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GETTING THERE TOGETHER

A year of listening to New Hampshire, 2,774 residents deep. What we found, what we built, and what we do next

NH Community Transportation Needs Assessment · Presented by Lily Wellington (NH Commission on Aging)

[BOTH OPEN — Jen lead] Good afternoon. We're Jen and Lily from Impact Consulting. For the past year-plus, the Commission on Aging has had us doing one thing: listening to New Hampshire about how people actually get where they need to go.��And "we" is the wrong word, honestly. Many of you in this room are the reason this exists. The Advisory Group that guided it, the RCCs that opened doors, the Mobility Managers who connected us to riders. We'll thank you properly at the end, but know from the start: this is your work as much as ours.��The theme says it exactly. Mission Critical, Mission Possible, Mission Go. So: why it's critical, the proof it's possible, what it takes to go.��[Replace LOGO placeholder with the official COA logo on every slide. Replace slide 4 with the verbatim CTNA-E quote.]

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Community Transportation Needs Assessment

Getting There Together · NH Commission on Aging

What we heard from 2,774 people across all 10 counties.

The mobility transition in numbers and stories — what older Granite Staters told the CTNA.

Six recommendations the State Commission on Aging put forward in the action plan.

What you can do, and where to weigh in.

Source: NH State Commission on Aging, Getting There Together (2026).

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Established in 2019 to advise the Governor and General Court on policy and planning related to aging in New Hampshire.

The Commission on Aging

Getting There Together · NH Commission on Aging

26 Commission Members

1 State Senator

2 State Representatives

8 State Agencies

15 Governor Appointed Members

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Getting There Together · NH Commission on Aging

Largest Portion

60.7% of older adults in New Hampshire are 65-74 years old

Fastest Growing

11.3% of older adults in New Hampshire are 85+ years old

Demographics

We are living longer lives

The number of households with someone 80+ will double by 2040

From 2022-2065 the U.S population of adults 65+ will increase by 30 million

New Hampshire is the second oldest state in the country by median age

New Hampshire is one of 11 states with more older adults than children

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We kept hearing the same kind of story

Coös County

A 78-year-old stretches a 3-week prescription because she can't reliably reach the pharmacy.

Cheshire County

A veteran stops going to dialysis after the ride falls through twice in a month.

Hillsborough County

An 80-year-old nursing home resident in a wheelchair gets stranded at the dentist when her Medicaid ride doesn’t show up.

Grafton County

A caregiver turns down a part-time job; her mother's medical trips are unpredictable and nobody else can cover them.

Getting There Together · NH Commission on Aging

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What the Numbers Say

42.8%

Missed, delayed, or avoided medical care because of transportation

884 of 2,065 respondents

60 %

Experienced some level of transportation insecurity

1,201 of 2,001 valid TSI scores

87.1%

Had never heard of Keep NH Moving

1,450 of 1,665 respondents

Getting There Together · NH Commission on Aging

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What the Numbers Say for Older Adults

53.9%

Of survey respondents were 65+

CTNA Data Companion (2025b)

43.1 %

Of respondents age 65+ have already started driving less

CTNA Data Companion (2025b)

25.5%

Of respondents age 65+ not very confident driving self

n = 2,024; CTNA-B

Getting There Together · NH Commission on Aging

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Transportation is more than medical care

Isolation

44.5% of everyone felt isolated or stuck at home in the last 30 days.

Data Companion (CTNA-B) §2.3 (four isolation indicators) and §2.6 (Transportation-related isolation in selected counties and statewide)

Getting There Together · NH Commission on Aging

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The sharpest finding

67.6%

of working-age adults with disabilities

missed, delayed, or avoided medical care because of transportation.

Data Companion (CTNA-B) §2.2 carries the full subgroup breakdown.

Under-65 with disabilities

67.6%

All people with disabilities

54.7%

Veterans

42.9%

Older adults 65+

36.4%

Missed medical care, by who you are

Getting There Together · NH Commission on Aging

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The mobility curve

68.2%

20–29

51.6%

30–39

44.3%

40–49

44.8%

50–59

30.2%

60–69

35.6%

70–79

38.5%

80+

TSI moderate/high insecurity by age band. Gold = working age. Blue = older adults.

Acute now. Rising underneath.

Working-age insecurity is acute today.

43.1% of older adults are already driving less.

25.5% aren't confident driving.

