The Arc of Livingston-Wyoming operates 14 residences that provide safe, secure housing for neighbors with disabilities throughout Livingston and eastern Wyoming counties. Its KidStart program benefits more than 200 children at three locations. Hilltop Industries, The Arc's day services program, provides valuable work and life skills experience to more than 350 people at three sheltered workshops and two day habilitation locations. However, of all its offerings, The Arc is probably best known for its distinctive fleet of Hilltop buses, which are among 150 agency vehicles that are operated by various agency programs.

But today, Livingston County seniors and their families are looking at the familiar buses in a whole new way: as an integral part of life-sustaining medical services, thanks in part to a $32,000 New Freedom Transportation Grant awarded to The Arc by the Federal Transportation Administration, and administered by the New York State Department of Transportation (NYS DOT).

The grant enables The Arc to partner with three key Livingston County service agencies – the Department of Social Services (DSS), Office for the Aging, and Center for Nursing – and with Nicholas H. Noyes Memorial Hospital, to provide door-through-door, non-emergency transportation service for many of the area’s most frail and older residents. The target population includes Livingston County residents over age 55 with more than one limitation on daily living. Among those served: seniors who receive treatment at the new Noyes Center for Kidney Disease and Dialysis, located at the site of the former Geneseo Skilled Nursing Facility.

“Dialysis is best described as a life-sustaining treatment, and this transportation component is an integral part of that treatment,” says Gail Feathers, LMSW, Social Worker at Noyes and the Dialysis unit. “If a person who needs dialysis doesn’t get it, or they miss appointments, it can be a very serious medical situation.”

The transportation service is intended to meet the needs of Livingston County seniors who might otherwise not have the ability to reach scheduled health appointments -- a significant number in a county where well over 9,600 people are over the age of 60. Typical dialysis treatment can last 2½ to 4 hours, 3 days per week, making transportation a challenge for patients, as well as their families.

"Look at it this way," Arc Transportation Director John Prospero explains. "I live in Bergen and I work in Mt. Morris. My mother lives in Batavia. Now, that means I only live 12 miles from her, but if my mother was in a position where she had to get to dialysis three days a week, I wouldn’t be able to provide the transportation on my own. Not only do you have the ride there, you have the ride home, and a dialysis appointment can be 4 hours. That’s where this service is a great help."

The DOT grant will fund approximately 50 percent of the new service's projected annual budget of $60,000. Another $10,000 is being contributed by the Livingston County Office for the Aging. Medicaid reimbursements for some riders will also help to fund the service. Although the service is free to all riders, those not covered by Medicaid will be able help to defray the costs by making voluntary donations.

"The Office for the Aging is quite excited about its ability to support this new transportation initiative of The Arc with a $10,000 funding amount," says Office for the Aging Director Karren Smith. "Keeping New York seniors at home for as long as is safely possible is what we are all about. Getting people to non-emergency medical appointments is critical to keeping them healthy, at home, and avoiding premature nursing home placement and unnecessary hospitalization. This wonderful initiative between The Arc, DSS, Center for Nursing, and Office for the Aging will help in that mission."

Door-through-door transportation offers a very high level of service for seniors who may have significant mobility limitations. It differs from typical curbside service in that drivers are trained and able to assist clients in leaving their homes and doctors' offices, as well as boarding and un-boarding buses. To be able to perform these extra duties, Arc drivers will receive specialized physical therapy training through the Livingston County Center for Nursing.

Riders can utilize the new transportation service on a recurring basis or for a single, scheduled trip to a medical provider. All rides are coordinated through the office of Livingston County DSS Transportation Broker Denise Bentley, who acts as liaison with local transportation providers, medical offices, and other agencies to provide linkages and maximize available resources.

According to Bentley, the service reaches a segment of the population that had previously been difficult to serve. The closest transportation vendors that provide wheelchair support are typically based in Rochester, she explains. This makes Medicaid-funded cases especially complex, because Medicaid reimburses only "loaded miles," and not the mileage to and from a recipient's home.

"Especially with gas at $3.50-to-$4.00 a gallon, vendors don't want to come out from Rochester to drive somebody from Nunda to Geneseo, which is 18 miles,” Bentley says. “Essentially, they're going to get 36 miles paid, but in order to get those 36 miles they have to travel 70."

"This grant allows us to give a ride to that person who might need to travel even one mile to see their doctor, but who we weren't able to reach before," she explains. "It also brings a more reliable and dependable vendor source to meet the needs of our county residents who are wheelchair bound or require some type of hands-on assistance."

Bentley's team is also charged with ensuring that the new service is successfully realized without disruption to an already busy Arc Transportation schedule. This means coordinating trips during off-peak hours, such as early mornings and evenings.

Providing needed services to an audience that is not typically associated with The Arc is not new for the Transportation team, Prospero says. "The department was founded 25 years ago primarily to transport agency consumers into the Hilltop Industries workshops, but has since expanded to become the largest provider of transportation in Livingston County, performing more than 1,200 one-way stops each day," he explains.

Today, The Arc is the transportation provider for the Livingston County pre-school program, Livingston County Head Start, and a primary provider for two Finger Lakes DDSO Day Habilitation sites. In addition, the agency provides special needs transportation for 11 area school districts.

The fact that Arc buses are already certified ADA compliant, and are wheelchair accessible in order to meet many disabled consumers' needs, also makes them a perfect match to transport non- or less-ambulatory seniors. "Bottom line: nobody else provides this service to the extent that we can," Prospero explains.

Service began in early October, transporting its first two customers to the Noyes Center for Kidney Disease and Dialysis on a three-times-per-week basis. Two additional Dialysis patients were added on October 20. According to Feathers, the service illustrates a commitment between Noyes and Livingston County government. (The dialysis center is located in the county-owned building on Route 20A in Geneseo.) She is hopeful that it will continue to grow – assisting the unit to reach its goal of serving 48 people – and says it’s off to a strong start.

“As one of the patients has already said, ‘It’s a godsend.’,” Feathers comments.

For more information, including how seniors can take advantage of the service, contact Jeff Thomas, Public Relations Director for The Arc of Livingston-Wyoming, at (585) 658-2828 ext. 128 or jthomas@lwarc.org.