New program to give Berkshire seniors a lift to medical appointments

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PHOTO GALLERY: Council On Aging Van Service

For more than a year, it's been an "old business" agenda item on Hinsdale's seniors: Find an affordable way to get them to medical appointments, a service considered key to living independently.

Last June, the treasurer of the town's Council on Aging — which has no paid staff, much less its own van — agreed to find a way.

But Jim Manning came up short. That's why a new countywide pilot project excites him.

"I'd be very enthused to see this move ahead," he said Monday. "It's definitely an identified need of our seniors."

Starting in early April, seniors who live in towns without their own van service will be able to call Elder Services of Berkshire County and schedule a trip to see doctors or to undergo medical procedures.

The Berkshire Regional Planning Commission just secured $49,000 from the National Aging and Disability Transportation Center to test a new approach to the problem. The grant runs through December and was one of one six awarded in the United States.

Laura Kittross, manager of the commission's public health program, said people who request rides will be picked up by drivers working for cities and towns large enough to run vans.

But participation by those communities is optional — and some programs may not be able to join in due to a lack of capacity, interviews found.

Paying piper

Until now, the question of who would pay has hobbled the provision of van service across town boundaries, since taxpayers in one community can't be expected to pay for transportation for people living elsewhere.

The project will create an online mechanism allowing van drivers to submit billing details on each trip. Grant money will cover the cost of those runs, keeping the expense off the books of communities that operate the vans and removing a barrier to regional services.

"I really hope people take advantage of this," Kittross said. "This will be an opportunity to show that there is a need."

Erica Girgenti, director of the Adams Council on Aging, said towns in the North County without their own paratransit van service, as it's called, include Clarksburg and Florida.

She said her council will participate in the pilot project. "Right now it's all about collaboration and cooperation with each other," she said of such services. "To go into one of our neighboring towns and provide transportation, if they need it."

"We have one van and it's pretty booked," said Brian O'Grady, director of Williamstown's Council on Aging.

Though neighboring towns of Hancock and New Ashford don't have van service and could benefit from help, Williamstown may not be able to provide it, O'Grady said.

But he acknowledged the problem exists. "There is a need," he said.

Berkshire County has the second-highest percentage of people over 65, behind Barnstable County. Over half the county's roughly 130,000 residents are over 50, and that is expected to increase to 60 percent by 2030.

Top challenge

John Lutz, executive director of Elder Services, said the project is significant because it can help seniors remain at home. Transportation gaps top the list of human services challenges in rural areas.

"If you can't keep up with your medications or you can't see a doctor, then the next step is you're going to end up in the emergency room," Lutz said.

"Let's help them manage their own care, instead of having a crisis," he said.

Lutz' group will collaborate with councils on aging that elect to participate and with the planning commission and the Berkshire Regional Transit Authority.

"There's a genuine interest in trying to figure out this seemingly intractable problem," Lutz said. "This is an opportunity for lots of local entities to figure out what the size of the need is."

For Manning and others in Hinsdale, the need is clear.

When he set out to find a way for seniors in his town of 2,000 to obtain rides to medical appointments, he contacted the Council on Aging in neighboring Dalton. But limited availability there got in the way.

"We weren't able to work it out," Manning said.

Hinsdale has considered procuring its own van. Federal and state funding is routinely tapped to add vehicles for this use, people in the field say.

But costs still stack up for small towns. Some communities charge fees for van service, while others underwrite the cost through taxes.

"It's the cost of the drivers and trying to staff that," said Manning, whose council is scheduled to revisit the issue at a meeting Monday.

In the absence of a public transportation option, he noted that seniors face the need to use the Cabulance service run by County Ambulance. Manning estimated that round-trip travel from his town to Pittsfield costs in the range of $20.

While that may be affordable for occasional users, it can become expensive for people who need to make regular trips to medical appointments, including trips to receive chemotherapy.

"That's prohibitive," Manning said.

Girgenti, the Adams council director, recalls the case of a senior in her area who needed to receive day surgery at Baystate Medical Center in Springfield but planned to cancel it because it would have cost nearly $300 to hire transportation for the trip.

"They just couldn't afford that," Girgenti said.

The council was able to arrange coverage through the Help I Need Transportation (HINT) program set up after the closing of North Adams Regional Hospital.

The new pilot project will be limited to travel within Berkshire County.

While Girgenti notes that the county has many transit programs, they leave gaps.

In her town's case, trips to medical appointments represent a relatively small number of van runs. Girgenti believes that may be because family members are willing to get their relatives to their doctors.

"We might also find out that there isn't a need," Girgenti said of the project.

What happens from April through December will provide data to fill in that picture, she said.

While some councils that operate vans will be hard-pressed to find time to serve seniors outside their boundaries, others might opt-in because of the ability to be reimbursed for new services.

That might prove to be an incentive in towns that operate their vans only certain days of the week, Girgenti said.

Building case

Kittross of the planning commission said she hopes vigorous use of the project will help planners make a case for more permanent funding.

"This will show how much of a need there is in the smaller, surrounding towns that don't have Council on Aging vans," she said. "The idea is to build the evidence base."

The service is limited to pre-arranged medical appointments, not emergencies. That was driven in part by the limited capacity of existing vans to handle the extra riders.

The commission is using separate funding from AARP to build a website devoted to concerns of seniors in the Berkshires, following up on the group's ongoing Age Friendly Berkshires project.

Age Friendly Berkshires, launched in 2015, is shaping policies to address the county's growing proportion of seniors. Ensuring access to health care is one of its top goals, given that 20 percent of county residents are over age 65, compared to 14 percent for the state.

A web developer is creating the online submission form that will be used by van drivers. A spreadsheet will collect that data and be used to pay for the transportation provided.

The project will pay to roughly double the hours of an existing transportation scheduler at Elder Services. Kittross said the project wants to provide strong customer service.

"There is nothing more frustrating ... than to make four phone calls to reach someone who knows what they are talking about," she said.

The scheduler will contact the Council on Aging in the community closest to the caller and see if it is willing and able to take on the assignment. If so, the council will contact the client and make arrangements for pickup.

Details on how to reach that scheduler and use the service will be provided later this month.

Reach staff writer Larry Parnass at 413-496-6214 or @larryparnass


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