly individual or person with a disability to remain in the community.

In Home Respite Care

Programs that provide a brief period of rest or relief for family members, guardians or others who are regular caregivers for children and/or dependent adults by offering temporary or intermittent care for the individual(s) in their own home.

Out of Home Respite Care

Programs that provide a brief period of rest or relief for family members, guardians or others who are regular caregivers for children and/or dependent adults by offering temporary or intermittent care for the individual(s) in a community setting/facility.

Respite Care Subsidies

Programs that cover all or a portion of the cost of respite care in the home or in community settings/facilities in situations where family members, guardians or others who are the regular caregivers for dependent adults or children with disabilities need a brief period of rest or relief from their care giving responsibilities. Families generally select their own provider, negotiate their own rates and set their own schedules.

Carpooling Programs

Programs that make arrangements for people to travel together in private automobiles and/or vans during busy commuting hours or which provide a central telephone number for people to use to identify others who are commuting to and from the same general area with whom they might share. Vehicle options include vanpools and carpools. Vanpools may be publicly or employer operated or organized by an individual who owns or leases a van; the drivers are generally participating as commuters themselves, so are not paid.

Disability Related Transportation

Programs that provide door-to-door (or curb-to-curb) transportation for purposes of shopping, banking, social events, medical appointments, getting to and from work, and similar activities for people with disabilities who need special accommodations and are unable to utilize other available means of transportation. Also included are programs that provide transportation for youngsters with disabilities who have no other means of accessing necessary specialized services and activities. Some but not all vehicles used for this purpose are equipped with wheelchair lifts.

General Paratransit/Community Ride Programs

Programs that provide flexibly scheduled and routed door-to-door (or curb-to-curb) transportation services for the general public. Patrons generally have no private transportation and are unable to use the fixed-route public transportation system; or live in a rural area not served by a public transit system.

Local Bus Services

Programs that utilize buses to transport people to a specific destination (e.g., an airport or senior center) or to other locations within the community (e.g., a shopping mall or downtown) following standard and regular routes and fixed time schedules.

Local Rail Services

Organizations that provide fixed-route rapid rail services which transport people within the limits of a city, a metropolitan area, the county, or a multicounty region, or which move people from outlying areas into a city or metropolitan area. Included are streetcar services, rail-connected trolley services, metro rail services, monorail services and elevated railway services.

Ride App Services

Companies such as Uber or Lyft (formally known as Transportation Network Company Rides or TNCs), which provide prearranged ground transportation that is booked via an app or a website and connects passengers with drivers who use their own, noncommercial vehicles. Various levels of service are generally available and passengers only share the vehicle with others when service at the least expensive level is booked. Some companies may offer a variant arrangement where the passenger uses an online marketplace to retain a driver who drives the customer's own car for them; and a limited number offer accessible transportation options such as wheelchair accessible vehicles equipped with ramps or hydraulic lifts or door-to-door support for riders who may need help with wheelchairs, walkers and scooters or who have a service animal. A number of communities, governments and organizations have established rules and regulations that specifically govern TNCs and, in some jurisdictions, TNCs are completely illegal to operate.