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From page 84... ... 84 Introduction This chapter presents five case studies, set in communities from Lane County, Oregon, on the West Coast, to the Denver metropolitan region, to 10 rural counties in South Central Missouri. These case studies describe relationships and partnerships created between transportation and health-care organizations, demonstrating efforts to improve transportation access to medical and other wellness-related appointments and services; see the map in Exhibit 5-1. Read the entire page →
From page 85... ... Case Studies 85 For those communities interested in and considering their own efforts to improve transportation access to health care, the examples described in the case studies (as well as the collaborative practices presented in Chapter 6) provide ideas and possibly inspiration. Read the entire page →
From page 86... ... 86 Guidebook and Research Plan to Help Communities Improve Transportation to Health-Care Services Mobility Management -- Improving Access to Health Care in Central Texas: Capital Metro Transportation Authority and Capital Area Rural Transportation System Snapshot of Collaboration Two transit agencies in Central Texas -- the Capital Metropolitan Transportation Authority (Capital Metro) and the Capital Area Rural Transportation System (CARTS) Read the entire page →
From page 87... ... Case Studies 87 The Transit Empowerment Fund The Transit Empowerment Fund was established in 2011 through a partnership between Capital Metro, Austin's public transportation provider, and One Voice Central Texas, a coalition of more than 100 health and human service non-profit organizations. The goal was to address the effect of rising public transit fares on low-income individuals. Read the entire page →
From page 88... ... 88 Guidebook and Research Plan to Help Communities Improve Transportation to Health-Care Services job training programs, refugees, people experiencing homelessness, Medicare card holders, Medicaid recipients, and veterans. The goal of the program is to promote self-sufficiency by providing transportation for employment, health care, education, and social services. Read the entire page →
From page 89... ... Case Studies 89 • Pursue funding and sustainability. – Pursue grant funding through the Georgetown Health Foundation, which has provided $200,000 annually to the city of Georgetown for transit for three years. Read the entire page →
From page 90... ... 90 Guidebook and Research Plan to Help Communities Improve Transportation to Health-Care Services Exhibit 5-3. 2017 service gaps in Central Texas. Read the entire page →
From page 91... ... Case Studies 91 The OMM has close to 30 partners, most of whom provide support. These are depicted in Attachment 1 to the case study and are summarized as follows. Read the entire page →
From page 92... ... 92 Guidebook and Research Plan to Help Communities Improve Transportation to Health-Care Services (in conjunction with CARTS) and the Transit Empowerment Fund is critical to both. Read the entire page →
From page 93... ... Case Studies 93 Contact Information Office of Mobility Management Austin, Texas http://mytxride.com/ Attachments to Case Study of Capital Metro and CARTS Office of Mobility Management for Central Texas Attachment 1: Partnering Organizations • Transportation Providers – CARTS – Capital Metro – City of Round Rock–Transit – The HOP – Burnet County Vet-Rides – Drive a Senior–Health Care • Health Care Organizations – Austin - Travis County Integral Care – Central Health, Austin - Travis County – La Grange VA Outreach Clinic – Easter Seals of Central Texas – Hays County Veteran Medical Transportation Services – Health Foundation of Georgetown – Hill County Mental Health and Developmental Disability Center – Road to Recovery–American Cancer Society – Medicaid Transportation – Multiple health-care providers • Agencies Supporting the Social Determinants of Health – Age of Central Texas – ARCIL, Inc. – Area Agency on Aging – Austin Parks and Recreation Department – Bastrop County Emergency Food Pantry & Support Center – Bluebonnet Trails Community Services – Community Action, Inc. Read the entire page →
From page 94... ... 94 Guidebook and Research Plan to Help Communities Improve Transportation to Health-Care Services 1.3.2 Advocate to expand care delivery in under-resourced areas via options such as co-locating, building new facilities, and use of telemedicine. 1.3.6 Promote awareness of existing transportation resources, including Capital Metro's Mobility Management program, through a variety of communication avenues. Read the entire page →
From page 95... ... Case Studies 95 relied on taxis and NEMT services to provide transportation to people who were unable to use public transportation. However, challenges with existing transportation options often resulted in hours-long waits for patients after discharge. Read the entire page →
