Health

Diminishing drivers: Volunteer shortages complicate access to care in rural America


Several times a month, Jim Maybach drives from his home in Hay Creek, Minnesota, 5 miles toward the Mississippi River.

Upon arriving at Red Wing, a city of nearly 17,000 people, the 79-year-old retired engineer stopped to pick up a senior he then took to an appointment, such as a visit to the dentist or a doctor’s office. exercise class. When the appointment is over, Maybach is there to drive the person home.

It’s a routine and routine he repeats several times per month.

Unpaid Maybach, a volunteer among a cadre organized by Faith in Action in the Red Wing, a nonprofit that relies on retirees to get people to essential services.

Riders, mainly elderly people, are those who do not have an immediate means of transport, especially in rural areas where public transit options are limited or nonexistent.

There are a number of such programs serving rural counties in Minnesota, but, as with other services nationwide, their existence is precarious as the number of volunteer drivers steadily declines, according to reports. transportation advocate. Volunteers may come to a point where, because of age, they can no longer drive, or the costs associated with their volunteering are no longer sustainable. For decades, Congress has refused to increase driver reimbursement rates.

Experts say that with public transport in rural areas already inadequate and the long distances that people in rural communities have to commute to access healthcare, a network of drivers Reduced volunteering will leave older adults with even fewer vehicle options and may disrupt their health management. Now, volunteer-based social service organizations have begun to limit their service options and deny ride requests when a driver is not available.

One photo shows Jim and Judie Maybach together standing outside their car.  The city of Red Wing, Minnesota, is seen behind them.
Jim and Judie Maybach started driving for Faith in Action in the Red Wing after they retired.(Liam James Doyle for KHN)

Awareness of the need for drivers in their communities is often what drives volunteers to sign up in the first place, but as car insurance and gas costs rise, commitment isn’t a win-win. attractive as before,” said Frank Douma, director of state and local policy and outreach for the Urban and Regional Infrastructure Finance Institute at the University of Minnesota’s Humphrey School of Public Affairs.

Volunteers, like Maybach, are eligible for a 14 cents-per-mile reimbursement, which is often not close to the cost of gas and wear and tear on a vehicle. And while the Internal Revenue Service increased business fees from 58.5 cents per mile to 62.5 cents per mile in June, it did not raise the charity rate because it is under review by Congress and must be regulated by law. Charity rates were last changed in 1997.

Despite the age-old philanthropic fees, the United Community Action Partnership, a nonprofit that runs a volunteer driver program in southwestern Minnesota, has for years reimbursed drivers at business rates. Program administrators failed to realize that the IRS could count volunteer returns in excess of the charitable percentage as income.

Shelly Pflaum, driver program manager, said the organization experienced its “first major drop” in volunteer drivers before the covid-19 pandemic, after discovering the IRS rule and said with volunteers about the impact of taxes when the rate of return is higher. .

And though the nonprofit continued to reimburse at the business rate, remaining drivers were frustrated by the spring spike in gas prices, which dropped to just 58.5 cents per mile, never including fuel or maintenance costs.

“When you pay close to five dollars for gas, it doesn’t help anymore,” says Pflaum. “So there was some concern: ‘For the money I spent driving my car, this doesn’t make sense to me anymore – I can’t afford to volunteer’ which is basically what it’s all about. going to happen.”

The IRS business price hike in June was enough to convince most drivers to stay, but Pflaum said she lost a volunteer who had been driving for nearly 20 years.

A photo shows Michelle Larson handing a certificate to Katherine Bonine at a ribbon-cutting ceremony.

Michelle Larson, executive director and president of the Red Wing Regional Chamber of Commerce, (left) presents Katherine Bonine’s membership, Faith in Action in Red Wing, with a certificate of membership at the ribbon-cutting ceremony. on October 12, 2022. (Liam James Doyle for KHN)

Judie Maybach (right) and Katherine Bonine chat after ribbon-cutting the certified nonprofit in the Red Wing Regional Chamber of Commerce on October 12, 2022. (Liam James Doyle for KHN)

The issue of inequality rates has gained bipartisan attention in Congress, with the introduction of two receipt – both sponsored by Minnesota representatives who propose to increase charity mileage reimbursement rates to business rates. Similar proposals have been made in Parliament before and were unsuccessful.

Based on Research 2018 of the Volunteer Drivers Coalition, Minnesota had 1,900 volunteers that year who collectively served 77,000 riders.

One persistent hurdle that volunteers face is convincing their auto insurance companies that they are, in fact, volunteers and not rental drivers like Lyft or Uber drivers. Otherwise, insurance companies may require them to purchase more expensive coverage for drivers who hail commercial vehicles.

One Analysis by AARP Public Policy Institute found that, as of September 2020, seven states have implemented laws that prohibit insurance providers from denying or canceling coverage or raising rates because motorists are volunteers. Only two states differentiated hire drivers from volunteers in their insurance laws at the time.

Last year, Minnesota passed a law that separates volunteer drivers from rental drivers. Lawmakers also reduced the driver’s in-state tax liability.

In southeastern Minnesota, a driver shortage has prompted a program at the nonprofit Semcac to cut supply categories. It limits users to two non-thematic trips per month.

“We would have allowed more if we had drivers to do those things, but we don’t want to take drivers on non-medical trips and then someone doesn’t show up for a doctor’s appointment. their doctors,” said Jessica Sch tower, managing director at Semcac. “There’s more demand than we can provide, and it’s only getting worse.”

If Semcac is unable to arrange a driver for a community member who needs a ride, the person must find an alternative, such as having a family member drive or having a medical insurance provider ride them. their economic find. Semcac has partnered with several insurance providers to bring their clients to medical and dental appointments. Not all volunteer driver programs have this structure.

Sch tower manages 53 drivers spread across six rural counties. About half of that is in Winona County, nearly 650 square miles southeast of Minneapolis along the Mississippi River. She estimates that the average driver is 80 years old.

Sch tower says volunteers who stop driving for her nonprofit often cite medical reasons, such as not being explained by their doctor.

Douma, from the University of Minnesota, said the average age of the volunteers was also a factor in the decline. “As baby boomers retire, they are promoting the Silent Generation and the Greatest Generation, who are fewer than baby boomers, so you have more people to do. driving jobs for fewer people,” he said. “But now that the baby boomers have aged, the people most likely to be eligible to drive them are Gen X – and that’s a much smaller generation.”

A photo shows Jim and Judie Maybach standing on a hill overlooking the city of Red Wing, Minnesota.
Volunteers Jim and Judie Maybach help seniors in Red Wing, Minnesota – a city of nearly 17,000 people – get to appointments.(Liam James Doyle for KHN)

Jim Maybach started driving for Faith in Action after retiring in 2011. Six years later, his wife, Judie, now 78, joined him after retiring. They hardly imagine stopping anytime soon.

However, their volunteer program has begun planning a new recruitment strategy to appeal to a much younger workforce of stay-at-home parents.

“We’re just trying to think, ‘Well, who else can we get?’,” said Katherine Bonine, chief executive officer of Faith in Action. “Because when we had older people, we went from being a volunteer to being a recipient as they got older and their ability to drive changed.”

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