Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #114036

Steve Borders, MHA, School of Nonprofit and Public Administration, Grand Valley State University, 401 W Fulton Street, Grand Rapids, MI 49504, 616/331-6569, borderss@gvsu.edu, James Dyer, PhD, Public Policy Research Institute & School of Rural Public Health, Texas A and M University, MS 1266, College Station, TX 77843, and Craig Blakely, School of Rural Public Health, Department of Health Policy and Management, Texas A&M U, MS 1266, College Station, TX 77843-1266.

The Texas Medicaid program provides transportation assistance to clients who have no other means of transportation to their medical appointments. This type of transportation is known as non-emergency medical transportation (NEMT). The Texas Department of Health has identified transportation as a key issue inhibiting the full use of EPSDT services. An evaluation of NEMT services in 2003 found that such services greatly contribute to access of preventative EPSDT services. Medicaid clients that accessed NEMT services had higher utilization rates of EPSDT checkups than those who did not. The study also sought to understand the barriers that prohibit access to care among non-users. While both users and non-users of NEMT services had similar sized families, non-users of NEMT services were more likely (p<.05) to have younger children at home. Current policies may exacerbate transportation problems for Medicaid recipients, especially for families with more than one child. NEMT pays only for children who are accessing EPSDT services, forcing parents to find childcare for those who do not. Overall, non-users reported fewer barriers (p<.05) with access to an automobile, difficulties with paying for gas, and difficulties with money for parking expenses. Non-users also reported having shorter travel times and shorter travel distances (p<.05) in accessing EPSDT services. Despite having a fewer access barriers as a group, 34% of parents with Medicaid eligible children reported having unmet transportation needs and no knowledge of the NEMT, further suggesting that a substantial number of parents could potentially benefit from NEMT services if aware of the program.

Learning Objectives:

• 1)Recognize and discuss NEMT impedance factors and their impacts on EPSDT access and utilization.
• 2)Recognize the impacts of Texas Medicaid transportation policy and the barriers to accessing care it potentially imposes.
• 3)Analyze and develop potential policy alternatives to reduce transportation barriers for Medicaid recipients.

Keywords: Access, Medicaid

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.