Each year, 3.6 million Americans do not obtain medical care due to transportation challenges. These issues include a lack of vehicle access, long distances and lengthy times to reach needed services, and transportation costs. Because it touches many aspects of a person’s life, adequate and reliable transportation services are fundamental to healthy communities.
According to a report, Pathways to Progress, published by the Adirondack Gateway Council, transportation challenges are exacerbated in the North Country because of its expansive and mountainous geography and low population density. Additionally, the area has become automobile-dependent due to limited alternatives in large parts of the region. Indicator reports on the HealthyADK website show transportation costs are typically the second-largest budget item for most families and 8.5 percent of households in the region lack a vehicle.
Transportation can also be a vehicle for wellness and thanks to an influx of innovation funding from the Delivery System Reform Incentive Payment (DSRIP) Program, AHI Performing Provider System partners are making great progress tackling transportation challenges.
Uplift Warren Washington
Cassandra Fleury likens her role as Transportation Coordinator for the Uplift Warren Washington initiative to that of a care manager. “The personal interaction aspect of my program is really what makes it work,” asserts Cassandra. The free program, which kicked off at the end of May 2019 for residents of Warren and Washington counties, promotes preventative health through increased access to services. “Care management is more of an art than a science. I believe we need to work with people as individuals to meet their needs. If they are struggling with transportation to get to places to begin with, asking them to come to an appointment with me seems unrealistic. So, I will travel throughout the region to meet people and to connect them with transportation to get the services they need,” said Cassandra. “I try to be health proactive. It’s better if I help people access services before they get sick, rather than struggling with their recovery needs.”
Partnering with 820 River Street (The Baywood Center), Greater Glens Falls Transit, Tri-County United Way, Warren-Washington Association for Mental Health, Glens Falls Hospital, Hudson Headwaters Health Network, and many other organizations, the program has been providing transportation to and from venues not covered by Medicaid transportation, such as grocery store and pharmacy visits, care management and Department of Social Services appointments, and community-based support group meetings.
To date, Cassandra has distributed nearly 700 transportation vouchers to individuals for such things as taxi cab rides, gas cards, and bus passes. “I help by connecting people to transportation for services and then it’s up to them to take ownership of their own health. I want people to be empowered by eliminating this barrier to health,” stated Cassandra.
Cassandra singled out two cab companies – Queensbury Taxi and Eagle Cab – for their cooperation and commitment to the success of the program. “Queensbury Taxi has been fantastic. They’re available 24/7 and have a wheelchair-accessible van. They are always willing to help get someone to where they need to go, often on short notice,” said Cassandra. “Eagle Cab has been earnest and a pleasure to work with. I’ve been using them for long-distance travel. They once drove someone all the way to Ogdensburg for a procedure, but rather than dropping him off and leaving, they waited around for the all-clear. When the patient wasn’t admitted due to an error, they were there for him and able to drive him back home. They don’t just transport people – they make sure people are okay.”
Another story involved a little boy who was receiving psychiatric services at Glens Falls Hospital who had then been transferred to an inpatient unit in Syracuse. The boy needed his father to attend a discharge planning meeting in Syracuse for him to go back home, but the father couldn’t afford to attend. The program paid for Eagle Cab to transport the dad to the meeting and then brought the father and child home.
Perhaps the most heartwarming story shared by Cassandra involved a young woman struggling with drug and alcohol use issues who was living on her own for the first time. “She had SNAP to purchase food, but because she didn’t live near a grocery store, she was buying her groceries at Dollar General. At one point, she ran out of SNAP before the end of the month and was worried about how she was going to be able to get food to eat,” explained Cassandra. Cassandra provided the woman with vouchers to take advantage of the Salvation Army’s “food gleaning” program, an effort involving local markets in the region donating food to be provided free of charge to folks in need. She then went the extra mile and met the woman at the site to help her through the shopping process. “She was anxious about going alone, and anxiety often sets people back in their recovery, so the fact that I was there helped a lot,” said Cassandra.
“The program has been instrumental in helping people,” concluded Cassandra. “By providing transportation, we truly are giving people a ride back to health.”
For more program information, contact Cassandra at [email protected], or 518.320.6692.
Rides to Healthier Strides
A wheelchair-bound elderly woman in Olmstedville couldn’t afford ambulette transportation. She had been in the hospital and upon release needed to have follow-up appointments with her doctor. Because she couldn’t afford transportation, she went for three months without an appointment. With the advent of the Rides to Healthier Strides program, the woman is now able to make it to her appointments.
This success story is just one of many shared by LeAnn Java, Transportation Navigator, Mental Health Association in Essex County, who oversees the program which has been making tremendous strides in maximizing transportation services for the Medicaid population and those at risk for becoming an Asset Limited, Income Constrained, Employed (A.L.I.C.E.) household.
Working with such agencies as the Essex County Department of Public Works, Essex County Mental Health Clinic, Adirondack Community Action Programs, Inc., the Essex County Office for the Aging, Homeward Bound Adirondacks, Mountain Lake Services, the Community Services Board, Hudson Headwaters Health Network, and the University of Vermont Health Network – Elizabethtown Community Hospital, the program has gotten off to a fast start. The initiative, which commenced on July 10, has already received requests from and helped more than 420 people through its first five months.
LeAnn, who assists consumers by linking them to transportation services, providing travel training, managing vouchers, and handling gas card and other reimbursements among participating agencies, stated, “It’s been extremely gratifying to help so many people in so many different ways and I know there will be many more to come.” LeAnn illustrated the program’s assortment of services by sharing stories of transporting an individual to a food shelf for shopping after a grocery store in Port Henry closed, assisting a woman get to a job interview, and helping a person get to St. Joseph’s Addiction Treatment & Recovery Center for in-patient rehabilitation. “We even helped a frail 73-year-old woman who recently moved to Lake Placid from New York City get a ride back to the city for a doctor’s appointment,” shared LeAnn.
