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Special coverage: Medicare

Dialysis patients get help finding rides

With transportation benefits cut for low-income patients, the county's Sunshine Line van service steps up to help.

By LISA GREENE and BILL VARIAN
Published January 19, 2006

More coverage on Medicare Part D

TAMPA - Low-income dialysis patients in Hillsborough County who recently had their state transportation benefits cut will get rides from the county's Sunshine Line van service, county commissioners decided Wednesday.

Commissioners also asked health care workers to help patients enrolled in the county's indigent health care plan shift to Medicare for drug prescriptions, and not to remove them from the plan until they make the transition.

Both issues are part of the unexpected fallout of implementing the new federal drug benefit, Medicare Part D. Problems in paying for drugs and transportation, especially for poor and disabled patients, have been reported around the country.

The Hillsborough vote was a relief at the University of South Florida Dialysis Center, where about 10 patients recently lost medical transportation. A story in Wednesday's St. Petersburg Times told of how some were faced with walking to a bus stop nearly three-quarters of a mile away.

"I was thrilled with the outcome," said center social worker Cindy Miller. "I never thought we would have this much action today."

But dialysis patients all over Florida still face problems as a result of the cuts in state Medicaid transportation benefits, patient advocates said. State lawmakers made the cuts in response to passage of the Medicare plan. But, while the Medicare plan will provide drugs, it doesn't provide transportation help.

"I think every single dialysis unit in Florida is affected," said Juliet Venzara, South Florida regional director for the National Kidney Foundation of Florida. "Either they can't get to dialysis, or they have to beg somebody for transportation, or they have to pay for transportation, and they have no budget for that."

Venzara said she hopes dialysis staffers can help patients get rides from local programs. But as they look for solutions, patients are struggling to get to dialysis, which cleanses the blood when kidneys can't. Most patients are treated three times a week, and missing even a few sessions can land them in the hospital.

Existing local ride programs may not solve the problems, said Bruce Martin, social worker with Renal Advantage, which runs four Pinellas dialysis clinics. Martin said he's trying to help 10 to 15 former Medicaid patients. The best option for many is a local van service, but it costs $5 per round trip. For dialysis patients, that adds up to about $60 a month - a hefty expense when many make less than $600 a month.

"Once these people start having medical complications because they've been missing treatments, then you're going to have real problems," he said.

Hillsborough commissioners had previously voted to purge the county's indigent health care plan of people who qualify for other government assistance. But that can't be done immediately, Commissioner Kathy Castor said.

"They need help working through this very complex and confusing Medicare drug benefit plan," Castor said Wednesday.

Dave Rogoff, the county's director of Health & Social Services, said his staff is already working with the some 1,500 health plan patients who qualify for Medicare to assist with the transition. In the meantime, they won't lose coverage.

He also said the county should be able to work with Sunshine Line and the Hillsborough Area Regional Transit Authority to provide transportation for the medically needy.

"We feel like we have stop-gap measures in place," he said.

He said he had difficulty himself explaining to his mother how to enroll in the new Medicare program.

[Last modified January 19, 2006, 12:08:09]