5.3 Support Community Health

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Key Takeaway: Specialized public transportation is an essential piece of supporting public health. The Mobility Management Center is preparing to relaunch travel training with new sensitivities and understandings of current attitudes and perceptions in using the fixed-route system, such as personal safety and COVID-19 concerns.


The Importance of Paratransit

The COVID-19 pandemic reinforced how important paratransit services are for supporting public health. During the beginning of the pandemic, while SF Paratransit ridership decreased drastically, some riders continued to utilize the service for essential needs, such as life-sustaining medical treatments including dialysis and chemotherapy. 

SF Paratransit’s response to the pandemic was grounded in a need to safely transport riders with essential needs while also protecting the health and safety of paratransit operators and taxi drivers. Throughout the declared emergency, staff at the SFMTA and SF Paratransit worked diligently alongside public health professionals to establish programs and safety protocols that supported community health and were part of the community emergency response team that organized and provided special services in response to the pandemic.

The Launch of the Essential Trip Card

In response to drastically reduced Muni service during the pandemic, the Mobility Management Center launched the Essential Trip Card (ETC) program. The ETC program provides discounted taxi service to adults 65 and older and people with disabilities. Similar to paratransit taxi, for every $6 a rider contributes to their taxi debit card account, SF Paratransit loads $30 of value on their card. 

While this is a significant subsidy, it was difficult for some riders to pay this amount, particularly if they are enrolled in Free Muni. To address these financial needs, SF Paratransit worked closely with the local non-profit Community Living Campaign (CLC). CLC covers the rider-side contribution for eligible riders demonstrating financial need so that the ETC program is available at no cost to the rider. In rider surveys, 100% reported that CLC’s fare assistance “helps me get to medical appointments and procedures”, 58% reported that health care services were their most frequent trip designation, and 100% of subsidy recipients reported that the program helped them maintain or improve their health and their emotional well-being.    

Emergency Preparedness

There is an ongoing need for SF Paratransit to support community health and safety during emergencies as they arise. When the citywide Emergency Operations Center is activated, SF Paratransit coordinates with the SFMTA Departmental Operations Center (DOC) to provide transportation assistance and participate in planning meetings to ensure continuity of service for our riders. Effective coordination requires that keeping to the SF Paratransit Emergency Operations Plan (EOP), which outlines the procedures in the case of a citywide emergency, current, and continue to participate in city and region-wide emergency planning and tabletop exercises.

During the height of the pandemic, SF Paratransit provided free rides to and from COVID-19 vaccine appointments and paratransit operators trained by Emergency Management Services (EMS), teamed up with EMS staff to transport vulnerable people to COVID-19 testing, treatment and shelter locations. The work was only assigned to drivers who volunteered, even at the beginning of the pandemic, when no one fully understood the risks of the virus. At its height of demand, 27 full-time drivers were dedicated to this service.

In May 2022, the SFMTA Board of Directors recognized the employees of SF Paratransit for all the work they did during shelter in place, especially the work to innovate new programs that helped our passengers stay connected with essential services during the pandemic. The partnership with EMS also received the 2022 Innovative Practice Bronze Award from the National Association of City and County Health Officials.

Ongoing Paratransit Planning for Health

As paratransit ridership recovers following pandemic lockdowns and restrictions, transportation to healthcare continues to account for many of the trips provided through SF Paratransit’s services. Mobility management services can play an important role in identifying transportation barriers to healthcare as well as coordinating services that provide connection to care and social services. 

For example, the SFMTA and SF Department of Public Health (DPH) pilot, “Connecting Health Outcomes and Information Citywide for Equity,” or “CHOICE” Program is designed to provide counseling and discounted taxi trips to medical services specifically for patients of Potrero Hill Health Center and Southeast Health Center. During the pilot, a transportation liaison is available either face-to-face or over the phone to assess patient trip needs and develop individualized plans to ensure patients can access transportation to medical services. The goal of the program is to improve health outcomes by removing barriers to transportation for low-income individuals. As the project evolves, the SFMTA and DPH will evaluate its impact on health outcomes. 

It is clear from paratransit ridership trends, the impacts of the ETC program on riders, and the initial findings of the CHOICE pilot that specialized public transportation is an essential piece of addressing health needs. As climate change ushers in an era of extreme weather events, hazards and disasters, vulnerable communities are even more at risk when lifeline services lack back-up systems. The Mobility Management Center can build on our work to continue exploring and assessing how transportation coordination opportunities could improve health outcomes in user-friendly and cost-effective ways.