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VTrans official describes "braided" model for nonemergency medical transport
Summary
At a Senate Transportation committee meeting, Ross McDonald of VTrans outlined Vermont’s long‑standing "braided" model that combines multiple demand‑response programs — including Medicaid NEMT — into a shared scheduling, vehicle and call‑center system to secure efficiencies and prioritize Medicaid trips.
Ross McDonald, a presenter for VTrans, told the Senate Transportation committee the state’s long‑standing braided model for demand‑response services combines multiple programs into a single operating system to reduce duplication and lower per‑trip costs.
McDonald said the braided approach merges programs that serve older adults and people with disabilities, recovery and job access services, and the Medicaid nonemergency medical transportation (NEMT) program into a regional “clearing house” that uses the same call center, scheduling software, vehicles and drivers.
The braided system, McDonald said, uses a Medicaid‑first decision tree because Medicaid is an entitlement program, then routes other eligible trips (older‑adult, disability, job access) through the same dispatch and vehicle pool. "We are essentially braiding these programs into a clearing house in each of our transit regions," McDonald said. "That really does allow for some perceived efficiencies that were born out in the study last year, not least of which is using the same call center, and getting the information from one resource, rather than several call centers."
McDonald described other cost centers that VTrans has borne centrally for all demand‑response services, including scheduling and dispatch software procurement (which he said exceeded $4,000,000) and vehicle capital planning that accounts for NEMT demand when sizing regional fleets. He said those centralized investments make capacity more fungible across programs and reduce instances in which multiple vehicles perform the same trip.
He also urged that volunteer coordinator appropriations, if provided, be integrated into mobility management and volunteer recruitment rather than set up as stand‑alone funding; he said VTrans would follow up with committee staff on that point.
The committee did not take a formal vote on McDonald’s remarks; his presentation was introductory to later discussion of the transportation amendment package.
McDonald requested that the committee note the 2024 report the agency provided on the braided model and invited further questions or requests for examples of implementation, including imagery that a colleague (Caleb) could share offline.
