Over the past year, my uncle’s health has deteriorated quickly. He has a serious, chronic mental illness, and it was very difficult seeing him struggle through rehab after a bad fall and other health challenges. Now that things have stabilized for him a bit, we are all coming to terms with his new reality. The biggest challenge has been the fact that he is no longer able to drive. Seeking care at the VA hospital has been very challenging for him without his own transportation. His regular trips to volunteer there, which give him a sense of purpose, have been difficult to maintain, even before our current stay-at-home environment. We have all chipped in to give him rides, my parents have set him up with a transportation service that comes with his VA benefits, and he’s gotten used to navigating Lyft. However, none of these options work all that well for him. He still feels isolated and longs for more independence, which has a big impact on his health.
My uncle is not alone. Transportation is a major barrier to accessing care for nearly 300,000 Coloradans, and this is especially true for people of color, people with disabilities, rural Coloradans, and Coloradans with lower incomes. Lack of transportation also prevents people from accessing other necessary services and increases the risk of social isolation, which can have dire health impacts. That’s why Medicaid offers what’s called Non-Emergency Medical Transportation, or NEMT. This medical transport program—like a van service—takes enrollees to and from hospitals, clinics, assisted living facilities, pharmacies, dialysis centers, and other medical services. Unfortunately, the program has been dogged by quality and safety challenges for years and has been targeted for elimination since 2018 by the Trump administration as a way to curtail Medicaid costs.
Center for Health Progress, along with some of our partners, has been advocating for improvements to Colorado’s NEMT program since 2016. Now we’re ramping up our efforts on this issue because we’re hearing from our grassroots membership that transportation continues to be a top barrier to care. Last year, we launched a digital organizing program, with funding from Community Catalyst, to connect with users of this essential service and center their expertise and leadership in our NEMT campaign. Since then, we’ve heard dozens of stories and built a growing online community of individuals who care about protecting this program and making it work better for Coloradans.
This is even more important during COVID-19. Because of inequities baked into our laws and policies, NEMT is disproportionately used by seniors, people with disabilities, and those in rural areas, and many are chronically ill with multiple health conditions. When services are disrupted due to pandemic, those already-vulnerable populations are made more vulnerable. We have already heard from a number of riders and drivers whose health and safety have not been prioritized by the companies who provide NEMT services. These stories range from drivers with no face masks or gloves transporting multiple riders in one van, drivers being told that protective equipment is only necessary if a rider has tested positive (despite the risk to riders if a driver is asymptomatic for COVID-19), drivers not being told that their rider has tested positive for COVID-19, drivers mocking patient requests for sanitation and protection, and riders having to cobble together alternative transportation options because the NEMT options aren’t committed to keeping everyone safe.
This essential medical service can’t continue to fail the Coloradans whose lives are entrusted to it. Now is the time for action, and we’re working alongside NEMT users to determine the path forward. If you’re a user of NEMT services, whether as a patient, caregiver, or health care provider, we hope you’ll join our CONEMT Facebook Group and help guide this campaign. If you or someone you know is an NEMT user, we hope you’ll also use this Rider Resource to protect yourself while using NEMT services during COVID-19. And, if you agree that Colorado’s NEMT program should be strengthened and protected, we hope you’ll sign our petition and join the movement.