National Academies Press: OpenBook

Improving Mobility for Veterans (2011)

Chapter: Chapter 3 - Typical Transportation Options for Veterans

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Suggested Citation:"Chapter 3 - Typical Transportation Options for Veterans." National Academies of Sciences, Engineering, and Medicine. 2011. Improving Mobility for Veterans. Washington, DC: The National Academies Press. doi: 10.17226/14507.
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Suggested Citation:"Chapter 3 - Typical Transportation Options for Veterans." National Academies of Sciences, Engineering, and Medicine. 2011. Improving Mobility for Veterans. Washington, DC: The National Academies Press. doi: 10.17226/14507.
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Page 31
Suggested Citation:"Chapter 3 - Typical Transportation Options for Veterans." National Academies of Sciences, Engineering, and Medicine. 2011. Improving Mobility for Veterans. Washington, DC: The National Academies Press. doi: 10.17226/14507.
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Page 32
Suggested Citation:"Chapter 3 - Typical Transportation Options for Veterans." National Academies of Sciences, Engineering, and Medicine. 2011. Improving Mobility for Veterans. Washington, DC: The National Academies Press. doi: 10.17226/14507.
×
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Page 33
Suggested Citation:"Chapter 3 - Typical Transportation Options for Veterans." National Academies of Sciences, Engineering, and Medicine. 2011. Improving Mobility for Veterans. Washington, DC: The National Academies Press. doi: 10.17226/14507.
×
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Page 34
Suggested Citation:"Chapter 3 - Typical Transportation Options for Veterans." National Academies of Sciences, Engineering, and Medicine. 2011. Improving Mobility for Veterans. Washington, DC: The National Academies Press. doi: 10.17226/14507.
×
Page 34
Page 35
Suggested Citation:"Chapter 3 - Typical Transportation Options for Veterans." National Academies of Sciences, Engineering, and Medicine. 2011. Improving Mobility for Veterans. Washington, DC: The National Academies Press. doi: 10.17226/14507.
×
Page 35
Page 36
Suggested Citation:"Chapter 3 - Typical Transportation Options for Veterans." National Academies of Sciences, Engineering, and Medicine. 2011. Improving Mobility for Veterans. Washington, DC: The National Academies Press. doi: 10.17226/14507.
×
Page 36
Page 37
Suggested Citation:"Chapter 3 - Typical Transportation Options for Veterans." National Academies of Sciences, Engineering, and Medicine. 2011. Improving Mobility for Veterans. Washington, DC: The National Academies Press. doi: 10.17226/14507.
×
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Page 38
Suggested Citation:"Chapter 3 - Typical Transportation Options for Veterans." National Academies of Sciences, Engineering, and Medicine. 2011. Improving Mobility for Veterans. Washington, DC: The National Academies Press. doi: 10.17226/14507.
×
Page 38

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31 Chapter 3 TYPICAL TRANSPORTATION OPTIONS FOR VETERANS There are eight major types of transportation services typically available for veterans; the first four listed below are offered through the VA. Despite these potential options, individual communities may have only a few of these choices available. Each mode of transportation service that veterans use to travel is described in this chapter with examples if applicable. The eight major veteran transportation options are: 1. Veterans drive to VA Medical Centers. 2. Veterans receive transportation from nonprofit veterans’ service organizations, including the DAV and other veterans’ organizations. 3. VAMCs directly operate vehicles. 4. VAMCs contract with transportation vendors. 5. Veterans use county-provided services.

32 6. Veterans receive transportation services via community-based organizations. 7. Transit agencies offer transportation to veterans. 8. VAMCs provide transportation information for veterans. VETERANS DRIVE TO VA MEDICAL FACILITIES If they are physically and financially able to do so, many veterans drive to VAMCs. A major issue is that the vast majority of health care services for veterans are provided only at VHA facilities like Medical Centers and community-based outpatient clinics (CBOCs). There are 153 VAMCs and 731 COBCs throughout the United States, but veterans requiring specialized medical care cannot find that care at every VAMC or CBOC. In some rural areas, round trips to the nearest relevant VHA facility cannot be completed in one day. Multiple trips to these far away medical facilities can be burdensome. To offset the travel costs associated with obtaining medical services, qualified veterans may seek beneficiary travel mileage reimbursement (as described in Chapter 3). The number of veterans accessing their medical care by driving was 586,000 in FY 2009, a 30 percent increase from FY 2008 (VA, December 2009). The average amount per mileage reimbursement claim in FY 2009 was $75.66 (VA, December 2009), which suggests that the average round-trip mileage exceeded 185 miles. (An exact figure cannot be calculated because the current reimbursement of 41.5 cents per mile was not in effect for the entire 2009 Fiscal Year.) VETERANS RECEIVE SERVICES VIA NONPROFIT VETERANS’ SERVICE ORGANIZATIONS Veterans receive extensive services from nonprofit veterans’ service organizations. There is an extremely strong culture of “veterans taking care of veterans” that extends to transportation as well as many other kinds of needs. The voluntary services are an important resource that needs to be incorporated into any successful effort to improve the mobility of veterans. At the same time, it is crucial that one also understand the limitations of these services.

