Removing Transportation Barriers for Addiction Treatment in Cleveland

Author: Jerom Theunissen

Published: August 6, 2019

Person in winter coat gets into the rear seat of a Lyft on a winter day

For over 65 years, Rosary Hall, a part of St. Vincent Charity Medical Center in Ohio, has been helping patients overcome the disease of alcohol and drug addiction. However, participating in a weeks-long outpatient treatment program presents significant coordination challenges for patients, chief among them being transportation. Facing ineffective transport alternatives for patients with substance use disorders, St. Vincent Charity began coordinating Uber and Lyft rides with Circulation, being the first in the nation to do so. The outcomes are promising.

Despite a long history of success for Rosary Hall, transportation has been found to be one of the largest barriers for people seeking and receiving addiction treatment (source). Getting a ride to four or five appointments per week is no easy feat, with many patients having no family members, cars, or driver’s license enabling them a means to attend treatment. What’s more, public transportation can present patients with relapse triggers, where some patients have reported being approached by drug dealers and witnessing drug activity while waiting for and riding the bus. Those who were unsuccessful in completing treatment often cite a lack of access to an affordable, reliable, and convenient form of transportation.  Approximately 55% of Rosary Hall’s outpatient population utilizes Lyft rides to and from treatment.  Since the program’s inception in June 2017 through June 2019, Rosary Hall provided 11,747 rides spanning just under 100,000 miles.

 

Removing the transportation barrier

To help tackle the transportation issues facing patients with substance use disorder, Rosary Hall contracted with Circulation, a digital transportation platform that connects health systems to non-emergency transportation. Prior to executing the Circulation contract, SVCMC explored other transportation options, including its own van service, which had a significant up-front cost and numerous logistical challenges for this patient population and their outpatient treatment needs.

SVCMC caregivers schedule rides to and from treatment at its IOP location in Downtown Cleveland.

The rides are free of charge to patients, with the effort mainly supported by grants that have included contributions from the Alcohol, Drug Addiction and Mental Health Services Board of Cuyahoga County. SVCMC has shown that that the benefits of free rides for IOP patients far outweigh the costs and continues to seek philanthropic funding for this program. Private grant-making organizations see the success and have been financially supportive and St. Vincent Charity is hopeful that insurers will follow suit.

Prior to working with Circulation, SVCMC provided bus passes to clients.  Now that the program has been running for two years, SVCMC has been able to draw some promising conclusions about this service model.

 

Impact and Implications for Mobility Management

The ride service remains available as patients step down to less intensive outpatient care and counseling appointments, avoiding a common benefit cliff that many experience after intensive support programs phase out. The results of the pilot are promising: Approximately 75% of the people who use the transportation program are successfully discharged from IOP. This success number drops to approximately 25% for the people who do not utilize the program.  The caregivers who schedule rides report that their clients are extremely satisfied with the service, the sense of dignity it brings them, and the flexibility to even attend other appointments at SVCMC prior to or following their outpatient treatment.  They also report that Circulation is user-friendly and the safe, consistent, door-to-door Lyft rides contribute to their clients’ recovery.

Dozens of hospitals across the country have followed suit in providing TNC rides not just for those struggling with substance use disorder, but also for elderly, cancer, dialysis, physical therapy and low-income patients. These efforts reflect growing confidence in the TNC model for health care-related transportation. Based on outcomes so far at SVCMC, there are strong indicators that employing this model could effectively remove transportation as a barrier to treatment, and allow participants to focus on their road to recovery.

If you want to learn more, here is the contact of the person for the program:  Carrie Lang, Project Coordinator, Office of External Affairs, St. Vincent Charity Medical Center, carrie.lang@stvincentcharity.com

 

Co-written by Carrie Lang at St. Vincent Charity Medical Center

Image credit: St. Vincent Charity Medical Center

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