[{"_1":2,"_75":-5,"_76":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":72,"_73":56,"_74":56},"mediaId",6077835,"mediaKeyId","2963142-8e9237320215fa8890438764532291e4","parentId",2963142,"title","Senators, providers and transit agencies press for expanded Medicaid transportation and volunteer coordination to keep rural Vermonters connected to care","audioSeconds",5384,"startMs",288000,"endMs",5672000,"viewUrl","/Search/View?dp=1&key=2963142-8e9237320215fa8890438764532291e4&start=288&end=5672","thumbnailUrl","https://assets.pipeline.soar.com/2963142-8e9237320215fa8890438764532291e4/thumbnail_288000.jpg","articleUrl","/articles/6077835/Vermont/Senators-providers-and-transit-agencies-press-for-expanded-Medicaid-transportation-and-volunteer-coordination-to-keep-rural-Vermonters-connected-to-care","mediaUrl","https://secure.pipeline.soar.com/6077835-8648716dd163ea1c3f3648b7a450a549/orig.mp4?Expires=1771055427&Signature=L26dK0Z0mQ24~i6mM0yodLf9RG9D7IhcjLY~pn4I7LKDoBGSPOwcTiIGwjLIvCHx1uuvK8mh1v85Gn30fzaLfD9LTHQM60Wa7Sc7PaPtgL9ChP2-muDTX4LX0eWzbSnLw5HWU8WTzyoDR-JGfceP4w50A4bug2cjbKMKzeqAk5jehzO40K94Hy2BvY3d3QQrsBi8rRt4zYoWDN-3Tp2Sfw9yYjVY3eIAjlU7M-T7pABB1RUVBWUR9csO9c0D-1032dCUgkIGvzmYKiDW2jwS7gBk3C7A9pHZYqUiAfr1P3Q5laarPNM8PauqjaPVQ6i21juZDQf7yihRc0FB9bz4GQ__&Key-Pair-Id=KUT5TJCACFTXG","author","","date","2025-04-11T13:04:34Z","article","Senators and health‑care and transit leaders on Tuesday urged state action to shore up nonemergency medical transportation (NEMT) and related services that many rural Vermonters rely on to reach medical appointments.

At a joint hearing of the Vermont Senate Transportation Committee and the Senate Health and Welfare Committee, transportation providers, hospital officials and Agency of Human Services staff described a system under strain: volunteer driver pools are smaller than before the COVID‑19 pandemic, some clinics and services have closed or consolidated, and the statewide NEMT contract is due for rebid next year.

The concern is practical: “If people can't get access to care, if there's a reduction in their transportation options, it creates a ticking clock for some sort of healthcare crisis,” said Michael Costas, CEO of Gifford Healthcare. Costas said hospitals and clinics see delayed care that worsens outcomes and raises costs when rides are unavailable.

WHY IT MATTERS

Speakers said the problem is concentrated in rural areas where distances to clinics and hospitals are long and public transit options are limited. “Approximately 1 in 5 individuals who seek support from the Blueprint team state that transportation is a problem for them,” said Anthony Knox, Blueprint program manager for the Randolph Health Service Area, summarizing patient outreach in Orange, Windsor and Washington counties. Knox described canceled or impossible trips that prevented patients from getting preventive care, medication refills and procedures.

What witnesses described as immediate priorities were: (1) protecting and stabilizing Medicaid‑funded NEMT services while the contract is rebid; (2) investing in volunteer‑driver recruitment and paid coordinator positions; and (3) piloting community cars, community drivers and “mobility plus” gap funding to serve people who fall outside existing program eligibility.

DETAILS FROM PROVIDERS AND TRANSIT AGENCIES

Devin Green of the Vermont Association of Hospitals and Health Systems said the Oliver Wyman report tied to Act 167 identified transportation among core infrastructure needs and that EMS (Act 157) will issue a five‑year plan in December 2025. “We support a stakeholder process to address the non‑emergent medical transportation piece,” Green said.

Caleb Grant, executive director of Rural Community Transportation and vice chair of the Vermont Public Transportation Association, called Medicaid‑funded transportation a “lifeline” and warned that proposed federal or state Medicaid changes could reduce rides. Grant urged braided services—integrating Medicaid rides with other state and private funds—as a way to increase flexibility and reduce administrative burdens.

