From The Post-Standard in Syracuse, N.Y.:.SYRACUSE, N.Y. -- After the stroke paralyzed his right side 18 months ago, James Lander (pictured) grew to depend on Onondaga County's Homebound Transportation Program.
"I used it last year to go from my home to rehabilitation at St. Camillus," Lander said today, referring to the health and rehabilitation center in Geddes, across town from his Eastwood home.For $21.07, an Able Medical Transportation Service van would come to his house. The attendant would wheel him in his wheelchair into the van, secure him for the ride, wheel him into St. Camillus, then return him home.
Lander recently booked 30 more physical and occupational therapy sessions at St. Camillus, figuring he'd again be able to call Homebound for a ride.
He figured wrong.
The $129,600 Homebound contract with Able was one of the $1.8 million in human services contracts that county officials canceled two weeks ago to combat expected state funding cuts and the effects of the recession on county tax revenues. The service ends with the contract on Feb. 28.
That could strand 283 disabled Onondaga County residents who actively use Homebound, said Beata Karpinska-Prehn, director of advocacy for ARISE Center
for Independent Living.
With no other means of transportation -- or no other way to afford it -- these clients will become socially isolated, unable to leave the house to shop or visit family, Karpinska-Prehn said.
"The greatest concern we have is when people are left without services and vital transportation, it leads to institutionalization," Karpinska-Prehn said. The annual bills for two Homebound clients who, as a result of losing the service, have to go into nursing homes would wipe out any savings the county gains in ending the program, she said.
"Homebound is a great service. It has been wonderful," said Health Commissioner Dr. Cynthia Morrow, whose department had oversight of the program.
But it didn't meet the criteria -- being essential to providing food, shelter, health or safety -- that County Executive Joanie Mahoney set when her department heads began reviewing 141 contracts, valued at $41.5 million, looking for places to cut, Morrow said.
"The Homebound program was a program to assist with transportation for individuals who for medical reasons are confined to their homes," Morrow said. Trips "could be a visit to a hairdresser, transportation to go shopping. There were some medically related transports, but the majority were not related to medical care."
An applicant's doctor had to certify that the person was completely disabled, but there were no income-eligibility requirements.
"When cuts have to be made, this doesn't immediately jeopardize someone's health," Morrow said.
On Jan. 29, as county officials were informing Able Medical Transporation and 25 other human service providers that their contracts would be severed, they also sent letters to Homebound clients, telling them that service would be ending. The letter came with a grid of 20 services around the community that provide transportation to disabled or elderly county residents, with their phone numbers.
Karpinska-Prehn said she is concerned that Homebound clients won't get the same level of service. Centro's Call-A-Bus attendants, for example, won't come into a client's home to help them out of the house, as Able Medical Transporation's attendants do, she said. Other services may not serve the areas covered by Homebound or be available for disabled people, she said. Then there is the cost: Disabled transportation services charge between $50 and $70 per round trip, Karpinska-Prehn said.
The cost is on James Lander's mind. One service he called said it would cost him $80 per round trip to get to St. Camillus.
"I would have to reconsider rehabilitation, if that's the case," Lander said. "I probably would not be able to go at the current rates. I don't know what the alternative would be. My wife works every day now."
Karpinska-Prehn said she hopes county officials will apply for a federal Department of Transportation grant to restore the Homebound subsidy.
Meanwhile, help may be coming from Able Medical Transportation. Amanda Nestor, the county's public health administrator, said that Able officials, reluctant to abandon people who have been loyal clients for years, have offered a gentleman's agreement to make arrangements" with active Homebound clients within a certain radius.
"They can't maintain the $21.07 rate, but would be willing to work with current Homebound members," Nestor said. "My understanding is it was going to be a on case-by-case basis."Able Medical Transportation officials did not return calls seeking comment