YNHH transportation plan for controversial primary care shift troubling, concerns remain

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Monday, Yale-New Haven Health System answered the state’s eighth set of questions about their controversial application with the Hill Health and Fairhaven Health Centers to move primary care for 25,000 mainly low-income New Haven area residents out of the current neighborhood sites to Long Wharf. Among many concerns voiced by patients, advocates and community leaders was transportation to the new site distant from the current neighborhood clinic sites. To date, the applicant’s responses have been vague, relied on current services provided by the city, nonprofits and Medicaid’s troubled transportation contractor, and featured Uber Assist, a ride-sharing service that doesn’t serve CT now. The state’s latest questions include detailed requests for information on at least two contracted transportation providers, specific service standards for those providers, at least one ADA-compliant service, at least one service that does not require use of a smart phone, and exact specificity about eligibility for transportation services, subject to state review and approval. The state also wants YNHH to address wait times and timely drop offs for appointments.

Only current patients who cannot reach the appointment by car and whose trip on public transportation would be longer than forty minutes would be eligible for transportation assistance. YNHH estimates that over 9,500 patients would qualify.

The new plan still relies heavily on patients getting their own transportation, Medicaid’s troubled transportation vendor, and public services. Disabled Medicaid patients must rely on the state’s transportation contractor, Veyo. A CT class action lawsuit has been filed against Veyo for cancelled rides and stranded patients. Medicaid covers 75% of YNHH’s primary care clinic patients. Other patients needing rides must rely on federally-funded New Haven nonprofits. If these public resources do not fill the need, the plan includes contracts with the Milford Transit District (MTD) and Coordinated Transportation Services (CTS), both ADA compliant, in addition to Uber. The Uber Assist service is no longer in the plan. Disabled patients will have to apply for access to rides from MTD or CTS. To access all rides, patients must schedule through clinic staff; phone wait times to reach clinic staff are reportedly already very long. Patients given rides to the hospital for services only available there, may or may not get a return ride home. Appropriate child car seat availability for Uber rides is not clear. YNHH promises to monitor the adequacy of their transportation plan.

YNHH also notes that, for now, providers at the new facility will be able to tell patients about their right to abortion services and make a referral as new federal regulations are currently on hold.

Concerns about much higher costs to the state, much higher costs for uninsured and underinsured patients, access to medications, and executive bonuses attached to the deal have not been addressed.