Transportation may not be at the top of the list when behavioral healthcare facilities open their doors, but those established in the industry say patient transportation is a differentiator that can ultimately help patient access.
“It’s something that you don’t usually think about when you are thinking about treatment, but it’s a real cost factor,” says Jeremy Broderick, founder and chief executive officer at Windward Way Recovery in California.
According to the National Survey of Substance Abuse Treatment Services survey in 2011, 39% of substance abuse facilities reported offering transportation assistance to treatment. It was most common for residential treatment centers. According to the results, 62% of residential treatment facilities surveyed reported providing transportation assistance, while that percentage dropped to 46% for hospital inpatient treatment facilities and 35% for outpatient treatment facilities.
Those who do offer the services, see transportation assistance as a strategy to remove potential barriers to treatment as well as improve overall patient satisfaction.
“We made the decision that it’s a service to the clients to offer it because you want to remove barriers,” says James Geckler, chief operating officer of Harmony Foundation, a residential rehab center located in Estes Park, Colo.
But providing transportation assistance can also be associated with increased costs and the need for extra coordination and resources. For instance, Broderick estimates that he spends about $29,000 a month on all of his transportation costs, including staffing, lease payments, gas, insurance and maintenance. While he still feels the services are valuable and necessary part of his five-phase treatment program, Broderick and others who offer the services say there are strategies centers can adopt to make transportation assistance as effective as possible for both the patient and the enterprise.
1 Consider location
Experts say it’s important to consider location even before a treatment center site is determined. Facilities that are located in areas close to existing public transportation stops may be easier for patients to access and might reduce the amount of resources a facility needs to invest in transportation.
For instance, Concerted Care Group is located in the heart of Baltimore and surrounded by public transportation options. While the addiction recovery center used to run its own shuttle service, the service only had about nine regular users and presented some logistical problems for the center. Instead, Barbara Wahl, RN, MA, chief operating officer at Concerted Care Group, says they’ve opted to incorporate public transportation tokens into their incentive programs to reward patients who regularly attend sessions. The facility also helps patients who qualify secure disability bus passes by providing assistance from their on-site psychiatrist, who needs to sign off on the forms.
Broderick says transportation concerns weren’t even initially on his radar when he opened Windward Way Recovery about eight years ago but are now a key consideration for site expansion plans.
The alcohol and drug treatment center offers five levels of treatment from detox to an outpatient program, and Broderick says transporting patients to their 2,700 square foot clinical facility, residential quarters or throughout the city for errands or job interviews is a routine service.
A fleet of vans transport patients each day, but he sees the industry moving more toward campus-style designs that co-locate services. For instance, he has a 40-unit apartment located adjacent to his clinical building to reduce the number of trips patients need to take each day.
“Over time, I see that as the industry evolves, this will be one area which companies would look to for efficiency and try to streamline transportation,” he says.
2 Provide thorough training
Training is a key aspect of the transportation services provided at Black Bear Lodge, a residential addiction and mental health center in Sautee Nacoochee, Ga. The center is located more than two hours away from the Atlanta airport and is spread out across a mountain, making transportation a unique and essential part of the program.
Chuck Coker, LCSW, MBA, program director of Black Bear Lodge, says the center has a dedicated staff of 10 who pick up patients from the airport, run the shuttle route across the campus or take patients to off-site appointments. Coker estimates that it costs the lodge about $9,800 a month to provide transportation services, including labor, fuel and repair costs.
Each staff member has gone through a background check, has a clean driving record and goes through training before driving patients. Transportation team members participate in HIPAA training, vehicle operation training and shadow an experienced transportation specialist before climbing behind the wheel of one of the 15 passenger vans or four automobiles owned by the center.
The transportation staff is also trained in motivational interviewing, so they are know how to converse with patients during the trips in a non-confrontational manner. The transportation team is often the first contact patients make with the center, so Coker says it’s important that they prepared to interact with patients professionally and compassionately.
“We take it very seriously,” he says. “That first contact that they make with us can set the course for the rest of their stay.”
3 Place an emphasis on communication
Coordinating transportation for a large number of patients is no easy task, but those who provide transportation services say organization and communication are critical to a well run program.
At Black Bear Lodge, flights are arranged with help from a call center, run by the lodge’s parent company, Foundations Recovery Network. Patients pay for the flights themselves, but the call center helps them arrange the flights and coordinates with recovery centers to ensure the patients have transportation from the airport. Black Bear Lodge’s transportation director is in constant contact with the call center and sends out updated schedules that include information about when and where patients need to be transported, what vehicle will be used and the driver assigned to the job.
Each transporter is equipped with a company phone that has the Atlanta airport’s app to keep the staff member and the rest of the department up-to-date about flight delays, changes or cancellations.
“It’s important we’re there when the patients go through the airport and get their baggage,” Coker says. “They don’t need to be wandering around outside. So we’re there.”
Once the patient is picked up, drivers also communicate back with Black Bear Lodge to let them know an approximate time of arrival and a brief synopsis of the patient’s current condition, so the facility is prepared on arrival.
4 Reduce liability
Treatment center administrators agree that any time a company is transporting its patients, there is also an increased liability for the center. In addition to providing drivers with proper training, Geckler says he recommends centers only have employees transport patients in vehicles owned by the center so that both the driver and vehicle are covered under the company’s insurance. This also ensures that employees are delivering consistent messaging to the patient about the center.
For the safety of both the patient and the driver, Geckler also says that all drivers take the same route to and from the Denver airport to pick up patients during the five to six trips the center averages a week, so that the center knows exactly which roadways the driver will be on.
5 Set limits
To run an efficient transportation program sometimes means setting limits.
At Black Bear Lodge patient trips off-site for things such as outside appointments are limited to two trips a day. That way the center is still able to manage its shuttle route around campus and the transports from the airport.
“We’ve found that doable,” Coker says.
At Windward Way Recovery, Broderick says his urban California center provides its patients transportation, whether it’s to the grocery store or a job interview, only within a 15-mile radius. By placing a limit on the distance of trips, Broderick is able to reduce fuel costs and limit the time and resources required of his staff.
Jill Sederstrom is a freelance writer based in Kansas.
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