Health

Vehicle drivers reduced in rural America for patients


Several times a month, Jim Maybach drives five miles from his home in Hay Creek, Minnesota, toward the Mississippi River.

Upon arriving at Red Wing, a city of nearly 17,000 people, the 79-year-old retired engineer stopped to pick up a senior he then took to an appointment, such as a visit to the dentist or a doctor’s office. exercise class. When the appointment is over, Maybach is there to drive the person home.

It’s a routine and routine he repeats several times per month.

Unpaid Maybach volunteers with a staff member run by Faith in Action in the Red Wing, a nonprofit that relies on retirees to get people to essential services.

Riders, mainly elderly people, are those who do not have an immediate means of transport, especially in rural areas where public transit options are limited or nonexistent.

There are a number of such programs serving rural counties in Minnesota, but, as with other services nationwide, their existence is precarious as the number of volunteer drivers steadily declines, according to reports. transportation advocate. Volunteers may come to a point where, because of age, they can no longer drive, or the costs associated with their volunteering are no longer sustainable. For decades, Congress has refused to increase driver reimbursement rates.

Experts say that public transport in rural areas is not enough and the long distances that people in rural communities have to travel to access health care, a network of volunteer drivers. impairment will leave the elderly with even fewer vehicle choices and may disrupt their health management. Now, volunteer-based social service organizations have begun to limit their service options and deny ride requests when a driver is not available.

Awareness of the need for drivers in their communities is often what drives volunteers to sign up in the first place, but as car insurance and gas costs rise, commitment isn’t a win-win. attractive as before,” said Frank Douma, director of state and local policy and outreach for the Urban and Regional Infrastructure Finance Institute at the University of Minnesota’s Humphrey School of Public Affairs.

Volunteers, like Maybach, are eligible for a 14 cents-per-mile reimbursement, which is often not close to the cost of gas and wear and tear on a vehicle. And while the Internal Revenue Service increased the business rate from 58.5 cents per mile to 62.5 cents per mile in June, it did not increase the charitable rate because it is subject to congressional review and must prescribed by law. Charity rates were last changed in 1997.

Despite the age-old philanthropic fees, the United Community Action Partnership, a nonprofit that runs a volunteer driver program in southwestern Minnesota, has for years still reimbursed drivers using business rates. Program administrators failed to realize that the IRS could count volunteer returns in excess of the charitable percentage as income.

Shelly Pflaum, driver program manager, said the organization experienced the “first major drop” in volunteer drivers before the COVID-19 pandemic, after discovering the IRS rule and said with volunteers about the impact of taxes when the rate of return is higher. .

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And though the nonprofit continued to reimburse at the business rate, the remaining drivers were frustrated by the springtime spike in gas prices, which came to just 58.5 cents per mile, not included. fuel or maintenance costs.

“When you pay close to five dollars for gas, it doesn’t help anymore,” says Pflaum. “So there was some concern: ‘For the money I spent driving my car, this doesn’t make sense to me anymore – I can’t afford to volunteer’ which is basically what it’s all about. going to happen.”

The IRS business price hike in June was enough to convince most drivers to stay, but Pflaum said she lost a volunteer who had been driving for nearly 20 years.

The issue of inequality rates has gained bipartisan attention in Congress, with the introduction of two bills – both sponsored by Minnesota representatives who propose increasing rates. charity mileage reimbursement to business rate. Similar proposals have been made in Parliament before and were unsuccessful.

According to 2018 research by the Volunteer Drivers Coalition, Minnesota had 1,900 volunteers that year who collectively served 77,000 drivers.

One persistent hurdle that volunteers face is convincing their auto insurance companies that they are, in fact, volunteers and not rental drivers like Lyft or Uber drivers. Otherwise, insurance companies may require them to purchase more expensive coverage for drivers who hail commercial vehicles.

An analysis by the AARP Public Policy Institute found that, as of September 2020, seven states have implemented laws that prohibit insurance providers from denying or canceling coverage or raising rates because motorists are disabled. volunteer. Only two states differentiated hire drivers from volunteers in their insurance laws at the time.

Last year, Minnesota passed a law that separates volunteer drivers from rental drivers. Lawmakers also reduced the driver’s in-state tax liability.

In southeastern Minnesota, a driver shortage has prompted a program at the nonprofit Semcac to cut supply categories. It limits users to two non-thematic trips per month.

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“We would have allowed more if we had drivers to do those things, but we don’t want to take drivers on non-medical trips and then someone doesn’t show up to their doctor’s appointment. their doctors,” said Jessica Sch tower, managing director at Semcac. “There’s more demand than we can provide, and it’s only getting worse.”

If Semcac cannot arrange a driver for a member of the community who needs a ride, the person must find an alternative, such as getting a ride from a family member or an insurance provider their medical look. Semcac has partnered with several insurance providers to bring their clients to medical and dental appointments. Not all volunteer driver programs have this structure.

Sch tower manages 53 drivers spread across six rural counties. About half of that is in Winona County, nearly 650 square miles southeast of Minneapolis along the Mississippi River. She estimates that the average driver is 80 years old.

Sch tower says volunteers who stop driving for her nonprofit often cite medical reasons, such as not being explained by their doctor.

Douma, from the University of Minnesota, said the average age of the volunteers was also a factor in the decline. “As baby boomers retire, they are promoting the Silent Generation and the Greatest Generation who are less than baby boomers, so you have more people to do driving jobs for fewer people,” he said. “But now that baby boomers are getting older, the people who might be most eligible to drive them are Gen X – and that’s a much smaller generation.”

Jim Maybach started driving for Faith in Action after retiring in 2011. Six years later, his wife, Judie, now 78, joined him after retiring. They hardly imagine stopping anytime soon.

However, their volunteer program has begun planning a new recruitment strategy to appeal to a much younger workforce of stay-at-home parents.

“We’re just trying to think, ‘Well, who else can we get?’,” said Katherine Bonine, chief executive officer of Faith in Action. “Because when we had older people, we went from being a volunteer to being a recipient as they got older and their ability to drive changed.”

Kaiser Health News is a national health policy news service. This is an editorially independent program of the Henry J. Kaiser Family Foundation not affiliated with Kaiser Permanente.

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