TLPA

TLPA INTERNATIONAL HEADQUARTERS GRAND OPENING

TLPA held an Open House on Tuesday, April 1, 2008 to show off the new TLPA International Headquarters located in Rockville, Maryland, about 18 miles from the White House in Washington, DC. The Open House was scheduled to encourage members to see the new home of TLPA.

Members who attended commented that the office space is well lit with natural light. Some walls are painted sage green here and there to add a warm and inviting feeling to the 2,400 square foot office. All of the visitors commented on the “great artwork and memorabilia” hanging on the walls. Many members have donated gifts to TLPA such as artwork featuring transportation motifs, along with memorabilia such as taxicab badges and hats, a limousine license plate, and a letter thanking a TLPA California paratransit company member for exemplary service in transporting movie star Christopher Reeve.

TLPA President Brian Hunt commented that as the premier ground transportation association representing over 1,000 transportation companies that transport nearly 1 billion passengers per year, TLPA now has office space that matches the critical function it serves in effectively representing the for-hire vehicle industry. TLPA is proud of its heritage.

We brought some old faded photographs from the previous TLPA office and hung them in our new conference room. Members looking at them said, “Hey, that’s my grandpa;” “That’s my dad;” “That’s my uncle.” In the coming months TLPA will publish an enhanced copy of the photo in its Transportation Leader magazine to see if other members may be able to identify relatives in the photo. As TLPA members visit our nation’s Capitol they are welcome to visit the new TLPA offices.

From left to right:n Victor Dizengoff of the New York Black Car Assistance Corporation, Ellis Houston, Yellow Cab of Birmingham, AL, and Murray Rosenberg, Yellow Cab of Atlantic City (back to camera).

TLPA President Brian Hunt, Diversified Paratransit, Pomona, CA with TLPA President-Elect Richard Hewatt of Checker Cab, Atlanta, GA looking at some of the old photos in the TLPA conference room.

TLPA MEDICAID TESTIMONY

Many taxicab companies have contracts to provide transportation service to Medicaid clients. Recently, Medicaid published a Notice of Proposed Rulemaking that, if it were enacted, would give states the option, when certain conditions were met, to stop funding non-emergency medical transportation. TLPA filed testimony in opposition to this proposal. A brief summary of our testimony follows.

The result of removing non-emergency medical transportation (NEMT) assistance to special needs persons is that overall Medicaid costs will increase as medical visits become less frequent resulting in much more serious medical problems once the delayed treatment is obtained. The old adage that "an ounce of prevention is worth a pound of cure" is truly applicable to this situation and the pound of cure is dramatically higher medical treatment costs for persons who no longer have ready access (transportation) to medical facilities.

There are at least three studies, one local, one statewide and one national that illustrate the value and necessity of NEMT. The finest medical services are of little value to individuals who cannot access them. A 2001 report by the Cabarrus Health Alliance, Kannapolis, NC, stated that transportation is a key component in the health care equation. Lack of access to medical services results in:

• Decreased usage of preventive care services and health improvement programs. In other words, delayed medical attention leading in turn to more serious illnesses, reduced quality of life, and an overall increased cost of care.
  
  
  
• The unnecessary use of emergency room facilities and staff which increases costs and prevents those persons requiring immediate assistance from receiving necessary care.
  
  
  
• An increased dependence on expensive ambulance services for non-urgent care resulting in increased cost and less ambulance availability for true emergencies.
  
  

The Florida Commission for the Transportation Disadvantaged commissioned The Marketing Institute at the Florida State University College of Business to calculate the return on investment generated by funds invested by the State of Florida on transportation disadvantaged programs.

The report states that one of the primary purposes for transportation disadvantaged funding efforts is to support preventative medical care. Preventative medical care trips assist in keeping low income, elderly, and disabled Florida residents out of the hospital and nursing homes. Given that a nursing home cost approximately $5,000 per month, daily hospital stays costs approximately $7,900 and adult day care costs from $25 to $100 per day, the benefits that result from providing transportation disadvantaged Florida residents access to preventive medical care are substantial based on the state’s ability to avoid nursing home, hospital and/or adult day care costs.

The report uses an extremely conservative estimate that if 1 out of every 100 trips prevents a one day stay in the hospital, the resulting benefit would be a payback of $11.08 for every dollar invested by the state of Florida. A 1108% return on investment for NEMT makes it one of, if not the single most cost effective programs that Medicaid or any other federal or state program offers.

In response to the importance of examining the need for improved access to NEMT nationally, in 2006 the Transit Cooperative Research Program, which operates under the auspices of the Transportation Research Board of the National Academy of Sciences, published Project B-27, “Cost Benefit Analysis of Providing Non-Emergency Medical Transportation.” The goal of this study was to compare the costs and benefits, including potentially large net health benefits, of providing NEMT to those who lack access to it.

The study concludes that the net healthcare benefits of increased access to medical care for the transportation disadvantaged exceed the additional costs of transportation for all of these conditions. These benefits include both actual decreases in healthcare costs for some conditions (e.g., emergency care replaced by routine care) and improved quality of life for those who receive access. For three of the chronic conditions, asthma, heart disease, and diabetes, results show net cost savings; for the other four, depression, hypertension, chronic obstructive pulmonary disease, and end stage renal disease, improvements in life expectancy or quality of life were determined to be sufficient to justify the added expense.

In today’s economy, NEMT is inexpensive compared to the high and rapidly growing cost of health care. Therefore, while implementation of this proposed rule may result in a very brief period of short term savings for state Medicaid programs, the long term medical costs for the care of the 36 million or more America citizens that will be affected will certainly rise as their quality of life diminishes.

Harold Morgan, TLPA Executive Vice President, submitted this article.

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