TRANSPORTATION
Transportation among the refugee population is and will continue to be a problem affecting their access to healthcare. In an effort to provide a healthy lifestyle, transportation is an aspect of their care that can easily be overlooked. According to Reavy, Hobbs, Hereford & Crosby, 2012, a major contributor to missed appointments can be attributed to the lack of transportation due to refugees not understanding public transportation options. When referring back to the circumstances that distinguish between a refugee and immigrant “we need to remember the psychosocial needs of this population. Depression and anxiety are two common diseases that affect refugees arriving in America” (Brandner, Sokolowski, & Veurink, 2004). Inadequate access to transportation can further exacerbate these issues and heighten the fear of being unable to attain and maintain healthcare. “The population is steadily increasing and adequate transportation is a key issue in providing holistic care” (Brandner et al, 2004).
Within the Treasure Valley, Medicaid has contracted with the American Medical Response (AMR) to transport patients to and from their healthcare appointments. In order to schedule a patient pickup, clinicians need to fill out AMR’s Access2Care form at a minimum of 48 hours in advance. Within this form, the patient's address comes from the address on file with Medicaid. Here is the link the AMR Access2Care guide:
http://www.idahonemt.net/
The toll-free phone number for American Medical Response is 1-877-503-1261.
Here is an additional helpful link about this service:
http://www.healthandwelfare.idaho.gov/Portals/0/Medical/MedicaidCHIP/AMR%20Information%20Brochure.pdf
If the patients have moved or addresses are not kept up to date, they are often marked as “no shows” for their appointment. Also, for clinics that are not accustomed to handling refugee patients, follow-up paperwork is often handed to the patient with the expectation that the patient will arrange their next appointment, and up to 50% of missed appointments can be attributed to this (personal communication, Lingle, 2012).
After talking to numerous healthcare professionals from around the Treasure Valley, we have compiled a short list to help clinicians unfamiliar with refugee care:
Valley Ride Links:
Treasure Valley Map – http://www.valleyride.org/bus-services/boise-routes/
Disability Related - http://www.valleyride.org/special-services/paratransit/
Disability Form - http://valleyride.com/docs/ACCESS/BoiseACCESSForm.pdf
Non-profit form - http://www.valleyride.org/special-pass-offers/NonProfitPassRequest.pdf
Who Rides free - http://www.valleyride.org/guides/who-rides-free/
Steps to take for Refugee transportation:
Criteria: Agency sponsored (automatically have Medicaid)
1. Call or email agency to arrange transportation
2. Agency will arrange transportation
Criteria: Non-agency with Medicaid
1. Ask if they have transportation
2. NO: ask if they need help scheduling
3. Yes: fill out AMR form and fax/email to [email protected]. File in patient’s chart
4. AMR assigns (but will not confirm) ride: will show up at refugee’s house. Verify patient’s address is correct with Medicaid
Criteria: Non-agency without Medicaid
1. Ask if they need help with scheduling transportation
2. YES: Fill out agency financial assistance paperwork if available
3. Ensure that you inform the patient that they will be financially responsible for their visit, or provide them with information on the agency policy concerning agency payment plans. Non-English speaking refugees in the Treasure Valley face many obstacles in their adaptation to and accessing health care. Many of these obstacles can be minimized or eliminated by healthcare professionals, resulting in fewer missed appointments and better overall health of the individual.
Within the Treasure Valley, Medicaid has contracted with the American Medical Response (AMR) to transport patients to and from their healthcare appointments. In order to schedule a patient pickup, clinicians need to fill out AMR’s Access2Care form at a minimum of 48 hours in advance. Within this form, the patient's address comes from the address on file with Medicaid. Here is the link the AMR Access2Care guide:
http://www.idahonemt.net/
The toll-free phone number for American Medical Response is 1-877-503-1261.
Here is an additional helpful link about this service:
http://www.healthandwelfare.idaho.gov/Portals/0/Medical/MedicaidCHIP/AMR%20Information%20Brochure.pdf
If the patients have moved or addresses are not kept up to date, they are often marked as “no shows” for their appointment. Also, for clinics that are not accustomed to handling refugee patients, follow-up paperwork is often handed to the patient with the expectation that the patient will arrange their next appointment, and up to 50% of missed appointments can be attributed to this (personal communication, Lingle, 2012).
After talking to numerous healthcare professionals from around the Treasure Valley, we have compiled a short list to help clinicians unfamiliar with refugee care:
- Clinics making the referral should email the receiving clinic and request receipt of the referral.
- Check with patients at each visit to ensure that their address matches what is on file with both the clinic and Medicaid.
- Call patients the day before with an interpreter to remind them of their appointment.
- If patients are English speaking they can arrange transportation themselves through AMR.
- Follow up paperwork must be explained to the patient/interpreter to maximize their benefits while helping to minimize missed appointments.
- Instruct refugee patients that appointments are for the individual alone, not additional family members that often accompany them.
- If it is nearing the time of the patient’s appointment, and they have not shown up yet, call AMR to determine which cab company is being used. Call to verify the ride with the specific cab company.
Valley Ride Links:
Treasure Valley Map – http://www.valleyride.org/bus-services/boise-routes/
Disability Related - http://www.valleyride.org/special-services/paratransit/
Disability Form - http://valleyride.com/docs/ACCESS/BoiseACCESSForm.pdf
Non-profit form - http://www.valleyride.org/special-pass-offers/NonProfitPassRequest.pdf
Who Rides free - http://www.valleyride.org/guides/who-rides-free/
Steps to take for Refugee transportation:
Criteria: Agency sponsored (automatically have Medicaid)
1. Call or email agency to arrange transportation
2. Agency will arrange transportation
Criteria: Non-agency with Medicaid
1. Ask if they have transportation
2. NO: ask if they need help scheduling
3. Yes: fill out AMR form and fax/email to [email protected]. File in patient’s chart
4. AMR assigns (but will not confirm) ride: will show up at refugee’s house. Verify patient’s address is correct with Medicaid
Criteria: Non-agency without Medicaid
1. Ask if they need help with scheduling transportation
2. YES: Fill out agency financial assistance paperwork if available
3. Ensure that you inform the patient that they will be financially responsible for their visit, or provide them with information on the agency policy concerning agency payment plans. Non-English speaking refugees in the Treasure Valley face many obstacles in their adaptation to and accessing health care. Many of these obstacles can be minimized or eliminated by healthcare professionals, resulting in fewer missed appointments and better overall health of the individual.