Addressing Access to Services in Rural Southwest Virginia
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A Transportation Issue
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Lucinda Childs-White, Department of Corrections
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Brian Moyer, Department of Game and Inland Fisheries
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Cherrey Wallace, Department of Corrections
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Tom Herthel, Department of Veterans Services
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Lots of services exist in Southwest Virginia
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Medical (with limits)
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State-provided services
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Still, services are “unavailable” unless citizens have the
means to access and benefit from them
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Access is the gap which we address
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Multiple Definitions of “Rural”
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Census Bureau: “Any place outside a town, city, or ‘urban cluster’
with more than 2,500 residents.”
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SW Virginia is Mostly Rural – population of 392,112
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65 residents per square mile (compared to 202 per square mile state-
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White Areas = Rural Areas in Virginia
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Cost of Car Ownership - $9K Annually
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Single Vehicle Homes
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No Vehicle Homes
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Financial Limitations – Insurance, Gasoline
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No License:
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Elderly
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Substance Abuse (Opioids / Alcohol)
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Severe Disability
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Narrow and Winding Roads
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Tazewell to Salem – 121 Miles (2 hrs); RT gas $18-$36
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Clintwood to Abingdon – 60 Miles (1 hr 22 mins); RT gas $10-$18
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Grundy to Roanoke – 178 Miles (3 hrs); RT gas $27-$52
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Jonesville to Johnson City – 67 Miles (1 hr 22 mins); RT gas $10-$20
https://www.distance-cities.com
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SW Virginia has a health care workforce shortage
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Critical shortage of behavioral health providers
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Requires traveling long distances to access specialty health care
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The Elderly
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Disabled Citizens
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Low-Income Individuals and Families
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Veterans
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SW Virginia:
78,442 (20%)
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82,343 (21%)
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71,000 (18%)
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Approx. 25,000 (6.4%)
in SW Virginia
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Green – local community hospital
Red – Specialty services hospital
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No hospitals listed for specialty treatment of:
Ear, Nose & Throat (ENT)
Long term care
Ophthalmology
Rheumatology
https://health.usnews.com/best-hospitals/area/va/southwestern-virginia
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VA Community Based Outpatient Clinic (CBOC)
Larger county populations
VA Medical Centers
CBOCs
Jonesville
Marion
Norton
Tazewell
Vansant
Wytheville
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Personal Transportation
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Public Transportation – Limited in Scope
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Private Transportation – Taxis/Uber
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Community Based:
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VA Reimbursement and Vans (Limited)
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Medicaid Reimbursement
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Vanpools - Churches & Community Organizations
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Incentivize community facilities to provide transportation
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Vouchers or Tax Breaks
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Encourage local governments to expand public transportation
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Establish a partnership with private industry – Uber?
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More reliance on NGOs – Churches and VSOs
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Future Technologies – Self-drive Vehicles
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Develop alternatives to transportation
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Telehealth Services (Broadband infrastructure improvements)
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Grow local delivery options similar to Amazon and Uber Eats
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Special Thanks to :
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Carole Pratt, Department of Health
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Brittany Voll, Virginia Department of Rail and Public
Transportation
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DRAFT 2019 Coordinated services Mobility Plan
http://www.drpt.virginia.gov/media/2895/draft-2019-
virginia-drpt-coordinated-human-service-mobility-
plan.pdf
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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.”
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State Government: DRPT, VDH, DMAS, DARS, DVS, DBHDS
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Local Governments
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Medical Providers
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Local Colleges and Universities
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Chambers of Commerce
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NGOs – Churches, VSOs, etc
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Southwest Virginia faces challenges in accessing essential services due to transportation barriers, limited resources, and a rural population distribution. Issues such as high costs of car ownership, distance to medical facilities, and workforce shortages contribute to the gap in accessing services in the region.
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Presentation Transcript
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 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 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 Rural Southwest Virginia SW Virginia is Mostly Rural population of 392,112 65 residents per square mile (compared to 202 per square mile state- wide) White Areas = Rural Areas in Virginia
Limiting Factors Limiting Factors Access 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 Limiting Factors Distance & Weather 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 https://www.distance-cities.com
Limiting Factors Limiting Factors- -Medical Shortage 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: Impact On: The Elderly Disabled Citizens Low-Income Individuals and Families Veterans
Impact On: Elderly Impact On: Elderly
Impact On: Elderly Impact On: Elderly SW Virginia: 78,442 (20%)
Impact On: Disabled Impact On: Disabled
Impact On: Disabled Impact On: Disabled 82,343 (21%)
Impact On: Poverty Impact On: Poverty
Impact On: Poverty Impact On: Poverty 71,000 (18%)
Impact On: Veterans Impact On: Veterans Approx. 25,000 (6.4%) in SW Virginia
Local Community and Specialty Care Hospital Local Community and Specialty Care Hospital Locations in Southwest Virginia Locations in Southwest Virginia Green local community hospital Red Specialty services hospital
Specialty Care Hospitals Specialty Care Hospitals Location Hospital Specialties Cancer treatment, cardiology & heart surgery, diabetes & endocrinology, gastroenterology & GI surgery, geriatrics, gynecology, nephrology, neurology & neurosurgery, orthopedics, pulmonary & lung surgery, urology Roanoke Carilon Roanoke Memorial Hospital Cancer treatment, diabetes & endocrinology, gastroenterology & GI surgery, nephrology, neurology & neurosurgery, orthopedics, urology Salem Lewis-Gale Medical Center 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 https://health.usnews.com/best-hospitals/area/va/southwestern-virginia No hospitals listed for specialty treatment of: Ear, Nose & Throat (ENT) Long term care Ophthalmology Rheumatology
Veterans Care Facilities 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 Wytheville Salem VAMC Buchanan Roanoke Mont- gomery Tazewell Bland Pulaski Tazewell Russell Wise Wythe Smyth Abingdon Washington Scott Lee Grayson Mt Home VAMC, TN
Current Transportation Options 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 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 Many Available Resources
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://www.drpt.virginia.gov/media/2895/draft-2019- virginia-drpt-coordinated-human-service-mobility- plan.pdf
Recommendation 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
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