NEMT BUSINESS STRATEGIES - When exploring the possibilities of starting a Non-Emergency Medical Transportation (NEMT) business, entrepreneurs may be concerned over the presence of paratransit services in their market area. They may ask: how can my new venture compete with a government subsidized program that provides a similar service? It’s presence in the community will have an effect, just as the availability of wheelchair accessible taxis or other NEMT competitors will also contribute to the mix of transportation options available to your potential customer base.
Americans with Disabilities Act - An important thing to remember is that paratransit is government mandated. As such, it operates under specific national standards that are spelled out in the Americans with Disabilities Act (ADA), although there may be some local exceptions, especially in smaller communities where they sometimes take on additional responsibilities. ADA Paratransit is there primarily to compliment transit; to fill in the gaps in accessibility that the fixed route service is not meeting. What paratransit can do, or can't; all revolves around that fact. That is what this post is all about: finding the potential for NEMT in market niches that paratransit is not serving. Here are some examples:
Curb-to-Curb Service - Many Paratransit agencies provide curb-to-curb service. Some may go door-to-door, but they are not required to do so. NEMT providers on the other hand routinely provide door-through-door service. For example taking the passenger into the nursing home and handed to staff. Potential customers, programs, and facilities may not be aware of the difference.
Shared-Ride Service - Paratransit is a scheduled shared-ride service that can often result in on-board ride times in excess of an hour. While most clients will accept that inconvenience because the service is affordable; there could be situations when time is of the essence (non-emergency), or when a direct trip would be worth paying extra for private-pay trip with a NEMT company. Examples of which could be pain issues associated with long bus rides, or if the client is prone to car sickness.
Limited Service Area - The minimum service required under ADA stipulations is to provide service within a 3/4 mile radius of an operating transit route; usually restricted within the city limits, unless some form of regional transportation coordination has been established. As a private transportation provider, a NEMT company can provide service to customers outside of this area, as well as providing trips between communities, and even out of state (if the company has met state requirements). See the "Eligibility' section below for more information.
Limited Service Times - The hours of operation can vary widely from community to community, some are quite generous, while others are surprisingly limited. In such cases, anyone (for example) needing wheelchair accessible transportation to catch an early flight or take in a late movie would not be able to do so with paratransit. A NEMT company could provide service that extends beyond the regular operation hours of the local paratransit program. This would also compliment other programs that NEMT companies may provide services for during regular office hours, such as Medicaid or Veterans Affairs.
Eligibility - Eligibility is an ongoing issue that tends to get public attention only when there has been a policy change that effects a large number of users of paratransit, such as happens when a transit route has been eliminated (see 'Limited Service Area' above). Otherwise, it happens on a individual basis such as could result from a client's periodic eligibility review if for example, their mobility has improved to a point that the agency considers them now able to access regular transit services. This can leave people that had previously relied on paratransit, scrambling to find transportation. It's impossible to know who might find themselves in this position, but if a NEMT company has a presence on the internet or in the community through word-of-mouth, then there is a greater likelihood that they might consider your company for private-pay trips.
As local governments continue to grapple with fiscal restraints, paratransit programs are being eyed for possible cuts. This often results in reduction of services, sometimes to the minimum compliance under the ADA, while at the same time maintaining the long term plan of expanding the number of accessible fixed-route transit services; further reducing the demand for paratransit under the program. For NEMT companies, this means there will continue to be potential opportunities available to attract customers that paratransit is not reaching or is providing inadequate service for.