Sunday, May 5, 2013

Para Transit

A heartwarming story of government services meeting the needs of its vulnerable citizens.


There is a common misconception that health insurance and community programs will provide for all, or at least most, of the needs of the geriatric and disabled populations.  

Ha! Not even close. Nothing that is considered “custodial care” is covered by health insurance.  When mom or dad have spent almost all of the family assets on care, then, they can apply for state assistance and that typically means they will have to access care out of the home and in a facility.


The Community Assistance Programs have some fantastic services but they are always limited in funding. (Currently, the Area on Aging program in my county is “on hold” for an indefinite amount of time while the state decides if it wants to fund Sheriff Joe’s Tent City, Congressional junkets to Costa Rica  or a program allowing thousands of elderly citizens to stay in their homes.)   


While explaining the limitations of care, this is typically the point where the kids go nuts.  It’s a whole parameter shift, finding out that long term care is an out of pocket expense and yep, there isn’t going to be much to inherit.  Furthermore, even if they pinky promised mom she could stay in her house until she died, there is no way, even with state assistance, that mom is getting care in the home for more than a few hours a week.


Anyway, a big piece of keeping people in their homes is providing transportation.  I should clarify, safe transportation. (Sending great grandpa out in his forty year old Buick is probably not the preferred method.)


Consider, if you can’t drive and you need weekly lab draws and you’re being followed by half a dozen specialists all over the valley, it may present a bit of a problem.  Not to mention just getting the grocery store or running errands.   


Enter the Para Transport system. Ta Da!!


This is a program set up to comply with federal regulations but managed city by city making unique program parameters within the federal requirements. However, one of the universal restrictions is transportation can only happen within that city’s boundaries.


So, even if mom is approved for the program, she would be required to call five days in advance to arrange for the city van to pick her up.  To accommodate as many transportationally challenged people as possible, the pickup time frame is pretty broad.  She could end up waiting a few hours at any of the points of service so she better have a good bladder control. (Not a common attribute of most older people.)  


If she had to get to the next city, she would also have to schedule a ride from the neighboring city van and arrange for a transfer at the city limits, again with the broad time frame from both systems coming into play. And a reverse trip would had to be arranged.  Good luck mom!


But wait! There is more to the story! In most cities, to qualify for services, mom needs to be certified as disabled within the federal guideline.  


So she is required to find some sort of transportation to and from the doctor’s office for the proper medical documentation.  Then she has to find transportation to the transportation office to prove that she has an inability to access transportation.


Brilliant!  If no one can qualify for the service you are mandated to provide, you can shrug your shoulders and say, “Well we are within the providers’ guidelines so what else could we have possibly done?”


By the time I can’t drive, forget the labs and doctor’s visits, but they better have some good restaurant delivery options.


Taxmom said...

We've been dealing this past year with an elderly relative who still lives at home (and manages) but no longer drives. He lives about 6 hrs away from us. He actually rides his 3-wheeled tricycle to the grocery store every day, but other trips are too far. On the long car rides to and from our visits I've been dreaming up something called "daughter in town" which would be like task rabbit for eldercare. You could register yourself and your adult, and your respective towns and then swap out errands. I'd be happy to take an hour out of my day to take someone local to a MD appt, if through this registry I could get someone to take grandpa to get his blood drawn in his town. For example. Wish there was such a thing. I'm new to your blog and like it a lot, espec. the very relevant pics.

March Matron said...

"Daughter in Town" is a fantastic idea! I hope you can make things work for your grandpa. It's so frustrating and I'm worried it will get worse. I hope not. Thanks for your nice comments.