From page 96... ... 96 Guidebook and Research Plan to Help Communities Improve Transportation to Health-Care Services Description Case managers at the hospital and patient navigators in outpatient clinics work with patients to identify their transportation needs, provide information about public transit options, and schedule rides. For example, patient navigators have provided recent immigrants with education about navigating the public transportation system. Read the entire page →
From page 97... ... Case Studies 97 Lessons Learned Denver Health created strict guidelines for rides provided through Lyft to address liability concerns. Patients may only be transported within 25 miles of the hospital, cannot make additional stops on route to their destination, must be ambulatory, and must acknowledge that they are receiving a ride from a third-party vendor. Read the entire page →
From page 98... ... 98 Guidebook and Research Plan to Help Communities Improve Transportation to Health-Care Services How Did the Collaboration Start? Flint's MTA points to two seminal events that catalyzed the transit agency's well-known Rides to Wellness program: • Genesee County Department of Health and Human Services' agreement to pay for a higher level of transportation service for the MTA dialysis riders, which acknowledged that prescheduled, shared-ride ADA paratransit service was not effective for dialysis riders who needed a more specialized service, and • Flint's water crisis that resulted in dangerous levels of lead in the water at residents' homes. Read the entire page →
From page 99... ... Case Studies 99 were told to use only bottled or filtered water for drinking, cooking, bathing, and cleaning. A federal state of emergency was declared in January 2016. Read the entire page →
From page 100... ... 100 Guidebook and Research Plan to Help Communities Improve Transportation to Health-Care Services was clear that the cost was higher -- $15 per trip. According to the MTA, none of the agencies "blinked an eye at the cost" during these meetings. Read the entire page →
From page 101... ... Case Studies 101 Description By 2019, the MTA had 13 agency-partners in the Rides to Wellness program. Several of these are listed on the MTA website, including the Genesee Health Plan, which offers free rides to health and wellness destinations for their Spanish-speaking clients, and the American Cancer Society, which supports trips for patients in its Road to Recovery program. Read the entire page →
From page 102... ... 102 Guidebook and Research Plan to Help Communities Improve Transportation to Health-Care Services eager to find a reliable and reasonably priced transportation service that could take people to and from health-care services. Barriers, Constraints, and Challenges At the start, one of the MTA's major challenges to its Rides to Wellness service was teaching the agency's staff that this new service was not traditional ADA paratransit. Read the entire page →
From page 103... ... Case Studies 103 from the higher fares charged for the trips and MTA's local operating money. The MTA then received a grant of $310,000 from FTA's Rides to Wellness grant program in 2016. Read the entire page →
From page 104... ... 104 Guidebook and Research Plan to Help Communities Improve Transportation to Health-Care Services Wellness services (they even use MTA Rides to Wellness logo) : Greater Lapeer Transit Agency, Shiawassee Area Transit Agency, and Saginaw STARS. Read the entire page →
From page 105... ... Case Studies 105 Breaking Down the Funding Silos Through a series of local and state decisions in Oregon, historical transportation funding silos were broken down at a time when many states were building silos. In Lane County, Medicaid NEMT and veterans' transportation programs were combined with transit and other programs, addressing needs for health-care and human services. Read the entire page →
From page 106... ... 106 Guidebook and Research Plan to Help Communities Improve Transportation to Health-Care Services Development and Description Starting almost 20 years ago, LTD developed and perfected the concept of a fully integrated human service, health-care access, and public ADA transportation program operated by an urban transit system with multiple contracted providers through RideSource. Since its start, RideSource has expanded to serve a wide variety of human service and health-care agencies and providers. Read the entire page →
From page 107... ... Case Studies 107 LTD and LCOG together were able to recruit other partners and, most importantly, Medicaid NEMT. Including Medicaid transportation in the coordinated mix changed the dynamics of RideSource in a positive way. Read the entire page →
From page 108... ... 108 Guidebook and Research Plan to Help Communities Improve Transportation to Health-Care Services • RideSource ADA -- This is LTD's origin-to-destination ADA paratransit service within the metropolitan area for people unable to use regular bus service (some or all of the time) because of a disabling condition. Read the entire page →
