Changing Transport Needs Expectations of HACC Clients. Helen Battellino and Julie Gee Community Transport Northern Sydney

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1 Changing Transport Needs Expectations of HACC Clients Helen Battellino and Julie Gee Community Transport Northern Sydney

2 Transport the Essential Connector Basic human contact the meeting of the eyes, exchanging of words is to the psyche what oxygen is the brain

3 Regional Co-ordination Office for Community Transport Services in Northern Sydney

4 What is Community Transport? Community Transport is primarily funded under the HACC program administered through NSW Transport and Infrastructure Clients HACC eligibility guidelines - frail aged, people with a disability, carers of these people and transport disadvantaged people Majority of clients are frail aged $39m allocated to 128 Community Transport providers across NSW budget - 2.6% real increase under HACC

5 Community Transport Services Range of vehicle types minibuses, vans, cars, wheelchair accessible, modified with low steps, handrails, lifts Paid and volunteer staff Door to Door Service

6 Community Transport in NSW Had an estimated 150,000 clients Provided 2.5 million passenger trips Each client on average received about 16 one way trips ie went out 8 times in the year, which is less than once a month Owned approximately 800 vehicles Drove 30 million kms Employed around 600 staff Relied upon approximately 3,000 volunteers

7 Community Transport Connecting communities Reducing social isolation Community Transport can take people from this to...

8 Purpose of Trips Community Transport trips NSW Other 9% Day care 18% Medical 27% Social/Rec 26% Shopping 20%

9 Changing Needs for Trips In the beginning mid 1980s - Community Transport services were set up to provide shopping services in areas where there was no public transport eg Bathurst, St George Other services were funded and social outing and shopping trips were most popular Group shopping, social outings and transport to day care centres are main reasons for travel

10 percentage of total trips Changing Needs for Trips Growing demand for individual trips mainly for medical visits 70% of new enquiries for medical trips 80 Community Transport TRIP PURPOSES Centre based groups Social Shopping Medical

11 Types of medical transports Doctors appointments local Other services dentist, physiotherapy, podiatry Specialist appointments longer distance Hospital clinics stroke, hydrotherapy... Specialist treatment chemotherapy, radiation Dialysis Day surgery admissions Hospital admissions Hospital discharges

12 Challenges for Community Transport Individual medical transport trips: more expensive than group transports depending on distance but could be $100 + per trip Take more admin time to schedule Have to meet hospital and doctors schedules Clients may be unwell, high need Clients using oxygen Risks associated with patient transport Drivers are trained in customer care and basic first aid, but no medical training

13 Challenges for Community Transport Funding: Medical trips represent a disproportional amount of budget Health provides limited funding (eg 20% of health trips) Boundaries between Community Transport and Health Related Transport are not clear Equity Requests often for regular transport trips over a number of weeks/months ie one client receives a lot of service Individual trips consume more resources less for group transports for other purposes

14 Stretching Community Transport Health transport Public transport Tighter restrictions on ambulance transport Community Transport resources Bus reform streamlining bus networks

15 Advantages for Clients Door to door service Caring staff and especially drivers who provide assistance It is a great service that allows me not to become completely housebound It is a life support to the elderly. There are no other services when you have walking disabilities. I have not got any family living close to me they are all in different States. This is a wonderful service & makes such a difference to our lives, as I do not have any relatives save my invalid son it is a lifesaver to both of us for outings and trips to our doctors.

16 This report documented the problems faced by clients in getting transport to health appointments and made a number of recommendations - but there has been no change

17 Challenges for Clients Access to service HACC eligibility assessment transport often the first need Cost occasionally, especially if need long distance and regular transport Availability of trips Can t always travel when they need to (90,000 health trips p.a. refused) Limited to CT hours early appointments and late finishes are difficult Nothing on weekends Regular trips unavailable or restricted Longer distance trips for medical services difficult CT won t always take them eg using oxygen, hospital discharge, dialysis

18 Outcomes for Clients Find alternative transport friends, family, other community services if available Only make essential trips hierarchy of needs Visiting partners in hospitals, nursing homes Medical appointments Shopping Personal business Social outings Don t travel stay home Implications for health and social isolation?

19 Potential responses More funding there has been no real increase in funding from Health or Transport Departments for nearly 10 years More efficient use of resources: Group transports Shuttle services Taxis How appropriate are these for medical transport? Bigger areas, co-ordination of services vs local identity? Local Councils are filling gaps in some places

20 Recommendations Guidelines are developed as to what is Health Transport and what are Community Transport s responsibilities in relation to transporting clients for medical reasons Conduct a review as to what is the role of Community Transport Support from regulators for closer co-operation between local councils, bus companies, taxi companies and Community Transport to fill the gap in services for those who can t use the mainstream public transport system

21 Thank you