Mt. Ascutney Hospital and Health Center, a Critical Access Hospital, reduces the barrier of transportation in a rural environment
Transportation combined with poverty creates a true barrier to health care in a rural environment. In the Mt. Ascutney Hospital and Health Center (MAHHC) service area, 7% of households have no vehicle available. Compared to New Hampshire and Vermont, 5.2% and 6.6% respectively, the service area has significant disparity in available transportation. In MAHHC’s most recent community health needs assessment (CHNA), transportation ranked third in overall barriers to care. Key stakeholders in the CHNA ranked lack of transportation as the number one barrier to accessing services (72.7%).
What We Tried
We developed a multipronged approach to address lack of transportation building upon our preexisting work and integrated concepts that had been found successful in other areas:
- Two specific algorithms (Transportation Algorithm Windsor) were developed to maximize options for patients. Patterned after the Springfield, VT Community Health Team, these algorithms address rides available through Medicaid support, elderly and disabled transportation, limited public transportation, taxis and volunteers.
- The MAHHC Community Health Team evaluates transportation as part of the assessment process and assists complex high-risk patients to overcome this barrier, often using the options identified in the transportation algorithms.
- Partnerships with local, on-topic funding sources, such as The Jack and Dorothy Byrne Foundation, were created to help us provide gas cards and payment for transportation for patients in poverty.
Jill Lord RN MS, MAHHC Director of Community Health, reports, “We have spent considerable time working with patients, volunteer agencies, and local transportation companies to help patients overcome problems related to lack of transportation.”
Data, including the number of miles driven by volunteer drivers, is tracked to monitor project success. Over the past year alone, we provided over 15,000 miles of volunteer transportation. Carla Kamel from the MAHHC Community Health Team states:
“If one of our patients is impeded by lack of transportation to their healthcare provider, then it creates a snowball effect. Missed appointments can lead to a crisis visit at the ED via an ambulance. As a Care Coordinator, it helps to transport the patient to their appointments and to assist them in listening to what the provider is communicating, and then ensuring transportation is guaranteed for the follow-up appointment.
Transportation can be a hidden barrier. I sense there are many patients who are too proud or embarrassed to say that they’re unable to keep their scheduled appointments due to lack of transportation. The provider is not aware of this as a barrier to treatment and may assume that the patient is choosing to avoid the appointment, or to pick up their prescription at the pharmacy.”
Learn of and maximize the resources available in the community, and work as a team with community partners.