Senate Transportation hears that Vermont’s demand-response transit and Medicaid NEMT are straining under higher costs, fewer volunteer drivers

The Senate Transportation Committee on April 3 heard that Vermont’s demand-response public transit, including Medicaid nonemergency medical transportation (NEMT), is under growing strain because of rising per-trip costs, fewer volunteer drivers and service consolidations by health providers.

At the hearing, Ross McDonald, public transit program manager at the Vermont Agency of Transportation, told senators the state’s braided demand-response system — in which transit providers use the same call centers, vehicles, drivers and administration for both state transit programs and Medicaid NEMT — produces efficiencies but now faces capacity limits. “We feel those efficiencies and those, shared costs, kinda lift all boats,” McDonald said.

McDonald and other witnesses described a system funded by multiple federal and state streams: FTA Section 5311 and FHWA funds for rural transit and mobility programs; a Medicaid NEMT program managed by the Department of Vermont Health Access (DVHA); and local in-kind match and small private-pay fares. McDonald said the NEMT split is “approximately 56 and 44 federal state,” and characterized Section 5311-funded older-adult and disability services as roughly 80% federally supported, with a 20% local match that can include in-kind hours.

Why it matters: demand-response trips are largely medical and social-care related. Witnesses said a large share of rides serve dialysis, opioid treatment and adult-day services; those long or out-of-area trips drive costs higher and reduce overall vehicle availability for other riders.

Key figures and operational constraints cited at the hearing - Advance booking: Most demand-response trips require about 48 hours’ notice to allow efficient shared-trip scheduling, McDonald said. Short-notice calls are handled when…