“Another situation involved a homeless mother and child. We transported the woman to work and her child to school with the help of Mountain Lake Services. “It was great because the two of them were eventually able to move into an apartment,” said LeAnn.
“The partners have been great to work with,” said LeAnn. “I also have to mention that American Taxi out of Ticonderoga, Brant Lake Taxi, and We Care out of Plattsburgh have been fantastic for our ambulette needs.”
“This program’s impact has been astonishing. It’s greatly needed, as well as appreciated,” stated LeAnn. “With this funding and all our collaborative efforts, we’ve been able to fill a lot of gaps.”
For more program information, contact LeAnn at [email protected], or 518.412.6186.
St. Lawrence County Access to Care Program
The St. Lawrence County Access to Care program has received nearly 2,500 referrals involving more than 1,100 unique clients since its inception in April 2019.
An authorized transportation service program for Medicaid beneficiaries to travel to and from service destinations not eligible for funded transportation, the initiative has helped people in a multitude of ways. “We help people pick up groceries, obtain their prescriptions from the pharmacy, and attend chronic disease self-management, early parenting, and other continuing education courses,” explained Cassy Dodd, Director, Partner Engagement, St. Lawrence Health System, who, along with colleague Rachel LaPoint, the health system’s Quality Improvement Coordinator, oversee the program. “In addition, the program has assisted clients with transportation to and from work and to sign up for essential services such as SNAP, WIC, HEAP, and more.”
The program is a collaborative partnership of St. Lawrence Health System, the Community Health Center of the North Country, the St. Lawrence County Department of Labor, the St. Lawrence County Department of Social Services, the St. Lawrence Health Initiative, St. Lawrence County NYSARC, St. Lawrence County Public Transit, the Seaway Valley Prevention Council, Transitional Living Services, United Helpers, and the Volunteer Transportation Center of the North Country.
Christine Richardson, Program Director, Volunteer Transportation Center, explained, “Clients can be assisted in different ways depending on their situation. Some are provided gas cards, some are paid mileage reimbursement, and some ride the public bus without paying the $2 ride fee. We also offer the First Mile, Last Mile program where volunteer drivers provide car rides for people to and from their homes to the bus stop.”
“Let’s say, for instance, you’re a diabetic, but you haven’t gone grocery shopping lately and everything in your cupboard is either full of carbohydrates or is processed. That’s going to play a significant factor in your health and wellness,” said Rachel. “Our program can get that person to a store that has healthy food options.”
Clients who have received transportation services have been tracked to determine a correlation between providing rides and admission and readmission rates to the hospital. So far, it’s having an impact on reducing those numbers. “The program has really been working well and we’re so proud of our accomplishments so far,” concluded Cassy. “We look forward to helping many more people in need.”
For more program information, contact Cassy at [email protected], or 315.261.2129.
Rides to Healthier Options
Transportation services have been expanded for those in need in Franklin County by way of the dissemination of bus tickets, gas cards, assistance with minor vehicle repairs, and ride assistance from taxi cabs companies and other providers for non-medical needs.
According to Lee Rivers, Executive Director, Community Connections of Franklin County, the Rides to Healthier Options program has been a huge success and an eye-opener. “Throughout this entire process, what was so simple to see was that individuals living in rural populations do not have enough money to pay for transportation services. This is a catch-22 because transportation companies have a hard time making it without riders,” said Lee.
To date, the program has provided more than 3,300 bus passes, 460 gas cards, and nearly 500 rides for medical, behavioral health, dental, and eye care appointments, grocery store and pharmacy visits, support group meetings and transportation to and from work. It’s also paid for 19 vehicle repairs.
In addition to Community Connections of Franklin County, the initiative involves partner organizations The University of Vermont Health Network – Alice Hyde Medical Center, JCEO, the Franklin County Office for the Aging, St. Joseph’s Addiction Treatment & Recovery Centers, the Franklin County Department of Social Services, Citizen Advocates, Adirondack Health, and Franklin County Public Transportation.
“A program like this only works if everyone works together,” said Lee. “In this case, our efforts have been successful in that every stakeholder knows and plays its role.”
For more program information, contact Lee at [email protected], or 518.521.3507.
Fulton County Transportation Project
“One of the largest deterrents to health care in our region has been transportation. Fulton County is a very rural community with a limited transportation network. For years, many of our residents have been unable to get to their health care appointments and other important destinations,” stated Kathy Calabrese, Children and Family Services Director, The Family Counseling Center. Kathy, Coordinator of the Fulton County Transportation Project, added, “With innovation funding and the launching of this project, we’ve been able to help recipients get to their appointments, pick up medications at the pharmacy, and take care of other needs that otherwise would have resulted in a further decline in one’s wellness if left unmet.”
In addition to The Family Counseling Center, participating organizations include Nathan Littauer Hospital & Nursing Home, Planned Parenthood Mohawk Hudson, The Community Health Center, HFM Prevention Council, and the Mental Health Association of Fulton and Montgomery Counties. Each partner has received a supply of vouchers to share with patients and clients.
At the outset of the project, collaborators anticipated distributing approximately 3,100 taxi cab vouchers, 3,700 bus tokens, and 600 gas-only gift cards to individuals in need over a two-year period. To date, according to Kathy, nearly 600 vouchers have been circulated.
“This program has given us the ability to bridge large gaps in transportation resources,” said Kathy. “We are extremely excited to be able to offer this service to those who have struggled with this challenge for such a long time. It has been a very beneficial and practical resource to be able to offer individuals as we continue to build a healthier community.”
For more program information, contact Kathy at [email protected], or 518.725.4310, ext. 109.