Committee hears that senior and waiver transportation gaps are driving avoidable EMS use and multimillion-dollar costs

At the April 2 meeting, Christina Sailing and Cheryl Howdy Shell of Turnagain Social Club and the Commission on Aging told the Community and Economic Development Committee that Anchorage's non-emergency transportation system is fragmented and underfunded, and that the gap is increasing reliance on emergency services.

Sailing summarized the scale: "Anchorage Fire Department responds to tens of thousands of calls every year. Over 36,000 total calls with nearly 25,000 of those relating to medical," she said, and noted Anchorage has roughly 48,000 Medicare enrollees, including about 9,000 who are dual-eligible for Medicaid and Medicare. The presenters argued that dual-eligible and waiver populations account for a disproportionate share of health spending and are particularly vulnerable when transportation is unavailable.

The presenters described how reimbursement rates make community-based transport financially unsustainable. They said Anchor Rides's cost per trip is about $42.75 while reimbursement for Home and Community Based Waiver transportation was cited at $22.98, leaving a gap that discouraged private providers from offering waiver transport. One presenter summarized: "The reimbursement's not feasible to run a transportation company," and explained many independent providers exited the market in 2021 because rates did not cover costs.

Turnagain Social Club and other witnesses suggested that more reliable, adequately reimbursed transportation could reduce preventable emergency-room visits and EMS responses. They cited an estimate that roughly 21,000 ER visits could be "more than likely preventable" and illustrated how even a modest reduction in avoidable 911 calls could save the municipality millions in acute-care expenditures.

Committee members asked for more detailed data on trip distances, zip-code origin/destination and exact counts of EMS calls made expressly for transport. Chair and members signaled interest in convening a multi-department follow-up with public-health, transit and fire department leaders to explore coordinated solutions and funding approaches.

The committee did not adopt policy in the meeting; members encouraged staff to organize a cross-departmental follow-up meeting to develop options for the waiver population and anchor rides.