Public transportation agencies, specifically the Federal Transit Administration’s Formula Grants for Rural Areas - 5311 and Urbanized Area Formula Grants - 5307, are often asked to provide customized-services aimed at specific client/user groups. Examples include services that meet the needs of the following groups: independent living centers, adult day care facilities, low income workers, public event shuttles, individual employers (employer shuttles), hospital release patients (after hours), Medicaid NEMT, specialized medical treatment facilities (dialysis), and premium senior services.

Determining if these types of services "must" or ‘can" be provided as public transportation has caused significant confusion for service providers and sponsors. In addition, deciding on how to best provide and fund these services with federal and state supported transit funds, especially revenue sources, can be challenging for many reasons.