By Tony Leys for KFF Health News.
Broadcast version by Mike Moen for Minnesota News Connection reporting for the KFF Health News-Public News Service Collaboration

Myrna Peterson predicts self-driving vehicles will be a ticket out of isolation and loneliness for people like her, who live outside big cities and have disabilities that prevent them from driving.

Peterson, who has quadriplegia, is an enthusiastic participant in an unusual test of autonomous vehicles in this corner of northern Minnesota. She helped attract government funding to bring five self-driving vans to Grand Rapids, a city of 11,000 people in a region of pine and birch forests along the Mississippi River.

The project's self-driving vans always have a human operator in the driver's seat, poised to take over in complicated situations. But the computers are in control about 90% of the time, and they've given 5,000 rides since 2022 without any accidents, organizers say.

"It's been fun. I'm really sold on it," said Peterson, who used to rely on her power wheelchair to travel around town, even in winter.

Autonomous vehicles, which can drive themselves at least part of the time, are making news in urban areas, such as San Francisco, where extensive tests of the technology are underway.

Rural experiments have been set up in a few other states, including Iowa and Ohio. Peterson hopes the pilot projects help bring a day when fully autonomous cars and vans assist the estimated 25 million Americans whose travel is limited by disabilities.

Fully independent vehicles remain far from everyday options, as tech companies and automakers struggle to perfect the technology. Recently, for example, General Motors recalled all its self-driving cars after one struck and dragged a pedestrian who had been hit by another vehicle.

But Waymo, a corporate relative of Google, is forging ahead with fully autonomous taxi rides in multiple cities.

Peterson is among those who believe autonomous vehicles someday will become safer than human-driven models.

"Look at how many times the lightbulb failed before it worked," she said.

Unlike many smaller towns, Grand Rapids has public buses and a taxi service. But Peterson said those options don't always work well, especially for people with disabilities. The autonomous vehicle program, known as goMARTI, which stands for Minnesota's Autonomous Rural Transit Initiative, offers a flexible alternative, she said. She hopes it eventually will ease a national shortage of drivers, which tends to be especially acute in rural regions.

The project is funded through the spring of 2027 with more than $13 million from federal, state, and local sources, much of it coming from the 2021 federal infrastructure bill.

The project's distinctive Toyota minivans are outfitted by a Michigan company, May Mobility, which is backed by the Japanese auto giant and other investors. Slogans painted on the side invite the public to "Experience Self Driving in Minnesota's Nature." The vans bristle with technology, including cameras, radar, GPS, and laser sensors. Their computer systems constantly monitor surroundings and learn from situations they encounter, said Jon Dege, who helps manage the project for May Mobility.

Users arrange free rides via a smartphone app or the 211 social service telephone line.

On a recent chilly afternoon, a goMARTI van pulled up near Peterson's house. She soon emerged, bundled in a bright purple parka honoring her beloved Minnesota Vikings football team. She rolled her electric wheelchair to the van, up a ramp, and into the back. Van operator Mark Haase helped strap the wheelchair in, then climbed into the driver's seat for a demonstration.

As the van pulled onto the street, the steering wheel seemed to shudder, reflecting tiny adjustments the computer made. Haase kept his foot poised near the brake pedal and his hands cupped around the steering wheel, ready to take over if a complication came up. After moments when he needed to take control of the vehicle, he pressed a button telling the computer system to resume command. "It was weird at first, but it didn't take long to get used to it and trust the system," Haase said.

The Minnesota Department of Transportation helped direct federal money toward the Grand Rapids project, which followed a similar effort in the southern Minnesota city of Rochester. Tara Olds, the department's director of connected and automated vehicles, said her agency sought smaller communities that wanted to give autonomous vehicles a shot.

Neither kind of driver will ever be perfect, Olds said. "You know, humans make mistakes, and computers make mistakes," she said. But the public would understandably react differently if a fatal crash were caused by an autonomous vehicle instead of a human, she said.

Frank Douma, a research scholar at the University of Minnesota's Center for Transportation Studies, has analyzed the Grand Rapids project and other autonomous vehicle programs. He said running such projects in smaller towns isn't necessarily harder than doing so in urban areas. "It's just different."

For the foreseeable future, such services probably will need to run on predetermined routes, with regular stops, he said. It would be more complicated to have autonomous vehicles travel on demand to unfamiliar addresses out in the countryside.

Developers will need to overcome significant challenges before autonomous vehicles can become a regular part of rural life, he said. "But it's no longer something that can be dismissed as impossible."

A 2022 report from the National Disability Institute predicted that autonomous vehicles could help many people with disabilities get out of their homes and obtain jobs.

Tom Foley, the group's executive director, said a lack of transportation often causes isolation, which can lead to mental health problems. "There's an epidemic of loneliness, particularly for older people and particularly for people with disabilities," he said.

Foley, who is blind, has tried fully autonomous vehicles in San Francisco. He believes someday they will become a safe and practical alternative to human drivers, including in rural areas. "They don't text. They don't drink. They don't get distracted," he said.

For now, most riders who use wheelchairs need attendants to secure them inside a van before it starts moving. But researchers are looking into ways to automate that task so people who use wheelchairs can take advantage of fully autonomous vehicles.

