MANSFIELD — Imagine walking three miles just to get a check up.
If your doctor is in Mansfield, the journey may include walking cracked or missing sidewalks, dodging downtown traffic, fighting to stay upright in the wind and snow or mopping midsummer sweat from your forehead.
When all is said and done, you may decide it’s not worth it.
A new partnership between Third Street Family Health Services and Richland County Transit is aiming to bridge the gap for patients without reliable transportation.
Third Street Family Health Services is a federally qualified, non-profit community health center. That means the agency receives funds to support underserved populations, regardless of their insurance coverage or ability to pay.
“For our population of patients that we work with, transportation is a major barrier to access,” said Alex Goff, vice president of business development at Third Street. “If we can help mitigate some of that, it helps the community access those healthcare needs that they have.”
Since May, Third Street has contracted with RCT to provide scheduled rides for patients living and receiving care in Richland County.
Goff said the service has been reliable for patients and improved attendance rates for appointments.
“Patients are extremely grateful for the transportation services we provide. Prior to having transportation available, many patients missed appointments because they had to walk, were affected by poor weather conditions or had to rely on family and friends for rides,” Goff said.
Lora Ellis has worked as an RCT driver for more than three years. The work is rewarding in part, she said, because she remembers the frustration of raising children while driving an unreliable car.
She said private transportation can be expensive and options are limited in Richland County.
“Some people are out quite far, some transportation doesn’t go out that far,” Ellis said. “And a lot of times (cabs) are not available when they need to go.”
Ellis has picked up riders of varying ages for the Third Street partnership.
“The people that I’ve been picking up have been really appreciative of being able to get to their appointments,” she said. “With our service, they’re able to get there on time and not worry about standing around after waiting for their ride to come.”
How does it work?
Patients can request a ride while scheduling their appointment. Third Street staff pass along the patient’s appointment date, time and pickup location to RCT.
Riders are given a 30-minute window for when their driver might arrive. Drivers are scheduled to return at the appointment’s estimated end time.
“If the patient gets done with their appointment earlier, they can let us know. I can’t promise we’ll be able to come early, but we will try. If we can, we’ll do it,” said Jean Taddie, transit manager for the Richland County Regional Planning Commission.
Patients are also asked to notify RCT if, for whatever reason, their appointment gets delayed.
Third Street covers the cost of the rides using a combination of its own funds, grants from United Way of Richland County and other philanthropic dollars.
Many patients missed appointments because they had to walk, were affected by poor weather conditions or had to rely on family and friends for rides.
Alex Goff, vice president of Business Development at Third Street Family Health Services
“We believe that it’s really an important need for the community, so we are willing to absorb some of that cost,” Goff said.
Tehnika Baker has used the service twice since moving to Mansfield about eight months ago.
“It is a good service for low income people,” she said. “I myself am disabled and also a caregiver, so money is tight.”
Transportation for Third Street patients isn’t new. The agency operated its own transportation program for about three years.
But when Third Street was running its own program with just one van and one driver, not everyone was able to secure a ride.
“When we were doing this ourselves, the utilization was so limited. Our driver would book out weeks and weeks ahead,” Goff said.
Cost was another challenge. Third Street was covering two employee salaries (the program also included a scheduler), auto insurance, vehicle maintenance costs and gasoline.
“We just thought, ‘There’s got to be a better way of doing this than what we’re doing now,'” Goff said.
Goff said working with a private company would have been cost prohibitive. So he approached Taddie about partnering with RCT, a publicly-funded agency that runs fixed bus routes and dial-a-ride services.
RCT now handles all of Third Street’s patient transportation within Richland County as part of a six-month pilot program.
“Before, around 97% of those transports that we were providing were here in Richland County,” Goff said. “We’re still working through what opportunities may be available in Ashland, Crawford and Marion counties.”
“We may have to look at more private options in those counties, but we’re still kind of working through that,” he added.
Early results show costs are down while ridership is up
After just two months, Goff said the amount Third Street spent on patient rides dropped significantly.
“It’s probably reduced our cost to about 30 to 40 percent of what our costs would have been,” he said.
Meanwhile, RCT transported 121 patients in June.
“It’s effectively doubled our volume in terms of transportation,” Goff said. “We previously averaged about 650 round trips annually and are currently on pace to complete approximately 1,150, based on our current trajectory.”
Goff said it’s hard to know for sure whether that trend will continue, but he noted that Third Street typically experiences in uptick in patients requesting rides during the winter months.
Partnership helps build sustainability for local transit
Third Street and its patients aren’t the only ones benefiting from the arrangement. Taddie said it also helps with RCT’s financial obligations and sustainability.
About two-thirds of the RCT’s operating expenses are covered by federal grants from the Federal Transit Authority. But RCT is required to come up with state and local dollars to “match” those federal funds.
Revenue from bus passes and fares don’t count towards that local match, Taddie said, but contracted services do.
“We need to raise about a million dollars every year in local funds to match a couple million in federal funds,” she said. “Every year is as new adventure.”
Large urban transit systems are often supported by tax levies, Taddie said. But that’s not the case in Richland County.
Matching funds typically include contributions from the state transportation department, city and county governments, North Central State College, Ohio State University’s Mansfield campus and the county mental health board.
“Having multiple streams of income is important,” Taddie said. “It’s important that we have a diverse number of areas that we get revenue from and build partnerships that make good sense for both agencies.”
RCT is legally obligated to prioritize its public routes over private contracts. Taddie said it can be difficult to find contracted service agreements that provide enough revenue to cover operational costs, but don’t overwhelm the system.
But the amount of rides Third Street needed was a perfect fit.
“(Third Street) was kind of like that Goldilocks for us,” Taddie said. “(Partnering with Third Street) helps to increase the amount of local revenue we have to coming in to support our transit system as a whole, which provides more ability for us to provide the public services that we do.”
RCT transports Third Street patients with the same vehicles and drivers that run its dial-a-ride program.
Dial-a-ride is reserved for individuals with disabilities that prevent them from using RCT’s regular, fixed-route service. But Taddie said the demand for those services never fully recovered after COVID-19 pandemic.
‘Do not be afraid to explore operations around transportation’
RCT and Third Street began their partnership with a six-month contract. The temporary agreement allowed both parties to test the waters and work out any kinks.
Both parties said the only challenge that has emerged is no-show patients. Goff said Third Street staff are currently considering how best to handle patient reminders and follow-up communication to reduce no shows.
Both Goff and Taddie said they believe the partnership has the potential to last long-term.
Goff said his advice for other service providers wanting to tackle barriers to health care access is not to do it alone.
“A lot of people are very quick to just dismiss offering transportation in any capacity because people are always afraid of the liability. People are afraid of the cost. Do not be afraid to explore operations around transportation,” he said. “Try and work with local partners as much as you can.”
