1. Rides to Wellness Judy Shanley, Ph.D. Asst. Vice President, Education & Youth Transition Co-Director, National Center for Mobility Management Easter Seals, Chicago, IL

2. Learning Objectives  Understand Rides to Wellness and Social Determinant Model  Review of FTA multi-prong approach and Challenge Grant Solutions  Leverage community and national resources from NCMM

3. Social Determinants of Health as a Framework

4. Why Does Mobility and Transportation Pose a Barrier to Access to Healthcare? 4

5. What Transportation Issues Affect Access to Healthcare?  People lack knowledge and skills regarding using public transit  Fear related to using transportation  Healthcare personnel may lack connections with public transportation and mobility management  Transit may lack connections with healthcare  Lack of transportation options  Inconvenience of transportation options  Cost of transportation 6

6. Federal Transit Administration Initiative Supported by National Center for Mobility Management

7. Mobility Management Applied to Healthcare - Rides to Wellness…

8. Have you Heard of Mobility Management?  Yes, I am involved in providing mobility management services.  Somewhat. Not engaged in any mobility management activities.  No, never heard of mobility management.

9. What is Mobility Management Mobility management is an approach to designing and delivering transportation services that starts and ends with the customer. It begins with a community vision in which the entire transportation network—public transit, private operators, cycling and walking, volunteer drivers, and others—works together with customers, planners, and stakeholders to deliver the transportation options that best meet the community’s needs. 8

10. Why Mobility Management?  Customer - person-focused  Emphasis on coordination and collaboration  Innovative and flexible  Technology-driven  Expectation of continuous assessment – data collection

11. Healthcare Access Mobility Design Challenge Grant Program

12. About the Design Challenge  16 community-level teams total  Competitively selected  Teams will work during 6 months to design a ready-to-launch responsive and sustainable solution  NCMM provides teams with  Guidance and support, and  Up to $25,000 in grant dollars

13. During the 6-month Design Challenge Each selected team will work through a 2-phase process Goal: Prepare 1 healthcare access solution for implementation Phase 1: May to July -- Begin with 2 proposed solutions  Learn about each solution through conversations with partners and potential customers  Strengthen each solution using results from feedback and other research Phase 1 concludes with the team forming a single solution to take into Phase 2

14. Phase 2: August through October -- Begin with single solution  Learn about the solution through conversations with partners and potential customers  Strengthen the solution using results from conversations and other research  Prepare a business plan that provides a roadmap for customer outreach and marketing, operations, and financial sustainability  Prepare and deliver a presentation – a pitch – describing the solution Grantees may be testing the solution with actual customers

15. Each community gains confidence that it has crafted a solution that: Goal 1: Will be wanted and used by customers Goal 2: Can be operationally and technologically feasible Goal 3: Can be financially launch and sustained Purpose of Two Phases

16. How do you Solve Problems?  What processes do you use to develop solutions?  What are the pros and cons of the processes you use?

17. Think About…  Do any of the proposed solutions make sense for your setting? – Why or why not?  Have you implemented or could you implement these solutions?  Have you heard any themes?

18. Four Challenge Areas 1.Access to preventive care, primary care, and/or health education opportunities 2.Access to ongoing dialysis treatment 3.Access to post-hospitalization medical appointments, rehabilitation therapy, and other services to help people avoid re-hospitalization 4.Access to behavioral health treatment

19. Prevention – Birmingham, AL Prevention- Primary Care  Multi-Modal Access Guides. Guides would include maps and other information on access by people with disabilities to a particular destination, including availability of transit and taxi services, and the quality of walking conditions.  Non-transit-based demand-response services. Use private service providers (i.e. Uber) and ensure private providers have polices in place to support people with disability and incentivize accessible vans to participate in the service.  Increase use of fixed-route service. Using universal design principles, develop improved fixed-route transportation services users.

20. Prevention South Central Missouri (9 counties)  Train-the-trainer curriculum. Volunteers from the hospital auxiliary, senior center, and other – trained regarding transportation options, Healthtran.  Healthcare providersubscription service to transportation.

21. Prevention-Worcester, MA  Web-based application thatwould facilitate scheduling appointments.  Bus for patients going to healthcare appointments. Bus would travel from5-6 different regions on different days of the week. Scheduling of the appointments at a hospital can be done based on which day the bus is running in the patient’s respective neighborhood.

22. Prevention Buffalo Moms  Transportation Navigator at OB clinic. Provide personalized trip planning and education program to provide low-income, pregnant women with information on access to alternative transportation options.  Building Savings Behaviors. Use existing Individual Development Accounts (IDAs) or voucher savings programs to enable EITC-eligible young families & pregnant mothers to afford unlimited monthly transportation passes.

23. Dialysis Sandusky, OH  Sustainable volunteer driver program. Transport dialysis patients when transportation requests are outside of service hours, the public transit provider is at capacity, or public transit is closed for the day.  Scheduling and delivery model. It involves setting up a communication system between the dialysis center staff, patients, and the transportation provider.

24. Readmission Ada, Gem, & Canyon Cos., Idaho  Coordinated Programmatic and Information Support. Use the current one-call center to provide web based reservation system, traveler orientation services, and coordinated marketing. Clinic workers would be trained to easily assess patients’ transportation needs.  First/last mile solutions. Coordinate solutions that provide first-and last-mile solution for patients fitting top 5 diagnoses for hospital readmission.

25. Re-Hospitalization Franklin, Jackson, Perry, and Williamson Cos., Illinois  Proactive Identification of At-Risk Patients: Patients would be referred to mobility management services. Mobility managers would create relationship with these patients to ensure they make their appointments.  Education of Patients and Health Care Providers: Employ a comprehensive education strategy, which targets both those patients who are most at-risk of re-hospitalization, as well as those health care providers that most commonly treat these patients to inform them about MedTrans mobility management services.

26. Dialysis Atlanta Regional Commission, DeKalb, GA  Reimbursed private rides. The project proposes to identify ways to both train more drivers and increase ridership.  Expanding volunteer driver pool. Tap into ARC’s robust Retired Senior Volunteer Program consisting of 179 volunteers and exploring other options to recruit additional driver volunteers to boost capacity.

27. What’s Next?  Extension of investment programs  Identify promising practices  Provide forums for exchange and learning – Coordinating Council on Access & Mobility  Encourage sustainability and replicability

28. The Difficulty in Finding Mobility Management Practices

29. Not Sure if a Practice is Appropriate?

30. Not Enough Information to Make a Decision?

32. Mobility Management Information and Practices (MMIP) Database  Identify descriptions of mobility management practices – State and county levels  Descriptive information about practices – context, demographics  Facilitate interactivity via searchable database features  Flexible tool - Update content continuously

33. Practice Descriptions  Innovation  Knowledge base  Stakeholder engagement  Monitoring and evaluation  Efficiency  Impact

34. Share Your Practices http://nationalcenterformobilitymana gement.org/share-your-practices/

35. Tap into Resources www.projectaction.org www.nationalcenterformobilitymanagement.org http://webbuilder.nationalrtap.org / Transitplannning4all.org

36. Judy Shanley, Ph.D. jshanley@easterseals.com 312-551-7227