Tuesday, December 13, 2011

Models to Improve Transportation for Veterans, Patients and People with Disabilities

Community Transportation Association of America
CTAA's National Resource Center for Human Service Transportation Coordination released NRC Report: Transportation for America's Veterans and Their Families, which discusses improving transportation for our nation's veterans through partnerships and coordination. Examples of the work of regional ambassadors are given. The NRC also maintains a webpage "bookshelf" with veterans transportation resources.

Life-Saving Transportation

CTAA also distributed the Dialysis Report, which discusses the dire, complicated transportation demands that dialysis patients present.
The crux of the transportation challenge is that the majority of dialysis patients are covered by Medicare, which — unlike Medicaid — does not offer non-emergency transportation as a benefit. Three out of four dialysis patients in the U.S., are Medicare primary, meaning that Medicare sets the reimbursement rate and pays 80 percent of that amount ...

Indeed, in background discussions with community and public transit officials around the country for this article, a common refrain was the difficult position in which many transit operators find themselves — how to continuously add new dialysis patients to the transit schedule with no means of payment.
The situation places transportation providers between the proverbial rock and a hard place. CTAA is advocating for a funding mechanism within Medicare and for increased kidney organ donation. "Transplants can add decades to people’s lives and significantly forestall the need for dialysis, but only when the needed organs are available."

Solutions Possible to Realize Decades-Old Commitments

Association of Programs for Rural Independent Living

APRIL's Executive Director, Billy Altom, testified before the Senate Health, Education, Labor and Pensions Committee about the need for affordable, accessible and available rural transportation. Forty years after the Urban Mass Transportation Act and 20 years after the passing of the ADA, Altom argues, "minimal or nonexistent transit services in rural areas still create serious barriers to employment, accessible health care, and full participation in society for people with disabilities."

Altom sees some solutions that are working - mobility management and voucher programs. Altom praised the Easter Seals Project ACTION Mobility Management Independent Living Coaches program and he cited as an example the Center for Independent Living for Western Wisconsin Regional Mobility Management/New Freedom Program, which provided 12,000 rides last year and coordinates in seven counties with public and private transportation providers. More than 140 volunteer drivers provide the rides and the program is expanding into an 18-county area. Already weekly rides are being supplied to 130 veterans.

Partnership for Mobility Management
member Denise Larson is the mobility manager for the program. She also serves on the Partnership's advisory committee.

Another Type of Coordination

American Public Human Services Association

Bridging the Divide: Leveraging New Opportunities to Integrate Health and Human Services is APHSA's new report about the value added of coordinating and aligning health and human services for clients beyond eligibility and enrollment for a "customer‐focused, one‐stop shop, 'service home'." Such coordination makes sense, according to the report, because:
Many of the same people who qualify for Medicaid, CHIP or some level of premium subsidy identified through the Exchanges also qualify for one or more human service assistance programs.

The positive impact of coordinated care and integrated case management on improving the overall health and well‐being of individuals and populations— strengthening families, achieving employment and independence, improving the well‐being of children, youth, people with disabilities, seniors and other vulnerable populations—is well documented. Better outcomes mean healthier, safer, stabilized individuals and families with a better chance of sustainable independence from government services and long‐term personal success.
The report contains case studies of what several states are doing and the impending impact of the new healthcare law.

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