BRAINTREE - Penny Shaw, a former teacher with a doctorate in French literature, was 58 when a series of falls brought her to the hospital with what doctors would diagnose as a rare neuromuscular condition.
After five bedridden years, Shaw recovered enough to venture from her nursing home in a power wheelchair. Now she goes out a few times a week - to see friends, attend meetings, visit the library - using The Ride, the MBTA’s door-to-door service for the disabled.
But changes in the service that have been proposed as part of the T’s broader deficit-cutting plan would drive up the $4 round-trip cost for Shaw and thousands of others to between $6 and $24, prices that some say would keep them homebound.
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“I think I’m in denial; I can’t tell you what I would do,’’ said Shaw, who says her $72.80 monthly income quickly disappears on dental care, cellphone minutes, and Ride trips. “I’m actually feeling a little desperate that my quality of life and my ability to get out into the community is about to be destroyed.’’
State officials acknowledge the plight of Shaw and others but wrestle with inexorable numbers: Over the past decade, usage of The Ride doubled, and cost quadrupled - with more riders and rising gas prices - to roughly 2.5 million annual trips and $114 million.
Although The Ride accounts for less than 1 percent of all trips provided by the MBTA, it consumes nearly 10 percent of the T’s operating budget. And the trend shows no sign of abating, with the population aging.
“It’s a budget buster,’’ said Richard A. Davey, the secretary of transportation.
Transit agencies nationwide are grappling with the same issue. The T and its peers are required by the Americans with Disabilities Act to provide taxi-style service to those unable to use conventional buses, subways, and trolleys.
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At more than $40 per one-way trip, The Ride ranks in the middle of the pack nationally on per-trip cost. But ridership is much higher per capita in Massachusetts than in other regions, according to T statistics.
Advocates, customers, and officials say that is partly because the T operates a nationally recognized program providing fuller service than most. But users fear it will be pared back to federal minimums.
Federal law requires service be provided only for people living within three quarters of a mile of a rapid transit station or bus stop and only when buses or trains are running. It also allows fares for services such as The Ride at double the lowest subway or bus fare.
But the T offers The Ride to anyone living in a town with even one bus stop, a roughly 700-square-mile area, and charges $2 each way, same as the cash subway fare. The Ride operates from 6 a.m. to 1 a.m.
“An organization that is doing that should be commended,’’ said Pam Boswell, an American Public Transportation Association vice president who studies paratransit.
Davey said the T has made a point of not cutting service on The Ride, calling it “a lifeline for our customers.’’
But customers say MBTA proposals for the budget year starting July 1 amount to cuts.
The T would still cover the same turf, but anyone living beyond the three-quarter-mile mark would become a “premium’’ customer, as would anyone taking The Ride when nearby buses are not running.
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Customers inside the three-quarter-mile mark would pay $3 or $4.50 under two MBTA proposals; premium customers, $5 or $12.
Planners predict this would shave $9 million to $19 million from the T’s deficit.
“Don’t say on the one hand that you’re retaining that service area and price it such that people can’t afford it,’’ said Rick Morin, 58, a Ride user from Waltham and a board member of the Bay State Council of the Blind.
The council and Morin say a Ride fare increase is in order but should be proportionate with subway and bus increases. They say the T should instead seek savings through deploying vehicles in a smarter fashion.
State officials say they are focused on efficiency, with changes planned for next year and for mid-2014, when the latest five-year contracts expire with the vendors who operate The Ride.
Governor Deval Patrick issued an executive order last year creating a commission to study all social-service transportation. The goal is a coordinated system to better deploy taxpayer-funded vehicles and drivers.
The T is also mulling penalties for the 8 percent of users who cancel Ride reservations with less than an hour’s notice or do not show up for pickups. And in July it will begin performing assessments of applicants. It is the last major transit agency to do this, relying until now on the word of an applicant’s medical provider.
A pilot program next year will offer vouchers for short trips that might be handled more cheaply by cabs. The T will also end lifetime Ride eligibility, recognizing that some users have temporary conditions.
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The T predicts greater applicant scrutiny could weed out up to 25 percent of Ride customers, leaving service for those who most need it. It is encouraging Ride users to reconsider the subway and bus system after investing hundreds of millions in elevators and accessible equipment.
Some users worry about the fairness of the scrutiny. Even those who support assessments say fraud is overstated.
“It’s not waste, fraud, and abuse,’’ said Paul Regan, executive director of the MBTA Advisory Board, which represents the cities and towns that pay part of the MBTA budget. “Demographics is the biggest driver.’’
Christopher Hart - director of transportation projects for Boston’s Institute for Human Centered Design, an organization promoting better infrastructure and product design for people of all abilities - has cerebral palsy and uses a power wheelchair. He also serves on the state’s Transportation Advisory Committee.
Hart, 34, uses the bus and subway system for most trips from his Hyde Park home. But even with the investments the T has made, barriers remain for many - impassable sidewalks, unfamiliar turf - leaving The Ride as the only option. “By and large, the folks who need it, need it,’’ he said, “and anyone who takes it will tell you it’s no picnic.’’
He called the governor’s commission a good step, but one that should have been taken years ago, given the looming need.
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“It really won’t hit until the baby boomers start giving up driving,’’ Hart said. “You can see the tidal wave. It’s gray, it’s white, it’s balding, and it’s coming.’’
Eric Moskowitz can be reached at emoskowitz@globe.com.