33 Veterans Use Disabled American Veterans (DAV) Transportation Services Description of DAV Transportation Services The Disabled American Veterans organization (DAV), a nonprofit veterans’ service organization, has been offering various transportation services to veterans for many years. DAV serves veterans using DAV’s pool of volunteer drivers, and the local DAV chapters also work with VAMCs and other community organizations to secure vehicles. “The Volunteer Transportation Network (VTN) is designed to provide transportation services to veterans seeking benefits at VA facilities, including Veterans Benefits Administration (VBA) offices, and who have no other means of transportation.”35 VTN services are not to be used for any other trip purposes. In fiscal year 2008, DAV transported 25,483 veterans and drove 28 million miles.36 On an annual basis, these figures equate to an average of 1,098 miles per year per veteran transported by DAV to medical services. (That figure is nearly equal to the estimated number of miles traveled per year by a veteran who drives to their VHA medical appointments.) For the 2009 calendar year, the figures are similar: DAV volunteers drove 28.3 million miles and provided 743,701 trips to veterans. The average trip length in 2008 and 2009 was 38 miles. The total cost of DAV national transportation network grants in 2009 (to support Hospital Service Coordinators and to purchase vans) was $4 million. 37 The proportion of veterans needing transportation who used DAV transportation in a particular year is currently unknown. DAV operates the largest program in the Veterans Transportation Network (VTN). DAV offers services for most (but not all) locations in the VA healthcare system. Their program provides free transportation for veterans for health care trips. DAV employs Hospital Service Coordinators (HSCs) at major VA medical facilities to operate the transportation program at those facilities. A typical situation is that the local DAV chapter raises contributions that are used to buy vans; the vans are donated to the VA, which then provides insurance, fuel, and maintenance. DAV does not purchase vehicles accessible to veterans in wheelchairs, and DAV’s volunteer drivers are not authorized to lift or provide medical services to any rider. 35 VHA Handbook 1620.02, Volunteer Transportation Network, May 24, 2007. http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1572, accessed November 19, 2010. 36 Interview with Michael J. Walsh, National Director of Voluntary Services, December 2009. 37 Michael J. Walsh, DAV Annual Report, http://www.dav.org/volunteers/documents/AnnualReport.pdf, accessed November 22, 2010.

34 Example of DAV Transportation Services Program: DAV Transportation Services Location: Lebanon, Pennsylvania Key Features: Volunteer driver-based transportation Door-to-door, shared-ride program No accessible vehicles available DAV-supplied vehicle and volunteers; the VAMC is responsible for fuel, maintenance, and insurance. The DAV transportation program associated with the Lebanon VAMC uses 13 vans and has 70 volunteer drivers. The program transports 30 to 35 passengers daily. The service covers 13 counties and is available for longer trips throughout the state on an as-needed basis. On any given day, volunteer drivers start driving at 6 a.m. to pick up the first veteran rider; they then continue their assigned route in their region. By 8:30 a.m. they arrive at the VAMC with their passengers. The HSC and scheduling staff at the VAMC, as well as the patients themselves, attempt to ensure that all medical appointments are completed by 12:30 p.m. The DAV vans depart the hospital no later than 1 p.m. The volunteer drivers may have spent a total of 10 hours or more that day (driving, waiting, and driving) by the time all passengers are dropped off at their respective homes. Two key factors are needed to successfully operate DAV transportation program: qualified volunteers and collaboration with VAMC. Volunteers are crucial to this program. All drivers, as well as the HSC, volunteer their time to help veterans. They all believe in veterans serving other veterans and work hard to make the program work. Another important factor is partnership with VAMC. The DAV hospital service coordinator needs to work with various VAMC employees, such as travel office staff, scheduling office staff, and clinical staff. The HSC assists veterans to decide appropriate level of transportation services by referring them to VA travel office. The DAV hospital coordinator also reminds the medical scheduling office of the DAV van schedules; this helps ensure that veterans who need transportation get medical appointments when transportation service is available. In addition, it is often the hospital coordinator who makes sure that group riders’ appointments are

