Transportation is another pandemic hurdle for those seeking treatment

Mauro Falaschetti can rattle off the numbers.

About 25 people are living in the three recovery houses he owns and operates through Philadelphia Recovery Residences in South Philly.

And before COVID-19, Falaschetti said, he was proud to boast about dozens of Alcoholics Anonymous and Narcotics Anonymous meetings within two miles of the housing; many are now halted or conducted on Zoom. Those aren’t the same, he said, so the residents head to the Northeast, where some in-person meetings are still happening.

Getting to meetings is where things get tricky. Philadelphia Recovery Residences has two vans providing transport to outpatient care and 12-step meetings, but because of social distancing, only seven people can ride at a time instead of the usual 13. That means making multiple trips or hailing an Uber. And rideshare is about twice as expensive nowadays, he said.

It’s draining.

“We’ve found ways around it. The problem is, there are so many other problems that are also minimal like that due to the scenario,” Falaschetti said. “That it kind of tips the scale into a point of, like, we’ve figured everything else out, and now we still have to figure this out?”

The pandemic has brought renewed attention to some of society’s greatest inequities, from housing and health care to education and unemployment. Transportation is no exception. Whether it’s a more costly rideshare that chips away at constrained budgets, or “erratic” SEPTA schedules, transportation challenges over the last few months are another hurdle for some who depend on the services the most.

Getting a Lyft for patients got much harder right as COVID-19 hit the Philadelphia region, said Brooke Feldman, center manager for CleanSlate outpatient treatment centers.

Feldman hails trips daily through Circulation, an app that books rides to medical appointments. It took as long as an hour to find a driver at the peak of the pandemic, and sometimes the only one available is behind the wheel of a more-expensive luxury vehicle. Other times, she said, there’s no driver around at all.

“For some people, [transportation] really is a difference between whether they come to their appointment or not,” she said. “And there’s a life-or-death implication to that.”

Barbara Williamson, owner of Way of Life Recovery, a group of recovery and sober houses across the region, has plenty of anecdotes to share. People “were losing their jobs” when SEPTA halted bus routes during its limited “lifeline” service earlier in the pandemic. Ubers and Lyfts are still more expensive than she was used to paying before the pandemic.

A ride from Delaware County to Philadelphia would have cost about $50 months ago, but more recently was nearly $120, Williamson said. An afternoon Lyft ride in late June traveling about 41 miles cost $141, according to a screenshot Williamson provided to The Inquirer.

“It’s just one more barrier, and people in early recovery, they already have enough barriers,” Williamson said. “So, when you take away transportation and things like that, that’s just another challenge for them. And I feel like, they just feel like giving up a lot of times.”

As a coronavirus safety mitigation measure, both Uber and Lyft indefinitely suspended their shared-ride services, which put a few passengers traveling a similar direction into the same car at a lower cost. Recognizing that Lyft’s shared ride was its “most affordable option,” the company rolled out “Wait & Save,” allowing riders to pay a bit less as long as they’re willing to wait a little longer for a ride.

“As cities have begun to reopen, rider demand has outpaced the supply of available drivers, and we are actively working to reengage drivers to best serve the transportation needs of the community,” Lyft spokesperson Fatima Reyes said in a statement.

Uber’s surge pricing, or hiked costs when rider requests outpace available drivers, was capped at the height of the pandemic, according to Uber spokesperson Alix Anfang. The company said it has since seen prices normalize. Uber did not comment on why some who spoke with The Inquirer were experiencing increased costs or prolonged wait times.

“Surge pricing ensures that riders — especially essential workers who need to get around — have access to affordable and reliable transportation and that drivers can earn more on trips during busy times,” Anfang said in a statement.

CrossRoads Treatment Centers, an opioid use treatment facility with locations across the Philadelphia area, has “care coordinators” to help schedule transportation services through Medicaid — "but that’s hardly a perfect system,” said Kevin Moore, CrossRoads’ director of integrative medicine. Most patients use public transportation, he said.

Though a majority of patients are taking advantage of telehealth and other innovations CrossRoads beefed up during the pandemic, lessening the transportation burden, he said.

“There’s more access and more sort of instant access than there was before,” Moore said. “So while transportation remains an issue, particularly for the more extroverted folks, I also feel like the silver lining is there’s also more resources.”

The issue isn’t isolated to those in addiction treatment or recovery.

The American Cancer Society suspended “Road to Recovery," a popular volunteer service taking cancer patients to and from treatment. Last year, Road to Recovery provided more than 50,000 rides in the Northeast region, which stretches from Maine to northern Virginia.

Suspending the program because of safety concerns was "one of the most heartbreaking decisions this organization has had to make,” said Jim Mathieson, senior director of cancer control program management at ACS.

“I’m sure there’s frustration, as well, because if you have a patient that needs to get to their treatment and we’re not available to help ... and I’m sure other folks have been doing the same thing that we’ve done,” Mathieson said, “it limits the solutions.”

Cancer Treatment Centers of America confirmed that some of its patients also face delays or increased costs on rideshare. Steven Standiford, surgical oncologist at CTCA Philadelphia, said it’s “unfortunate” that it’s “seeing yet another barrier to cancer care during the current pandemic.”

“Data shows that screenings are down dramatically, and cancers are being missed because routine medical appointments or treatments are being delayed or even canceled,” Standiford said. “We urge patients not to be discouraged and to do everything in their power to maintain and access their medical appointments.”

That’s easier said than done.

As the months pass by and the region adapts to new lifestyles, Williamson, of Way of Life Recovery, describes challenges surrounding transportation as not necessarily getting any easier. They’re just different.

“We’re just trying to get A to B, out here in life,” she said. “And you can’t even do that.”