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Rx for Rural Health Part 3: Medical transportation often an issue for those most in need of it

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Rx for Rural Health: Medical transportation often an issue for those most in need of it


Geography, combined with the economic and physical limitations of patients, can have a real impact on the ability of reliable transportation to medical appointments across Pennsylvania.

In the Valley, a shared-ride service is offered by rabbittransit in Montour, Northumberland, Snyder and Union counties. It is a door-to-door service, but hours and travel areas are limited and riders must apply for the program and book reservations. In the Coal Region, the Lower Anthracite Transit System is also available.

A lack of reliable transportation can limit a patient's access to and ability to coordinate health care to maintain their well-being, according to a report released in January by the Medicaid and CHIP Payment and Access Commission, or MACPAC.

The non-partisan MACPAC provides policy and data analysis and recommendations to Congress, the secretary of the U.S. Department of Health and Human Services, and states on a wide array of issues affecting Medicaid and the State Children’s Health Insurance Program (CHIP).

The report found non-emergency medical transportation is used extensively by a small number of beneficiaries. Seniors and persons with disabilities are the most frequent users. Those with intellectual or developmental disabilities and serious mental illnesses also use transportation more frequently than those with none of those conditions. The most common transportation destinations are to a physician's office or back home, the report said.

The problems range from a lack of or severe limits on the accessibility of transportation, to the length of time of some appointments and distance from medical facilities.

Residents in Crawford County and rural counties across Pennsylvania who may benefit the most from the transportation services often struggle to get appointments even though bus service has expanded within the past few years.

"There are still a lot of individuals out in the county who have no way to get to their medical appointments," Cindy Hall, Meadville Medical Center's program manager for medical transportation in Crawford County, said. "There are a lot of individuals who live in areas where public transit is just not accessible."

Geography is a factor in Crawford County. It is about 50 miles from east to west and 26 miles from north to south and the majority of the population lives within a 10-mile radius of Meadville in the center of the county. Meadville also is where the county's main hospital and most medical offices are located.

"We have a lot of people that go for four-hour or longer medical treatments — some might need to be in Meadville at noon and not get out until five or six at night," Hall said. "Those are the things that a person can't depend on a drop-off service because they don't know when they're going to finish with their appointment."

Limited options

Transportation options are limited in the Susquehanna Valley of Central Pennsylvania.

The Lower Anthracite Transit System operates a limited fixed-route system in the Shamokin-Mount Carmel area in Northumberland County. Stops along the route bring riders to or within a short walk of smattered health care providers in the region including the Geisinger-Shamokin Area Community Hospital.

Rabbittransit serves Montour, Northumberland, Snyder and Union counties. Fares vary but with transportation subsidies supplementing the service, affordability is high for senior citizens and persons with physical, mental and intellectual disabilities.

Last month, Northumberland County Veteran’s Affairs director Jeff Wojciechowski announced a partnership with rabbittransit that would provide free transportation for medical appointments for county veterans and their spouses/caretakers for the next year. The $5,500 program will be paid through community donations, local grants and county funds with a goal of extending the program indefinitely if community organizations step up to donate.

Rx for Rural Health: Medical transportation often an issue for those most in need of it

Dr Ayn Kerber

Dr. Ayn Kerber, who practices with Family Medicine of Evangelical-Lewisburg, West Branch, spoke of the pandemic and how it closed off people from others including relatives. Many patients who are elderly or disabled rely on family and friends for rides to medical appointments. Kerber said it became harder for patients in these situations to maintain this setup.

"People with more risk factors are having fewer interactions with their younger, more exposed family members," Kerber said. "These are the people who would often take them to appointments."

Winter weather also was another factor that would limit their ability to come to doctor visits, Kerber said.

Geisinger Medical Center has a limited transportation program for door-to-door service at its main hospital in Danville, Montour County.

Stacey Staudenmeier, associate vice president of behavioral health and health choices at Geisinger Health Plan, said community health assistants who work with patients in their homes find themselves tapping into emergency funding to help patients get to appointments.

Eric Scicchitano of The Daily Item contributed to this report. Keith Gushard can be reached at 724-6370 or by email at

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