A Healthy Blog

Massachusetts health care — wonky, with a healthy dose of reality

Using Transportation to Drive Healthcare Reform in Massachusetts

Using Transportation to Drive Healthcare Reform in Massachusetts

June 29, 2014

[below is a guest post by Jennifer Bonanno, Communications Director of More Than Wheels, a nonprofit car-purchasing program that helps struggling individuals and families break the cycle of poor financial decision making by using the car buying process to catalyze lasting change, financial stability and control]

Health reform, along with demographic changes, are rapidly increasing the demand for home and community-based care. As cost containment laws and regulations in Massachusetts, such as Chapter 224, are transforming the delivery method of healthcare, stakeholders  are recognizing that reliable and affordable transportation for the direct care and health workforce is KEY to successful health reform implementation.  Unfortunately, for many in this growing workforce, dependable transportation for patient care and career advancement is beyond reach.  Home care and health services employers describe three transportation-related barriers:

  1. Challenges to Providing Quality Care

Quality of care suffers when a direct care worker is unable to get to her client on time or at all, due to the lack of reliable transportation. Appointments are missed, caregivers are stressed and distracted, and consumers are left with inferior levels of care.

  1. Increase in the Total Costs

Transportation issues are increasing employer costs through loss of productivity and difficulty retaining good workers. Mental stress increases significantly when a worker does not know if she will be able to get to her job on time or at all. Transportation uncertainty results in employee absenteeism, tardiness, and staff turnover, forcing employers to turn to costly temp agencies to fill the gap or not be able to fulfill a request for services.

  1. Difficulty in Training & Career Advancement

Workers are derailed from career advancement due to unreliable transportation limiting their training opportunities. This barrier inhibits employees from meeting certification requirements and professional growth opportunities. It impedes employers from promoting from within and forces them to bring in new employees, resulting in a significant cost.

These obstacles aren’t new to the direct care and health workforce, but what is new is the speed at which the industry is transitioning to at-home care.  There is also a rise in new jobs opening up to low and moderate income workers, who often lack financial literacy and have credit issues, making them ineligible for auto loans.  

Take Terrie’s story from the Boston Globe for example:

Sixty-three-year-old Terrie Cherry, a personal care attendant, crisscrosses Worcester up to seven times a day on the local buses to reach her patients. She rides Route 6 in the morning, and if the bus is late, as it was twice last week, so are the clients and patients she helps care for when she prepares them for their doctor’s appointments. “I could walk it if it wasn’t all hills, and taking a cab means I’d have to give up at least one hour’s pay,” she said. “It is becoming a big problem.”  

Although Terrie is just one personal care attendant, the transportation challenges facing many workers is the same.

More Than Wheels provides a solution to overcome unreliable transportation issues in Massachusetts.  We are initiating pilot projects in several communities in the Commonwealth to better understand the cost and impact unreliable and unaffordable transportation has on the home care and health care sectors.

By collaborating with employers we are able to:

  • Increase awareness of options regarding transportation and money management
  • Incorporate our transportation and financial management knowledge into current workforce training programs
  • Offer our car-buying program services
  • Test innovative employer-paid benefits that address transportation issues at a reasonable cost

For more information about the workforce transportation challenge and More Than Wheels, please contact Jennifer Bonanno.