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Pages 53-83

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From page 53...
... 53 Introduction Once a dialogue has been established between health-care and transportation providers, as well as mobility managers and local leaders as appropriate, it is time to discuss the matching of patient transportation needs with appropriate transportation solutions. The term "appropriate" in this context means that the patients are willing and able to use the service and that the cost for the service is reasonable.
From page 54...
... 54 Guidebook and Research Plan to Help Communities Improve Transportation to Health-Care Services the right things) are essential.
From page 55...
... Develop Transportation Solutions 55 What the GAO report is saying (starting in 1979) , essentially, is the elimination of transportation funding and program silos will gain economies of scale: management, facilities, and administration can be reduced, and all drivers and staff will be properly vetted, monitored, and trained.
From page 56...
... 56 Guidebook and Research Plan to Help Communities Improve Transportation to Health-Care Services Communication Sometimes simple communication is a valuable form of collaboration. This could be as informal as a dispatcher talking or emailing a health-care office manager, case manager, or lead nurse, for example.
From page 57...
... Develop Transportation Solutions 57 vehicle hour. Productivity, which must be balanced with providing a safe (social distancing is critical at the time of this report given the worldwide pandemic)
From page 58...
... 58 Guidebook and Research Plan to Help Communities Improve Transportation to Health-Care Services Exhibit 4-2. RCT vehicles are attractive and easily recognized in the county.
From page 59...
... Develop Transportation Solutions 59 Summary: Grouping Trips Grouping passenger trips provides cost advantages. However, it should be understood that grouping trips is not necessarily a matter of placing seven or eight people on the small demand response bus when this is not appropriate.
From page 60...
... 60 Guidebook and Research Plan to Help Communities Improve Transportation to Health-Care Services Applicability: Fixed-route transit service can be a viable option for many riders to use for health-care-related trips. Many brokers and health-care providers routinely distribute tickets and passes to riders to use the community's fixed-route system to get to and from their medical appointment.
From page 61...
... Develop Transportation Solutions 61 Fixed-Route Service Design: Effective public transportation does much to improve access to health care across the country. The effectiveness of a fixed route, however, is strongly related to how the routes are designed, and this is borne out by two of many examples across the country.
From page 62...
... 62 Guidebook and Research Plan to Help Communities Improve Transportation to Health-Care Services transit service) operates two separate one-way 1.5-hour loops so that virtually all round trips are at least 1.5 hours, and 3 hours if a transfer is required (Exhibit 4-6)
From page 63...
... Develop Transportation Solutions 63 Exhibit 4-8. Great distances in remote rural areas require a different set of service design rules.
From page 64...
... 64 Guidebook and Research Plan to Help Communities Improve Transportation to Health-Care Services An example of a network of fixed-scheduled services, CARTS, is based in Central Texas. CARTS operates in eight rural counties and provides countywide service on a fixed schedule.
From page 65...
... Develop Transportation Solutions 65 Exhibit 4-9. Fixed-schedule public transit.
From page 66...
... 66 Guidebook and Research Plan to Help Communities Improve Transportation to Health-Care Services Exhibit 4-10. ADA complementary paratransit vehicle.
From page 67...
... Develop Transportation Solutions 67 Vehicles should be professionally maintained to stringent standards, including standards that address the age and condition of vehicles. Depending on the type of transportation service, health-care providers may consider the following minimum standards noted in Exhibit 4-11.
From page 68...
... 68 Guidebook and Research Plan to Help Communities Improve Transportation to Health-Care Services Understanding Mobility Limitations of Riders One Patient at a Time Articulating Service Needs of Riders (Patients) and Matching with Solutions The riders (patients)
From page 69...
... Develop Transportation Solutions 69 Using the Eligibility Process for More than Public Transit Service A formal process for determining eligibility for different types of transportation service can be used for more than public transit. For example, LTD, which brokers a range of transportation services both within an ADA service area as well as beyond, uses an eligibility determination process not just for its ADA paratransit service, but for its full array of services.
From page 70...
... 70 Guidebook and Research Plan to Help Communities Improve Transportation to Health-Care Services Contracting for Service When a health-care provider or consortium of providers initiate transportation service, the solution is often to contract the service either with local existing taxi companies and/or TNCs. At the same time, the health-care provider may purchase fixed-route bus tickets to distribute as appropriate.
From page 71...
... Develop Transportation Solutions 71 other organizations. Some rural public transit systems also act as broker-providers including Central Arkansas Development Council and Southeast Arkansas Transit.
From page 72...
... 72 Guidebook and Research Plan to Help Communities Improve Transportation to Health-Care Services The matrices define groups of patients by their transportation abilities or needs. The groups do not specify age or disability, since some people can use fixed-route transit and others cannot.
From page 73...
... Exhibit 4-12. Matching transportation needs with transportation services -- a continuum.
From page 74...
... 74 Guidebook and Research Plan to Help Communities Improve Transportation to Health-Care Services that less effectively serve health-care facilities. Two examples of local fixed-route systems are depicted in Exhibits 4-15 and 4-16.
From page 75...
... Develop Transportation Solutions 75 Exhibit 4-17. CARTS country bus provides fixedschedule services.
From page 76...
... 76 Guidebook and Research Plan to Help Communities Improve Transportation to Health-Care Services Second Stop: Demand Response Shared-Ride Door-to-Door Service The next group of potential solutions are all demand response-based, typically with door-to-door service. Shared-ride demand response or dial-a-ride is an appropriate service for many who cannot use fixed route.
From page 77...
... Develop Transportation Solutions 77 is a common practice across the country. In some cases, the transit agency (e.g., COAST in Washington State)
From page 78...
... 78 Guidebook and Research Plan to Help Communities Improve Transportation to Health-Care Services Exhibit 4-19. An accessible taxi.
From page 79...
... Develop Transportation Solutions 79 A Diverse Funding Base Once a transportation service is successfully operating, the focus should be on sustainability. One approach to sustainability is to find and maintain diverse funding streams.
From page 80...
... Organization/Location Transit Providers Health-Care Providers Federal/State/Local Governments Sponsorships/ Private Sector Non-Pro�its/ Human Service • • • • • – • • • • • • • • • • • Table 4-5. Matrix of funding sources.
From page 82...
... 82 Guidebook and Research Plan to Help Communities Improve Transportation to Health-Care Services – Taylor Regional Hospital in Kentucky, citing a lack of available transportation, chose to develop a service for its patients and fund it directly with support from other health-care providers. – In Southeast Missouri, the Missouri Rural Health Association's (MRHA)
From page 83...
... Develop Transportation Solutions 83 Chapter Notes 1. Report of the Comptroller General of the United States.

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