From page 109... ... Case Studies 109 and 17 different applications and processes that previously managed all of the services at RideSource, from call intake to service delivery and billing. The TripSpark software now provides all of these features in a single database. Read the entire page →
From page 110... ... 110 Guidebook and Research Plan to Help Communities Improve Transportation to Health-Care Services LTD reported that procuring a new call center contractor at the same time as implementation of new software in 2017 was a challenge. The outgoing contractor had developed its own software, and the transition to the new contractor and software was not easy. Read the entire page →
From page 111... ... Case Studies 111 Transferability Can any urban transit agency with a service area population of 500,000 develop a highly coordinated service to meet the transportation needs of their community's seniors, persons with disabilities, and others in need, either fully or in steps? The answer may be yes, if at least the following are addressed: • A transit agency willing to make a commitment in funding and staff -- LTD has committed to serving the mobility needs of seniors, persons with disabilities, and persons with a low income and has expressed that in its mission statement (Attachment 1, Lane Transit District Mission and Attachment 4, Long Range Plan) Read the entire page →
From page 112... ... 112 Guidebook and Research Plan to Help Communities Improve Transportation to Health-Care Services Attachment 2: Medicaid NEMT -- Managed Care Oregon began changing how it provides health-care services for people who receive healthcare coverage under the OHP (Medicaid) by creating CCOs in 2012. Read the entire page →
From page 113... ... Case Studies 113 Attachment 4: Excerpt from LTD Long Range Plan (7) GOAL 3: Ensure Equitable and Accessible Transit Service Throughout LTD's Service Area Transit is an essential community service that provides personal mobility and freedom for people of every walk of life. Read the entire page →
From page 114... ... 114 Guidebook and Research Plan to Help Communities Improve Transportation to Health-Care Services Building Transportation Options and Solutions for Rural Missourians: Missouri Rural Health Association's HealthTran Snapshot of Collaboration The Missouri Rural Health Association (MRHA) 's HealthTran program provides mobility management coordination and services through technology, education, and support. Read the entire page →
From page 115... ... Case Studies 115 The original HealthTran model began as a pilot program that connected rural residents to health-care facilities using existing public transit services. The pilot program hired local community members as HealthTran Coordinators (HTCs) Read the entire page →
From page 116... ... 116 Guidebook and Research Plan to Help Communities Improve Transportation to Health-Care Services • To create a sustainable program model. • To document the development and implementation of HealthTran to promote replication at the state level and across different communities. Read the entire page →
From page 117... ... Case Studies 117 Development In the pilot, HealthTran worked with local health-care providers to understand their hours and typical patient needs. HealthTran then connected with ambulance districts and public transportation providers to expand times and routes to better meet the needs of providers and patients. Read the entire page →
From page 118... ... 118 Guidebook and Research Plan to Help Communities Improve Transportation to Health-Care Services The volunteer technology tracks hours of service, miles driven, training records, and awards. Alerts are given to the Volunteer Manager when vehicle documentation is due (inspection, insurance) Read the entire page →
From page 119... ... Case Studies 119 be able to justify allocating funding to transportation when they are operating in the red. Community partners, including local public health departments or federally qualified health clinics, may be able to help rural providers offset transportation costs. Read the entire page →
From page 120... ... 120 Guidebook and Research Plan to Help Communities Improve Transportation to Health-Care Services among community members and providers to establish a system of volunteer drivers and enroll in a subscription service for transportation. Providers reported very high levels of satisfaction with the program. Read the entire page →

From page 84...

... 84 Introduction This chapter presents five case studies, set in communities from Lane County, Oregon, on the West Coast, to the Denver metropolitan region, to 10 rural counties in South Central Missouri. These case studies describe relationships and partnerships created between transportation and health-care organizations, demonstrating efforts to improve transportation access to medical and other wellness-related appointments and services; see the map in Exhibit 5-1.