# Presentation: 401642

## Who is responsible?

## Rural Health Care Barriers

**The older adult no longer drives **
**Older adults are no longer comfortable driving on the interstate in the metropolitan areas**
**Most of their specialists are in metropolitan areas**
**Many older adults would rather  miss an appointment than burden a child with driving them**

## Of 29 rich nationsUnited States has the highest rate of ‘amenable mortality’ (deaths that could have been prevented with timely care)before age 75U.S is falling further behind

- Nolte,McKee, London School of Hygiene and Tropical Medicine

## One out of every one hundred  (non emergency medical) trips prevents a one-day stay in a hospitalTotal statewide benefit of $1,425,906,024 (number of trips x.1 x average cost of one day hospital in Florida

- Florida Transportation Disadvantaged Services:  Return on Investment Study

## Rural transportation

## Ray County Transportation

**Rural Public Transit System**
**Began as a Senior Transportation Service**
**Became a coordinated transit system**
**By combining and coordinating contracts, they have been able to create a county wide system of 21 multi-function, multi-sized vehicles. **
**They cannot be the total transit option**
**Ray County Transportation is a private not for profit and receives no funding from county government**

## Hospital Funded Transportation

**Golden Valley Memorial Hospital  Clinton Missouri**
**Provide transit through a local transit provider**
**Hospital foundation funds the contract through grants and their foundation funds**
**No rider is refused for inability to pay.**
**OATS transit provides the vehicle and the driver. **
** ****The hospital foundation contracts for the service**

## Albany County, New York 

**Albany County New York DSS non emergency Medicaid transportation contracted with a broker (MTM) to provide the NEMT transportation.**
**Albany County New York DFA contracted with the same broker (MTM) to manage Senior transportation services.**
**The result was providers of senior services became  NEMT providers for their clients, thus allowing them to provide full service transportation**

## Where do we go from here?

**Do not assume transportation is available to meet Senior needs.**
**Do not assume another agency is providing transportation**
**In planning home and community based care include transportation**

## Be a part of Coordination

**Across the country transportation is working on coordination plans.  Metropolitan Planning Organizations, Regional Planning Commissions, Regional Transit Associations , etc are all a part of this planning process.  It is important that you be at that table to represent the issues you are having. **
**Contact your local transit agency, RPC, MPO, RTA or other planning organization to be a part.**
**Contact the State Department of Transportation for information about transit coordination.**

## What part do you play?

**Meet with your local public transit provider and transportation provider for older adults**
**Coordinate schedules and work to schedule appointments when transportation is available**
**Be a part of the coordination meetings**
**Look at ways to fund transportation or provide local match to increase transportation service options**
**Educate your legislators and congressional delegation as to the importance of transportation in the continuum of health care. **

## Transportation is life saving

**Valerie Miller**
**Community Transportation of Association of America**
**Medical Transportation Specialist**
- _[miller@ctaa.org](mailto:miller@ctaa.org)_
**800.891.0590 x713**
**V Miller & Associates**
**valerie.l.m@gmail.com**

## Resources for transportation information and technical assistance.

**Community Transportation Association of America**
**	****	**_[www.ctaa.org](http://www.ctaa.org/)_
**Valerie Miller, CTAA Medical Transportation Specialist  **_[miller@ctaa.org](mailto:miller@ctaa.org)_
**Georgia Transit Association**
**	****	**_[www.thegta.org](http://www.thegta.org/)_
**CTAA Regional Ambassador**
**	****	****Joann Hutchinson **_[hutchinson@ctaa.org](mailto:hutchinson@ctaa.org)_