1. The Medical Crisis and Transit Opportunity or Threat? Norm McLeod Manager, Transhelp President, OCTA

2. Transhelp Growth 1998-2001 10% 56% 49% 16%

3. Transhelp Rate of Growth: 1998-2001

4. Mobility Plus Growth 1999-2001 15% 20% Includes Project Lift and Cambridge data

5. Mobility Plus Rate of Growth 1999-2001

6. Dialysis Impacts: Urban Para-Transit Eligibility: –Dialysis: medical and variable –Para-transit: functional and stable Service: –Dialysis: Subscription rides fill schedules –Independent Living: Rides scarcer Budget/Funding -- No health care $$$ –Property tax base bears health care costs

7. Dialysis Impacts: Rural Community Transportation Long distances, frequent trips Multiple service models Volunteer resources mobilized e.g.: –Red Cross, Kidney Foundation, VON, United Way, Long-term Care facilities No reliable health care $$$ –CCAC/LTC funds in some communities –Charitable dollar stretched by health care

8. Dialysis Patient on Para-Transit Weak and sick Long wait Long time on board Uncomfortable ride Is this good health care?

9. Other Medical Impacts on Transit Long-Term Care day programs Stroke recovery and rehabilitation programs Hospital patient transfers

10. Divergent Businesses: Para-Transit, Medical Transport

11. You are in the Health Transport business when: The passenger is met at both ends by a caregiver; Timeliness is an issue affecting health and safety; Complaints come from a caregiver.

12. Building a Medical Transport System Health Care Dollars Hospital and Long Term Care Budgets Purchase of Service from: –Transit, Para-transit, Brokerage –Private or Non-Profit Sector Transit Advantages: –Reduced inappropriate demand on para-transit –OR Increased revenues to broker rides –Takes pressure off property tax base.