35 not delayed so that they can get a ride home. If veterans driven by DAV are not able to get a return ride, the HSC may need to find ways to arrange alternative transportation. Veterans Receive Services via Nonprofit Veterans’ Service Organizations Description of VSO Transportation Services Veterans’ service organizations (VSOs) may be better informed about veterans’ needs than other human service agencies. VSOs have unique characteristics that can be beneficial to veterans. Many volunteers and staff working for VSOs are veterans themselves or have strong ties to veterans. They are committed to their work and often go above and beyond their prescribed duties to help veterans. Example of Nathan Hale Foundation Transportation Services Program: The Troops in Transit Program, Nathan Hale Foundation Location: Plymouth, Massachusetts Key Features: Includes both paid and volunteer drivers Provides door-to-door service, shared ride program Offers prescheduled trips and some flexible trips. The Nathan Hale Foundation offers pre-established schedules Monday through Thursday so veterans know when to make their appointments. For example, a veteran traveling to the West Roxbury VA Hospital knows that the van goes to that location on Mondays. On Fridays, the Foundation provides trips for local appointments such as dentist, dialysis center, blood work, or grocery shopping. It is unique that this organization covers non-VA sites as well. The vans are driven either by volunteer drivers or staff drivers. Most volunteers come to the rider’s door. Their volunteer drivers are highly qualified (police officer, fire fighter, combat veterans, and transit drivers with Commercial Driver’s Licenses [CDLs]) and are committed to work with veterans. To be eligible for the rides, one needs to be a veteran. As long as the rider is a veteran, disability status or income level is not considered.

36 VAMCS DIRECTLY OPERATE VEHICLES In some instances, VAMCs have their own transportation programs. They utilize employee-drivers and VAMC-owned vehicles. VAMCs directly operate transportation programs. Some VAMCs have transportation programs whereby their vehicles are operated by the VAMC employees. Typically they use station wagons and minivans. The majority of the patients are transported from home to the hospital with these vehicles, with pick-ups starting as early as 5 a.m. This was the case for VAMC in Miami, Florida until 2009. More recently, the VAMC in Miami has discontinued its in-house transportation service and now has agreements with local vendors to provide transportation to veterans. VA facilities operate shuttle services between two VA-affiliated locations. It is not uncommon that some veterans travel to another nearby VAMC or VA-affiliated facility for medical treatments. For instance, veterans who have their initial appointments at their local VA clinic may need to be transferred to a larger VA facility for a specialized procedure. In the Brick VA clinic in Ocean County, New Jersey, such a program is available. Some veterans may only have scheduled round-trip rides from their home to specified VA sites. Shuttle services operated by a VA clinic allow veterans to get to another facility in time for the procedure. VAMCS CONTRACT WITH TRANSPORTATION VENDORS Description of Contracted Transportation Services Many VAMCs across the nation contract with private transportation vendors to provide rides to veterans. These vendors include taxicab companies, companies with wheelchair accessible vehicles, ambulance vendors, ambulette services, or Medi-van services. Contracted services from vendors such as taxicab companies may be used for overflow trips or have more significant roles in transporting veterans. Examples of Contracted Transportation Services For more than 20 years, Yellow Cab of Tallahassee, Florida has been working with VAMCs. Veterans contact the local VA Medical Center travel office and the travel office contacts Yellow Cab, which provides demand responsive, prescheduled, and subscription trips to veterans. Yellow Cab delivers veterans to VA facilities in Tallahassee, Lake City, Gainesville, and Marianna and picks

