The Infrastructure Gap: How Transit Affects Your Services
Accessible transportation is vital for caregivers to reach their clients and for clients to reach their appointments
Most people don’t think of a bus route as part of their homecare plan. But for thousands of Minnesotans who rely on in-home support—whether through PCA Choice, waivers, or CFSS—access to infrastructure like transportation is a critical (and often invisible) part of the equation.
Let’s break down how the infrastructure gap—specifically transportation—shapes what care you receive, when you receive it, and how smoothly it’s delivered.
Roadblocks to Transportation
Reliable transportation is vital not just for clients to get to appointments, but also for:
- PCAs and support workers to reach their clients on time
- Caregivers transporting clients to medical, dental, and therapy visits
- Accessing local resources like food shelves, housing supports, or disability programming
In Greater Minnesota especially, families often rely on a small number of community transportation providers. Long wait times, limited availability, and geographic gaps can make or break a care plan.
What Can Be Done?
Solutions are underway:
- Legislative efforts are aiming to increase public transit funding.
- Some counties are piloting rideshare-style transportation for waiver services.
- But progress is slow—and in the meantime, families and PCAs are left navigating these barriers with little support.
Transportation FAQ
Counties across Minnesota are leveraging state and federal funds to address transportation deserts by expanding rural and tribal transit services and piloting innovative mobility solutions.
With support from MnDOT and federal programs like the Low and No Emissions grant and the Advanced Transportation Technology and Innovation Program (ATTAIN), local agencies are modernizing bus fleets, building new transit facilities, and deploying on-demand and autonomous transit vehicle services like goMARTI in Grand Rapids.
Launched through a partnership between MnDOT, May Mobility, The PLUM Catalyst, and others, goMARTI operates a fleet of autonomous, electric shuttles offering free, on-demand rides across a 17-square-mile area. The service includes 70 pickup and drop-off points and features wheelchair-accessible vehicles.
A study by the University of Minnesota's Center for Transportation Studies found that goMARTI successfully fills previously unmet transportation needs in the community, particularly benefiting individuals unable to drive, especially those with mobility challenges.
Shared mobility initiatives, including e-bike programs in Duluth and Red Lake Nation, are also being piloted to improve access in underserved communities. Additionally, targeted funding supports tribal transit vehicle upgrades and regional mobility coordination through programs like the Regional Transportation Coordination Council (RTCC), helping ensure reliable transportation for all Minnesotans
Managed Care Organizations (MCOs) can help expand mobility options in transportation deserts in several ways.
- Create partnerships with transit agencies, rideshare companies, and community organizations
- Support infrastructure improvements like transit stops near clinics, fund place-based initiatives through value-based care models, and participate in cross-sector collaborations to co-develop sustainable access solutions.
- Advocate for policy changes that integrate transportation and infrastructure planning into broader health equity strategies.
For instance, Blue Plus (a Blue Cross and Blue Shield MCO in Minnesota) has invested in partnerships with community-based organizations to fund transportation and housing supports for Medicaid enrollees. They have also supported pilot programs like food delivery or transportation subsidies for high-risk patients.
MCOs have both the financial incentive and operational tools to be powerful players in improving infrastructure access—but doing so often requires stepping outside of traditional clinical roles and embracing community development partnerships.