Grace Johnson, a Medicaid policy analyst at the Agency of Human Services, walked the committees through how the state administers NEMT. The state currently uses a statewide contract with the Vermont Public Transportation Association (VPTA) as broker and coordinates rides through subcontracted local transit agencies. Johnson said the program provided about 312,000 rides in state fiscal year 2024 and served roughly 6,600 individual Medicaid members.

On cost, Stephanie Barrett, financial director at DV A (as stated in testimony), and agency staff reported total NEMT expenditures near $15.8 million in SFY 2024 and projected about $15.7 million through June 2025. The current payment structure is a per‑member, per‑week rate paid to VPTA ($45.80 per member per week), with a look‑back count of members who used NEMT in the prior 365 days; funding is roughly 58% federal and 42% state.

SERVICE GAPS AND PRACTICAL PROBLEMS

Witnesses described recurring operational problems that reduce effective capacity: volunteer drivers who decline long rural trips, limited evening/weekend service, last‑minute cancellations, and restrictions that disqualify rides if a household owns a vehicle that is not operable in practice. “Volunteers don't want to use their own vehicles and want to use company vehicles, which are just non existent,” Knox said.

Ashley Lincoln, a patient relations staffer at Gifford, described the downstream effect of last‑minute ride cancellations: missed clinic time, extra staff hours rescheduling, and in some cases use of emergency services for nonurgent transport. Officials also noted that a small share of high‑utilization riders account for a large share of trips—Grant said roughly 45% of trips are taken by about 9% of riders in some service areas—prompting discussion of targeted solutions such as mobile dialysis or other mobile clinical units.

PROPOSED PROGRAMS AND NEXT STEPS

Recommendations from transit providers included: dedicated, funded volunteer coordinator positions; a community cars program for riders without viable vehicles; a community driver classification that pays hourly for individuals driving their own cars as employees; expansion of microtransit where pilots have worked; and “Mobility Plus” gap funding to serve people who are not Medicaid eligible or whose trips are not NEMT‑eligible.

On procurement, Agency of Human Services staff said the current NEMT contract extends to June 2026 but will be rebid with an RFP in late spring/summer 2025. Several witnesses urged using the RFP window to embed program improvements and clarify allowable background checks, eligibility rules and braided funding approaches.

QUOTES FROM WITNESSES

“Medicaid funded transportation or NEMT helps individuals get to medical appointments, specialized care and pharmacies ... For many public transportation is not just a convenience. It's a lifeline,” said Caleb Grant, executive director of Rural Community Transportation.

“The NEMT benefit has been designed to ensure Vermonters can access essential medical services,” said Grace Johnson, Medicaid policy analyst at the Agency of Human Services, explaining federal requirements that shape eligibility and the “least costly appropriate” standard.

“There aren't any immediate Medicaid cuts being considered,” said Stephanie Barrett, financial director at DV A, while cautioning that volunteer capacity remains below pre‑pandemic levels and the system has little ability to absorb sudden demand increases.

FOLLOW‑UP ACTIONS AND COMMITTEE DIRECTION

Committee chairs said they want the Agency of Human Services to return with a proposal and next steps for coordinator positions and other near‑term actions before the RFP and contract rebid. Senators emphasized this is the start of a longer collaboration between the Transportation and Health & Welfare committees, the administration, providers and transit agencies.

ENDING NOTE

Witnesses did not report any formal votes at the hearing. Committees and agencies will continue stakeholder work and requested data on missed appointments and ride denials to help target investments during the NEMT contract rebid process.","mediaType","Video","parentTitle","Senate Transportation - 2025-04-11- 9:00AM","oneSentenceSummary","Senators and health‑care and transit leaders on Tuesday urged state action to shore up nonemergency medical transportation (NEMT) and related services that many rural Vermonters rely on to reach medical appointments.","taxTitle","Senate Transportation, SENATE, Committees, Legislative , Vermont","taxId",51841,"location","Vermont","headline","shortSummary","actionData","errors"]

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Senators, providers and transit agencies press for expanded Medicaid transportation and volunteer coordination to keep rural Vermonters connected to care