37 them up there for return trips. Many of the trips that veterans take run into several hundreds of dollars and the trips are for individual veterans only (there are no shared rides). The VAMC serving the Washington, DC area works with a local vendor called Battle’s Transportation, Inc. to transport veterans with disabilities. Battle’s Transportation is a private company categorized under Local and Suburban Transit and located in Washington, DC. Travel office employees at the VAMC arrange rides for veterans who need accessible vehicles or other type of special medical transport vehicles. VETERANS USE COUNTY-PROVIDED SERVICES Description of County-Provided Transportation Services In some areas, county-provided transportation services are available where no other type of veterans’ transportation services exists in the region. One model is to have veterans provide their own travel to a centralized pick-up location; group rides are then provided from the centralized location to VAMCs. Some vehicles may be operated by volunteer drivers and others by county employees. Example of County-Provided Transportation Services Program: Transportation Program for Clinton County Veterans’ Service Commission Location: Clinton County, Ohio Key Features: Centralized pick-up, shared-ride program Accessible vehicles available Driven by county employees. This program serves rural areas in Clinton County, Ohio. While it mostly uses centralized pick-ups, drivers pick up veterans at their home if they require accessible vehicles. To be eligible for the program, riders have to be veterans, reside in Clinton County, and should have standing

38 appointments at a VAMC. This service, which is provided only to a VAMC and to no other destinations, is free of charge. VETERANS RECEIVE SERVICES VIA COMMUNITY-BASED ORGANIZATIONS Description of Community-Based Transportation Services In some regions, community-based organizations develop veterans’ transportation programs. In New Jersey and Pennsylvania, local Red Cross chapters are involved in transporting veterans. In Michigan, Volunteers of America operates transportation services for homeless veterans. These organizations are nonprofit organizations serving specific geographic areas and their programs are designed to meet the local needs. Example of Community-Based Transportation Services Program: American Red Cross Northern NJ, Veterans Transportation Program Location: Morris County, New Jersey Key Features: Door-to-door service, shared-ride program No accessible vehicles available Driven by volunteer drivers. While it is not common to find veterans’ transportation programs within Red Cross chapters throughout the country, this particular program serves the critical unmet needs of veterans in Morris County. All VAMCs in the region are located outside of Morris County and the county-provided paratransit program does not transport riders to destinations outside of county boundaries. The Red Cross transportation program is the only service for many veterans to access VAMCs. To be eligible for the program, one has to be a veteran, ambulatory, and reside in Morris County. There is no DAV volunteer driver program in this region, but a local DAV chapter assisted the Red Cross by donating a vehicle.

39 TRANSIT AGENCIES OFFER TRANSPORTATION TO VETERANS Description of Transportation Services Offered by Transit Agencies Many local public transit agencies do not keep records of the trips that they provide to their local veteran population. Some local transit agencies do record trips that they provide to non-ambulatory veterans through the paratransit programs that they offer. Example of Transportation Services Offered by Transit Agencies In Lufkin, Texas, Brazos Transit contracts with Coach America and provides veterans’ transportation services. The program began in 2007 with financial support from a foundation. A passenger coach provides daily services from Lufkin to the VAMC in Houston. The over-the-road coach can transport 51 veterans per trip and can also accommodate two wheelchair users. Brazos Transit oversees the program while the service is operated by Coach America. Medical reservations are handled by the local VA clinic. See Chapter 5 for additional examples of transportation services offered by transit agencies to veterans. VAMCS PROVIDE TRANSPORTATION INFORMATION FOR VETERANS A number of VAMCs provide transportation information to help veterans make their own travel choices. For example, the VA Pittsburgh Healthcare System provides the following information about transportation services in their region on their web page: “Many modes of transportation are available to enable our patients and their families to travel to the VA Pittsburgh Healthcare System. Several transportation methods are listed below. – DAV Vans - complete van schedule from all of our spoke hospitals. – VAPHS Shuttles - for transportation between the three Pittsburgh facilities (University Drive, Highland Drive, and H.J. Heinz). Other Forms of Local Public Transportation

40 – Mass Transit - Port Authority of Allegheny County and ACCESS Transportation. – p.r.n. Para Transit Service - (412) 824-2181 or 1-800-860-8222 – Yellow Cab - (412) 321-8100/8112 – Transcare Ambulance - (412) 373-0200.” Veterans have a wider choice of travel options when they have this type of information.

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TRB’s Transit Cooperative Research Program (TCRP) Research Results Digest 99: Improving Mobility for Veterans mobility explores issues facing our veterans and illustrates some potential strategies for community transportation providers who are interested in enhancing mobility options for our veterans.

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