Access to Services In Rural Southwest Virginia: A

Access to Services In Rural Southwest Virginia: A

Access to Services In Rural Southwest Virginia: A Transportation Issue Lucinda Childs-White, Department of Corrections Brian Moyer, Department of Game and Inland Fisheries Cherrey Wallace, Department of Corrections Tom Herthel, Department of Veterans Services

Issue: Access to Services Lots of services exist in Southwest Virginia Medical (with limits) State-provided services Still, services are unavailable unless citizens have the means to access and benefit from them Access is the gap which we address Rural Virginia Multiple Definitions of Rural

Census Bureau: Any place outside a town, city, or urban cluster with more than 2,500 residents. Rural Southwest Virginia SW Virginia is Mostly Rural population of 392,112 65 residents per square mile (compared to 202 per square mile statewide) White Areas = Rural Areas in Virginia Limiting Factors Access Cost of Car Ownership - $9K Annually

Single Vehicle Homes No Vehicle Homes Financial Limitations Insurance, Gasoline No License: Elderly Substance Abuse (Opioids / Alcohol) Severe Disability Limiting Factors Distance & Weather Narrow and Winding Roads

Tazewell to Salem 121 Miles (2 hrs); RT gas $18-$36 Clintwood to Abingdon 60 Miles (1 hr 22 mins); RT gas $10-$18 Grundy to Roanoke 178 Miles (3 hrs); RT gas $27-$52 Jonesville to Johnson City 67 Miles (1 hr 22 mins); RT gas $10-$20 Limiting Factors-Medical Shortage SW Virginia has a health care workforce shortage Critical shortage of behavioral health providers

Requires traveling long distances to access specialty health care Impact On: The Elderly Disabled Citizens Low-Income Individuals and Families Veterans Impact On: Elderly Impact On: Elderly

SW Virginia: 78,442 (20%) Impact On: Disabled Impact On: Disabled 82,343 (21%) Impact On: Poverty Impact On: Poverty

71,000 (18%) Impact On: Veterans Approx. 25,000 (6.4%) in SW Virginia Local Community and Specialty Care Hospital Locations in Southwest Virginia Green local community hospital Red Specialty services hospital

Specialty Care Hospitals Location Hospital Specialties Roanoke Carilon Roanoke Memorial Hospital

Cancer treatment, cardiology & heart surgery, diabetes & endocrinology, gastroenterology & GI surgery, geriatrics, gynecology, nephrology, neurology & neurosurgery, orthopedics, pulmonary & lung surgery, urology Salem Lewis-Gale Medical Center Cancer treatment, diabetes & endocrinology, gastroenterology & GI surgery, nephrology, neurology & neurosurgery, orthopedics, urology

Abingdon Johnston Memorial Hospital Gastroenterology & GI surgery, geriatrics, nephrology, orthopedics, pulmonary & lung surgery Catawba Catawba Hospital Psychiatry

Marion Southwest Virginia Mental Health Institute Psychiatry Richlands Clinch Valley Medical Center

Pulmonary & lung surgery, urology Bristol Rehabilitation Hospital of Southwest Virginia Rehabilitation No hospitals listed for specialty treatment of: Ear, Nose & Throat (ENT) Long term care

Ophthalmology Rheumatology Veterans Care Facilities Larger county populations Beckley VAMC, WV Craig

VA Medical Centers VA Community Based Outpatient Clinic (CBOC) Giles CBOCs Jonesville Marion Norton Tazewell Vansant Wythevill

e Salem VAMC Roanoke Buchanan Di ck en

s Montgomery Tazewell on Bland Pulaski

Tazewell Russell Wise Abingdon Wythe Smyth

Washington Scott Lee Grayson Mt Home VAMC, TN Current Transportation Options Personal Transportation

Public Transportation Limited in Scope Private Transportation Taxis/Uber Community Based: VA Reimbursement and Vans (Limited) Medicaid Reimbursement Vanpools - Churches & Community Organizations Filling the Gap Incentivize community facilities to provide transportation Vouchers or Tax Breaks

Encourage local governments to expand public transportation Establish a partnership with private industry Uber? More reliance on NGOs Churches and VSOs Future Technologies Self-drive Vehicles Develop alternatives to transportation Telehealth Services (Broadband infrastructure improvements) Grow local delivery options similar to Amazon and Uber Eats Many Available Resources Available Resources

Special Thanks to : Carole Pratt, Department of Health Brittany Voll, Virginia Department of Rail and Public Transportation DRAFT 2019 Coordinated services Mobility Plan http:// pt-coordinated-human-service-mobility-plan.pdf Recommendation Create a state-funded grant to organize all stakeholders local and state to identify and consolidate available

transportation assets and develop low cost solutions to fill the gaps. State Government: DRPT, VDH, DMAS, DARS, DVS, DBHDS Local Governments Medical Providers Local Colleges and Universities Chambers of Commerce NGOs Churches, VSOs, etc Questions

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