The Grand Rapids project covers 35 miles of road, with 71 stops. The routes initially avoided parking lots, where human drivers often make unexpected decisions, Dege said. But organizers recognized the street-side stops could be challenging for many people, especially if they're among the 10% of goMARTI riders who use wheelchairs. The autonomous vans now drive into some parking lots to pick riders up at the door.

During the recent demonstration ride with Peterson and Haase, the van turned into a clinic parking lot. A lady in an orange car cut across the lot, heading for the front of the van. The computer driving the van hit the brakes. A split second later, Haase did the same. The orange car's driver smiled and gave a friendly Midwestern wave as she drove past.

The autonomous vans have gone out in nearly all kinds of weather, which can be a challenge in northern Minnesota. Grand Rapids received more than 7 feet of snow last winter.

"There were only three or four times when it was so snowy we had to pull it in," Dege said. The autonomous driving systems can handle snowflakes in the air and ice on the pavement, he said. They tend to get confused by snow piles, however. The human operators step in to assist in those situations while the computers learn how to master them.

The robot drivers can get stymied as well by roundabouts, also known as traffic circles. The setups are touted as safer than four-way stops, but they can befuddle human drivers too.

Haase took control each time the van approached a roundabout. He also took the wheel as the van came up on a man riding a bicycle along the right side of the road. "Better safe than sorry," Haase said. Once the van was a few yards past the bicycle, he pressed a button that told the robot to resume control.

Peterson takes the vans to stores, restaurants, community meetings, hockey games - "and church, of course, every Sunday and Wednesday," she said.

She said the project has brought Grand Rapids residents together to imagine a more inclusive future. "It's not just a fancy car," she said.


Tony Leys wrote this story for KFF Health News.

Disability groups in New Hampshire are calling for an end to the word "special" to describe people with disabilities.

They said terms like "special" or "special needs" imply people are somehow broken and undermine the long-term fight for disability rights.

Isadora Rodriguez-Legendre, executive director of the New Hampshire Council on Developmental Disabilities, said when people ask not to be called a certain word, it should be reason enough not to use it.

"It really is a label that kids and adults with disabilities found to be alienating," Rodriguez-Legendre explained. "Because it kept them apart and separate."

Rodriguez-Legendre pointed out a new public awareness campaign encourages people to visit the website stopspecial.org and read a more appropriate language guide. Nearly one of every eight New Hampshire residents has a disability.

Backers of the "Stop Special" campaign said language is evolving and such euphemisms as "special needs" or "special education" need correction. Rodriguez-Legendre emphasized students should simply be called "students," or even "students with disabilities." She understands it will not be an easy change, especially for those who work with laws and regulations but added the goal is to ensure equitable access to education and public spaces.

"Communities actually are better when people with disabilities are participating in them, because they bring awareness about how to make things more accessible for everybody," Rodriguez-Legendre contended.

The "Stop Special" campaign is backed by the Institute on Disability at the University of New Hampshire, the Disability Rights Center of New Hampshire and the New Hampshire Council on Developmental Disabilities.


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The U.S. Office for Civil Rights has issued a ruling ensuring that an Iowa man with disabilities is able to live in his home and receive round-the-clock medical care.

Advocates for people with disabilities hope the move sets precedent for other people in Iowa and around the country.

When he was about five, Cedar Rapids resident Garret Frey suffered the same spinal cord injury that Superman star Christopher Reeve did in an equestrian accident.

Reeve lived for about a decade after his accident.

Frey is closing on 40 years, and sued the state, claiming it violated his rights by failing to provide the 24-hour home-based support and services he needs to live at home, where he said people with disabilities want to be.

"It is truly where most of us are happy, healthy," said Frey, "and it's most cost-effective."

The U.S. Department of Health and Human Services agreed to raise the provider reimbursement rate for in-home caregivers, allow for respite services, expand the health-care provider base - and help secure overnight, in-home nursing care for Frey.

HHS will monitor Iowa's progress for a year. Frey said he wants this ruling to set precedent for other people with disabilities in Iowa and across the country.

"It's one baby step in the right direction," said Frey, "because there are many other disability-related concerns and issues that are ongoing."

The ruling requires Iowa Health and Human Services to work with federal officials to ensure Frey's needs are met during that year, and report on their progress monthly.

Teens and young adults in Texas who have disabilities have an opportunity to get a paid internship this summer.

The Texas Workforce Commission offers its Summer Earn and Learn program for students between the ages of 14 and 22. The students are placed with large and small businesses to earn a paycheck and learn valuable work experience.

Joe Esparza, the commissioner representing employers, said all 28 workforce development boards across the state participate in recruiting students and employers

"The employers are obviously benefiting because they're investing in their communities, and they get somebody who's motivated to work," Esparza explained. "I think having that opportunity gives these students a chance to interact with customers, to learn IT systems, to just engage in something that they are very interested in."

He said more than 14,000 students have been placed in internships since the program started in 2017.

More than 1,300 employers across Texas participated in the program last year, giving students hands-on experience. Some of the businesses include the Amarillo Zoo, the Fort Worth Botanic Garden and Odessa College. Esparza noted the internships last five to eight weeks and student participants attend work readiness training to prepare them for their work experiences.

"We at the state level always encourage employers to get involved and create programs," Esparza emphasized. "In most every business, there's usually an opportunity to bring somebody in as an internship and it's a great opportunity for them to learn new skills and become part of the workforce there."

Some of the students have been hired full-time by the companies at the end of their internships.


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