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Addressing Substance Use Disorder in the Appalachian Region

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During the National Regional Transportation Conference (June 2019, Columbus, OH), Ryan Brumfield shared information about how the Appalachian Regional Commission is identifying potential interventions to support transportation to medically assisted treatment for substance use disorder and other destinations.

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Addressing Substance Use Disorder in the Appalachian Region

  1. 1. • 13 states • 420 counties • 205,000 square miles • 25 million people • 73 local development districts Appalachian Region
  2. 2. County Economic Status, FY 2019 ARC’s five county economic status designations are based on three indicators: three-year average unemployment rates, per capita market income, and poverty rates. • Distressed: The most economically depressed counties, ranking in the worst 10% of the nation's counties. In FY 2018, 84 Appalachian counties are designated as distressed. • At-risk: Counties at risk of becoming distressed. • Transitional: Counties transitioning between at-risk and competitive status. • Competitive: Counties able to compete in the national economy but don’t rank in the highest 10% of the nation's counties. • Attainment: The economically strongest counties, ranking in the best 10% of the nation's counties.
  3. 3. Key Factors Affecting Access to Treatment and Recovery  Availability of treatment and recovery services – presence of physical infrastructure or remote/telehealth alternatives.  Availability of mobility solutions (car, transit, rideshare, volunteer driver, safe walking/biking infrastructure, etc.).  Linking available treatment and recovery services with available mobility solutions. • Knowledge and awareness of mobility solutions among clients AND treatment and recovery service providers. • Use of mobility management ideas, tools and technologies.
  4. 4. Treatment and Recovery Journey • No/emergency treatment • Harm reduction, considering detox or other program • In treatment for a couple of months or more • In a treatment program with coach/counselor • Stable recovery and considering training, employment, other self-sustaining activities • Sustained long term recovery • Stable housing, employment & transportation
  5. 5. Transportation Needs Along Journey • On-demand rides – sometimes long distances • Some predictable trips (bus, prescheduled ride) • Total reliance on mobility services, family and friends for rides • More predictable trips to similar destinations each day/week • Some unexpected/unique trips which could be scheduled in advance or may require on-demand • Largely relying on mobility services, family and friends • Predictable trips for a routine purpose • May need long-term assistance to work/school • Self-sufficient - has license and car, limited support needed
  6. 6. Hypothetical Project Concept Summary: Targeted mobility management Details: • Establish and maintain a knowledgeable mobility advisor network through training and guidance. • Introduce new or improved mobility solutions like Lyft Concierge and a more robust volunteer driver network. • Introduce new software tools to optimize selection of mobility solutions based on payment structure, trip location, urgency of trip, etc.
  7. 7. Hypothetical Project Concept • Subsidize rides for select individuals who identify transportation as a key barrier to treatment and recovery. • Measure treatment engagement, client perception of transportation barriers, number of “graduates” who become transportation independent, and number of individuals trained to be mobility advisors. • Collect data and summarize in report at project conclusion – include lessons learned, sustainability plan, and expansion recommendations.
  8. 8. Other Concepts • Train and provide ride scheduling abilities to United Way 211 or other call centers/dispatch services. • Tap into state or federal (FTA 5310) funding to purchase vehicles and for mobility management activities. • Car donations for “graduates” who demonstrate program success and have kept or reobtained license. • Employers work with local/state workforce board to subsidize initial transportation costs to employment at re-entry.

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