Advocates for the disabled have a message for the state: Yale New Haven Hospital’s transportation options for patients to get to a new clinic site won’t work.
Jan. 28–NEW HAVEN — Advocates for the disabled have a message for the state: Yale New Haven Hospital’s transportation options for patients to get to a new clinic site won’t work.
The hospital is proposing to relocate its primary care clinics to 150 Sargent Drive, where administration of the pediatric unit will be taken over by Fair Haven Health Care and adult and women’s clinics will be run by the Cornell Scott-Hill Health Center.
One of the general objections raised early on to the plan was the longer and fewer bus rides on CT Transit to the new site in the Long Wharf area for patients who are transferred to what will be the New Haven Primary Care Consortium.
Now, a letter sent to Victoria Veltri, executive director of the Office of Health Strategy, which has to approve the plan before it can go into effect, focuses mainly on problems for the disabled, but other categories are included as well.
It was signed by Michelle Duprey, who heads the city of New Haven’s Department of Services for Persons with Disabilities; Sheldon Toubman, attorney with New Haven Legal Assistance Association; Melissa Marshall, coordinator of the Connecticut Cross-Disability Lifespan Alliance and Kathy Flaherty, executive director of the Connecticut Legal Rights Project.
"For those who use wheelchairs or scooters, Uber simply will not work," they wrote.
The hospital is proposing to contract with UberASSIST, which has been used in other parts of the country, but not yet in Connecticut. It said drivers have to take an online course and drive a vehicle that can accommodate "an assistive device, such as a folding wheelchair or collapsible scooter."
The advocates were skeptical of a service that has no track record here, but more importantly, they said the majority of wheelchair users have non-folding devices.
These patients will have problems transferring from the wheelchair to the sedan and "the Uber drivers will be powerless to help them in these situations," they wrote. They said the solution is using a wheelchair van to transport them.
"Needless to say, the obligations of YNHH under the ADA (Americans with Disabilities Act) … do not extend only to those who use ‘foldable or collapsible’ wheelchairs or scooters, but to all people with disabilities. Indeed, the need for accommodation is greater for individuals who use more sophisticated mobility equipment which does not fold or collapse," they wrote.
Jeryl Topalian, director of strategy and regulatory planning at YNNH, in written answers to questions from the state, said the hospital expects "current and future patients with special transportation needs, utilizing the services of Veyo, medical taxes, or other modes of transportation would continue to do so."
The state Department of Social Services was hit with a class action suit earlier this month on behalf of thousands of Medicaid recipients whom Connecticut Legal Services said wait hours to get through on the phone for a ride or have missed or been late for appointments or been left stranded at doctor’s offices because of poor service.
The state gave Veyo a three-year contract to arrange and coordinate about 5 million rides and it has been fined multiple times by DSS, according to Ct Mirror. Connecticut Legal Services said DSS spent $50 million on the service last year.
The advocates said 78 percent of the disabled population is on Medicaid and cannot pay for medical taxis. They said Veyo is "notoriously unreliable" and will not be able to pick up the slack.
"We are the only voice of the people who cannot be heard," Toubman said.
The hospital, in its filings with the state, said they are working through the details of a contract with Uber and it will consider other ride-sharing services, such a Lyft. It promises to advocate for more frequent bus service.
In a survey of its patients, YNHH found that 66 percent of them drive to its primary care clinics, which are currently on York Street, and were happy that the 150 Sargent Drive site has a parking lot.
Topalian wrote that the Greater New Haven Transit District also provides transportation services for individuals eligible for ADA certification
The hospital official told the state that Coordinated Transportation Solutions offers transportation for school-aged children through older adults. Also, nonprofits offer transportation for certain populations: cancer patients, ALS patients, HIV and AIDS patients; individuals receiving HUSKY D or the Military Support Program, patients with multiple sclerosis and senior citizens.
The hospital has to show that the proposal is financially feasible, improves the quality of care, accessibility and cost effectiveness for the 28,500 patients who will be served.
YNHH plans to put $15.7 million into the 150 Sargent Drive site and another $4 million into bringing the Cornell Scott Hill Health Center onto its Epic computer sharing platform.
The advocates wrote that the hospital’s proposed use of a Uber ride service would not work for many clinic patients. Beyond the disabled, they said this included "seniors, … children who need car seats and pregnant women."
They said this is an issue after the hospital clarified that patients, who now walk or use public transportation, are only eligible for the service if they live within 10 miles of 150 Sargent Drive, and, if bus service is available, it takes 40 minutes or longer to get to the new site of the clinics.
The advocates then addressed the need to use a smart phone to book an Uber ride.
The hospital, however, has already told the Office of Health Strategy that a patient does not need a smart phone to use Uber. The health center staff will book a ride when the patient calls for an appointment and will then arrange for a ride home at the time of the visit.
The advocates said patients told them it is difficult to get through to the current YNHH clinics without the added burden of arranging Uber rides. They asked how the follow-up conversation with the driver, as he or she gets nearer to their destination, will occur when patients don’t have smart phones.
The hospital, in its answers to the Office of Health Strategy, said all coordination will be done through the center’s staff.
Vincent Petrini, senior vice president for public affairs, said in addition to looking at transportation options, " the current sites for Fair Haven Health Center and the Cornell Scott Hill Health Center will remain open for all patients, even after the Long Wharf site begins providing access to collaborative, high quality care in New Haven."
The plan is to transition the pediatric and women’s services to the new site in September 2019 and the adult medicine clinic in spring 2020.
On another topic, the latest YNHH filing with the Office of Health addresses a Patient Assistance Fund promised by the hospital to its existing patients who get more generous financial assistance than the policies in place at the Fair Haven and Cornell Scott Hill clinics.
The hospital said it will make it available to certain new members of its current families, such as newborns, adopted children or foster children. It said federal law does not allow the hospital to offer it to new patients who will be under the administrative control of the Fair Haven and Cornell Scott Hill clinics.
The rule prohibits any remuneration that would influence the selection of a particular provider.
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