Penquis will provide individuals in Penobscot and Piscataquis counties who are diagnosed with cancer direct access to transportation for cancer treatment, eliminating the transportation barrier for individuals who don't own a vehicle, can't drive, don't have access to public transportation, or cannot afford to pay for a taxi.
By April 30, 2015, increase access to cancer treatment for at least 15 individuals from Penobscot and Piscataquis counties for whom transportation is a barrier, as measured by Client Intake Form and Client Survey.
By April 30, 2015, increase awareness of Ride to Health among 35 front-line staff of eight medical and social service providers and cancer support organizations, as measured by Educational Assessment Survey.
CancerCare of Maine, in Brewer, is the only cancer treatment facility in the region. This means that many rural residents must travel 1½ hours or more to receive treatment. For many, this is simply not possible, either because they don't drive, or can't drive due to poor health or mobility, don't have a reliable vehicle, or can't afford the cost of a taxi. At Eastern Maine Medical Center, care is provided without regard to an individual's ability to pay, so sometimes the only barrier is transportation.
According to the American Cancer Society, "Cancer patients cite transportation to and from treatment as a critical need, second only to direct financial assistance."1 This was echoed in the 2011 Community Profile Report of the Maine Affiliate of Susan G. Komen for the Cure®, which stated, "Transportation to treatment for rural communities was a common theme throughout nearly every interview and focus group." Regional providers, also, assert that transportation to treatment is an ongoing need, demonstrated by their commitment to participate in this project.
A population of particular concern is the senior population, which has the highest cancer incidence rates. According to the Maine Annual Cancer Report 2013, the highest incidence rate (2605.7 per 100,000 populations) is among individuals 75-79 years, followed by 80-84 years, 85+ years, and 70-74 years. A 2005 study by the Eastern Maine Transportation Collaborative found transportation to be a significant obstacle to maintaining or improving rural elders' health status. Family members do not always live nearby to help. Those who do rely on family or friends may feel guilt and reluctance to be a burden, as many of those friends and family members are quickly becoming vulnerable to the complications of aging themselves. Adding to the urgency is the fact that Penobscot County's cancer incidence rate (529.7) is significantly higher than the state rate (496.6), as is the rate for the Penquis Public Health District (521.5).
From the data, we know transportation needs are varied, determined by such factors as individual health status, age, insurance, income, and social support networks. A multitude of transportation options must be available in order to address a wide range of abilities and circumstances.
Penquis is the Maine Department of Transportation regional transportation provider for Penobscot and Piscataquis counties. Its transportation program, The Lynx, provides demand response transportation, serving the general public and other social service clients by agency contract; paratransit services for Community Connector, a fixed route public transit system operated by the City of Bangor; and non-emergency medical transportation for MaineCare recipients. In FY13, Penquis provided transportation services for 415,161 trips, benefiting 6,335 clients, including those needing dialysis, physical therapy, cardiovascular services and more. Penquis works collaboratively on transportation issues, having taken part in the Eastern Maine Transportation Collaborative; currently serving on the Board of the Midcoast Public Health District Coordinating Council's Transportation Committee; working in partnership with Maine Primary Care Association and Health Access Network to identify service gaps and coordination opportunities; and, under grants from the Maine Cancer Foundation, Susan G. Komen for the Cure®-Maine and John T. Gorman Foundation, working with Eastern Maine Medical Center's CancerCare of Maine, Caring Connections (Bangor Y), Penobscot Valley Hospital, American Cancer Society, Maine Breast Cancer Coalition and Health Access Network to provide access to transportation for cancer treatment. While the Komen grants (in 2011-2013) have provided a wonderful service to breast cancer patients, the Maine Cancer Foundation grants have helped to provide these same services to individuals diagnosed with other forms of cancer.
By April 30, 2015, "Ride to Health" will provide transportation to cancer treatment for an estimated 15 individuals in Penobscot and Piscataquis counties. Transportation will be addressed in several ways in order to meet individual needs and provide services as efficiently and cost effectively as possible:
Taxi rides will be arranged when the need cannot be met by any other option. Individuals eligible to be served under an existing program may receive transportation assistance under the following, as appropriate. These individuals are not counted in the estimated 15 who will be served through the Ride to Health program.
The Transportation Assistance Project, funded by Maine DHHS, may be used for individuals with a major mental health diagnosis. Vouchers are provided for gasoline, bus passes and taxi fare.
New Freedoms, funded by the Federal Transit Authority through the Maine Department of Transportation, supports the transportation of adults with disabilities who live more than ¾ of a mile from the fixed route of the City of Bangor's bus system to locations within the Greater Bangor area. The customer pays $2.50 each way.
A Lynx staff member will complete intake over the phone and arrange transportation that is most appropriate and cost effective. While Ride to Health will be available to individuals residing anywhere in the Penquis region, it is anticipated that most beneficiaries will reside in rural areas. Ride to Health will increase knowledge/awareness of transportation services among 35 front-line staff of eight medical and social service providers. Project Director Marcia Larkin will make presentations to provider staff and volunteers and provide promotional materials such as posters and flyers for display and distribution. In addition, Marcia will engage in broad outreach efforts, disseminating information on the program through e-newsletters, Facebook, Penquis website, resource fairs, and newspaper, radio and television announcements. These efforts will result in increased awareness among an estimated 19,000+ individuals residing in the two-county area. Penquis Lynx Transportation will continue to partner with Eastern Maine Medical Center's CancerCare of Maine; Caring Connections (Bangor Y); Susan G. Komen for the Cure®-Maine; Penobscot Valley Hospital; American Cancer Society; and Health Access Network, all of whom will provide referrals and facilitate access to the Ride to Health program.
Ride to Health benefits from Penquis' existing collaborations, existing transportation infrastructure (including agency vehicles and volunteer drivers), past program success and the experience of its project director, Marcia Larkin, who has more than 20 years of experience working in Maine transportation services, 9 of which include the oversight of Penquis transportation functions.
The measure of success is increased access to cancer treatment. It is projected that 15 individuals will access treatment through Ride to Health. At least 35 front-line staff of medical and social service providers will increase their knowledge of transportation options to meet this goal. Marcia Larkin, Director of Lynx Mobility Services for Penquis, will conduct process evaluations monthly to include a review of project activities, presentations made and partners engaged, number of individuals served, types of transportation services accessed, and program expenditures. Impact evaluations will consider data from Client Intake Forms, Client Surveys, Educational Assessment Surveys, and the Lynx's ADEPT database to determine efficacy of trainings, information and outreach efforts, and services provided. Data will be collected from:
(1) Client Intake Forms – Information collected includes demographic data, purpose of trip, and program under which services are provided. Data is entered by Lynx Transportation staff into the Lynx's ADEPT database.
Client Survey – Mailed quarterly to clients. Collects client perspectives regarding transportation needs, knowledge of available services, utilization of available services, impact on access to cancer diagnosis/ treatment and quality of life, and service delivery.
Educational Assessment Survey – Survey of staff and volunteers participating in Lynx educational trainings. Survey assesses knowledge gained of transportation resources, perceived usefulness of information, suggestions for future topics and other improvements.