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Transportation is Lifesaving

Transportation is Lifesaving. Valerie Miller Community Transportation Association of America Medical Transportation Specialist. “The times, they are a changing”.

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Transportation is Lifesaving

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  1. Transportation is Lifesaving Valerie Miller Community Transportation Association of America Medical Transportation Specialist

  2. “The times, they are a changing” • The trends in health care are evolving. In the early part of the 20th Century, the doctor had the mobility role making house calls • In the last half of the 20th century, the patient and the doctor met at the hospital and long hospital stays became common.

  3. Twenty-first Century • Today, the patient is the mobile one • Outpatient surgery • Outpatient treatment • Outpatient rehabilitation

  4. Trends • Persons are living longer with more infirmities • The average hospital stay is much shorter • The population is aging • Obesity is becoming epidemic bringing with it many health related issues

  5. Trends • Addiction and the need for treatment is increasing • Dialysis treatment is growing • Mental health treatment is more acceptable and therefore increasing

  6. Veterans’ medical transportation needs • Our troops are coming home with critical mental and physical health issues • Traumatic Brain Injury • Loss of limbs • Stress related disorders

  7. WWII and Vietnam veterans • Aging is requiring increased medical care • Aging is requiring increased assistance in transportation

  8. Fuel prices!!!!! • Increased difficulty in travel to seek medical treatment • Increased difficulty in travel to employment in the medical industry

  9. Of 29 rich nations, the United States has the highest rate of ‘amenable mortality’ before the age of 75 • The U.S. is falling further behind Nolte,McKee, London School of Hygiene and Tropical Medicine

  10. Non-emergency medical transportation • The emerging transportation need of the twenty first century

  11. “No community can be truly healthy if a significant portion of the population is excluded from basic health care services…” • Volunteers in Medicine Institute

  12. Who are our customers? • Older adults • Veterans • Persons with disabilities • Children • Healthcare employees • persons who are “fuel challenged”

  13. Older adults • One in five persons over 65 does not drive • Compared with older drivers, older non-drivers in America make 15% fewer trips to the doctor • Men can expect to spend the last six years of their lives dependent on others for transportation. For women the time is 10 years. • Lack of transportation was named the No. 3 problem in the lives of seniors, ahead of both Medicare and Social Security issues.

  14. The need for NET is not just for older adults • Rising fuel costs have resulted in “fuel challenged” riders • Persons who have never thought of using public and community transportation are new customers

  15. Transportation is a part of the continuum of health care • America has some of the best medical facilities with the best medical care in the world. • This is no better than a third world country if the person cannot access the health care.

  16. One out of every one hundred non emergency medical trips prevents a one day stay in a hospital • Total statewide benefit to Florida of more than a billion dollars (number of trips x.1x average cost of one day hospital stay • Florida Transportation Disadvantaged services: Return on Investment Study

  17. The need for medical transportation is both urban and rural • Many older adults are not comfortable driving in the metropolitan area • Income and or disability may dictate the need for transportation assistance • Medical community does not consider transportation in land use planning

  18. Rural needs; rural barriers • Across the US • Average distance for medical/dental care was 10.2 miles • Rural trips average 17.5 miles vs. 8.3 miles for urban residents • Nationwide average medical trip took 22 minutes

  19. What is the future of non emergency medical transportation? How will people be able to get to the health care they need?

  20. What will transportation look like and how will we serve these needs? • Medical transportation has worked its way to the forefront of public and community transportation • Historically, private transportation has provided medical transportation

  21. Private • Brokerages manage non-emergency Medicaid transportation • Ambulance handles emergency transportation a emergencies and Medicare

  22. Medical transportation mix • Medical transportation need is so great it will require a variety of modes and levels of transportation • Incorporating these modes into coordination plan will take effort

  23. Be creative in your solutions • Think outside of the box • Work with new people • Don’t discount volunteers, donated labor • Work with family members of riders to see what they can offer to your system • Create unusual partnerships

  24. Who are your new coordination partners? • Introduce your system to the medical community • Invite the medical community into the transit community • Learn each others language • Identify each others assets • Identify each others needs

  25. Joint meetings • Work with state chapters of national medical associations • Work with veterans’ associations to identify their needs • Plan overlapping conferences and share common training

  26. Educate the medical community about transit funding • Help them to help you

  27. Understand MedicaidBe proactive not reactive • Educate your transit community about CMS • Follow proposed rule changes • Be educated---Be vocal

  28. Keep good client encounter data • When dealing with Medicaid • Keep accurate records • Be able to justify your cost from a third party vantage point • Insure that Medicaid is not paying for any costs not pertaining to Medicaid service

  29. Identify medical trips • Medical transportation is the new focus • Keep good data on numbers of medical trips, miles, mode of travel

  30. Given the trends of increasing number of persons with chronic disease and increase of outpatient treatment, greater government investment in non-emergency medical transportation is needed if Americans are to receive adequate healthcare.

  31. Exhaust the positive before considering the negative • Transportation is the difference between life and living

  32. Valerie Miller • Community Transportation Association of America • Medical Transportation Specialist • miller@ctaa.org • 202-294-2212 • www.ctaa.org

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