78.3% of 80+ year old respondents report a disability

Getting There Together · NH Commission on Aging

[Jen — THE HEART. The aging and disability threads fuse. Slow down.] Insecurity is highest among the young, 68% in the 20s, and falls through middle age. The 60s are lowest. So far it looks like older adults are fine.��But look right. Driving doesn't stop all at once, it erodes. 43% of older adults are ALREADY driving less. A quarter aren't confident. At 80-plus it climbs back as driving stops. Focus group participants described the fear: they know the day is coming, and don't see a system waiting.��So it's one story. Working-age adults with disabilities are in crisis today. Older adults are approaching the edge of the same cliff. The same coordinated system catches both. That's why this is a Commission on Aging project AND a disability project AND a workforce project. It's all the same ride.

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Find your region

Two gaps, and the one hiding inside them

Region

Transit desert % (navy) · Under-65 with disabilities, insecurity % (gold)

Sullivan

93%

85.7%

Monadnock

88%

78.6%

Mid-State

85%

54.4%

ACT

74%

54.7%

Grafton-Coös

61%

76.1%

Southern NH

45%

57.0%

Carroll

44%

n<10

Gr. Nashua

31%

67.3%

The gold bar is near the top everywhere.

Even where coverage looks fine, working-age adults with disabilities report 54% to 86% insecurity. Existing services serve who they're funded to serve. These riders aren't centered by any of them.

Data Companion (CTNA-B) §3.5b and §3.5c carry all eight regions by population. Pull yours.

Getting There Together · NH Commission on Aging

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The trap in the map

Coverage on a map is not a dependable ride in practice

Carroll County

44% desert (moderate), yet 60.6% insecurity, the highest in the state.

Coverage exists. It isn't landing.

Coös County

Tri-County Transit covers 16 of 20 towns, only 20% desert.

Yet Coös reports the 2nd-highest insecurity in the state and the highest rates of social isolation.

Good coverage on paper. Still not enough.

“Accessible existed on paper, but not in reality.” — focus group participant (CTNA-F)

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What this is already costs us

1,433

missed medical & therapy trips, one month, survey group

$105K

lost wages in a single month

$4.3M

annualized avoidable health spending when missed care escalates

$128K

lost in local retail spending

For older adults the bill is sharpest. NH nursing home care runs about $149,650 a year, and that's what we pay when in-home support isn't there. The cheaper intervention is more than dollars. It is dollars plus a system that knows how to use them. Both have to move.

Data Companion (CTNA-B) Impact & Policy Analysis (CTNA-D) carries the full model and sensitivity ranges.

Getting There Together · NH Commission on Aging

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What was missing, and what now exists

Definitions

No federal definition of “transit desert” exists. We built one, applied it the same way in all ten counties, and standardized unmet-need and denial definitions.

Data

There was no baseline. Now there is one: a repeatable instrument the state can measure every future investment against.

Coordination

116 federal programs fund this work across 9 agencies. No NH office coordinates any of them. The plan resources the function recognition never did.

Public access

87.1% had never heard of Keep NH Moving. The data, and the help, should live where people can actually find them.

Getting There Together · NH Commission on Aging

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The most valuable thing we leave behind

New Hampshire now has a baseline.

What it is

The Transportation Security Index is a validated 6-item measure, not a homemade metric. NH now has its first statewide TSI baseline.

What you do with it

An RCC can re-run it and watch its region year over year. The state can ask of any RHT or transit dollar: did the needle move?

What it protects

The equity dashboard tracks whether the worst county gaps (Carroll, Coös, Sullivan vs Grafton) actually narrow over time.

This is the durable asset. The report can sit on a shelf. The baseline keeps working every year someone measures against it.

Getting There Together · NH Commission on Aging

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Six recommendations. One system.

1

Designate one entity to coordinate the system, with real responsibility for oversight, navigation, reporting, and funding alignment.

2

Make Keep NH Moving the statewide starting point, with live help and low-tech access.

3

Put healthcare, providers, mobility management, and people with lived experience at the same operational table.

4

Adopt essential access standards and close the biggest trip gaps, including return trips.

5

Stabilize volunteer driver programs and create paid backup for critical-need trips.

6

Make the money work like one system through pooled or braided funding.

Data Companion (CTNA-B) Each maps to a costed investment package in the Conversion Playbook.

Getting There Together · NH Commission on Aging

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Getting There Together · NH Commission on Aging

Next Steps

Remember: Reports don’t open doors, people do.

Use the data in the CTNA and “Getting There Together” report.

Stay connected- sign up for our newsletter

Get involved

RCC, SCC, NHAHA

Carry volunteer driver program stabilization as a budget-cycle priority.

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Getting There Together · NH Commission on Aging

What We Do Next

Recommendations live on in AgeWellNH
Meet with state agencies, legislators, municipalities to present data
Work to align and map goals across existing systems

SPOA, SPIL, 10 Year Transportation Plan, Highway Safety Plan, DHHS Strategic Roadmap, SHIP, GO NORTH

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