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    <title>Transport Research International Documentation (TRID)</title>
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    <copyright>Copyright © 2026. National Academy of Sciences. All rights reserved.</copyright>
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    <managingEditor>tris-trb@nas.edu (Bill McLeod)</managingEditor>
    <webMaster>tris-trb@nas.edu (Bill McLeod)</webMaster>
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      <title>Transport Research International Documentation (TRID)</title>
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      <title>Scheduling Non-Urgent Patient Transportation While Maximizing Emergency Coverage</title>
      <link>https://trid.trb.org/View/1601399</link>
      <description><![CDATA[Many ambulance providers operate both advanced life support (ALS) and basic life support (BLS) ambulances. Typically, only an ALS ambulance can respond to an emergency call, whereas non-urgent patient transportation requests can be served by either an ALS or a BLS ambulance. The total capacity of BLS ambulances is usually not enough to fulfill all non-urgent transportation requests. The remaining transportation requests then have to be performed by ALS ambulances, which reduces the coverage for emergency calls. The authors present a model that determines the routes for BLS ambulances while maximizing the remaining coverage by ALS ambulances. Different from the classical dial-a-ride problem, only one patient can be transported at a time, and not all requests are known in advance. Throughout the day, new requests arrive, and the authors present an online model to deal with these requests.]]></description>
      <pubDate>Mon, 29 Apr 2019 09:25:06 GMT</pubDate>
      <guid>https://trid.trb.org/View/1601399</guid>
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      <title>Annual Report on FAST Act Section 3006(b) Pilot Program for Innovative Coordinated Access and Mobility Fiscal Year 2018</title>
      <link>https://trid.trb.org/View/1576422</link>
      <description><![CDATA[This report provides an update on projects selected pursuant to the Federal Transit Administration's (FTA’s) Notice of Funding Opportunity (NOFO) (81 FR 17549) for Section 3006(b) of the Fixing America's Surface Transportation Act (FAST), Public Law 114-94, Pilot Program for Innovative Coordinated Access and Mobility (ICAM Pilot Program). The primary purpose of these projects is to find and test promising, replicable public transportation health care access solutions that support the goals of (1) increase access to care; (2) improve health outcomes; and (3) reduce health care costs. Transit and Health Access (formerly “Rides to Wellness”) is a Coordinating Council on Access and Mobility (CCAM) initiative that works to build partnerships, stimulate investment, and drive change across the health and transportation sectors to ensure that transportation disadvantaged Americans can access non-emergency medical transportation to the health care services they need. CCAM is a federal interagency council established by Executive Order 13330 49 U.S.C. 101 note.]]></description>
      <pubDate>Sun, 30 Dec 2018 18:15:35 GMT</pubDate>
      <guid>https://trid.trb.org/View/1576422</guid>
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      <title>Handbook for Examining the Effects of Non-Emergency Medical Transportation Brokerages on Transportation Coordination</title>
      <link>https://trid.trb.org/View/1566761</link>
      <description><![CDATA[This report provides background information about Non-Emergency Medical Transportation (NEMT) and describes the different models available to states for providing NEMT for Medicaid beneficiaries. The handbook also discusses why human services transportation and public transportation providers encourage coordination of NEMT with other transportation services. The research approach for this project included:  a review of literature, regulations, and prior research; a state survey; and case studies.  NEMT, human services transportation, and public transportation have common desired outcomes: to improve health outcomes, to contribute to a better quality of service for customers, and to maximize transportation services delivered within available resources.  This handbook identifies opportunities and suggests strategies to coordinate these transportation programs to contribute to the common desired outcomes.]]></description>
      <pubDate>Wed, 14 Nov 2018 13:58:33 GMT</pubDate>
      <guid>https://trid.trb.org/View/1566761</guid>
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      <title>Public Dialysis Transport Efficiency Using Digital Media</title>
      <link>https://trid.trb.org/View/1517553</link>
      <description><![CDATA[The provision of paratransit services for patients needing dialysis is vital to patient maintenance. The availability of paratransit services varies in North Carolina counties depending on federal, state and local funding. Because these resources are limited, it is important to use available technologies to maximize resource usage. A survey was developed and administered to paratransit county administrators. Results of the preliminary data analysis showed that the use of technologies increased as the number of available dialysis centers increased. Counties also invested in more technologies as their feelings about funding adequacy for investments in general and from federal sources increased. Finally, those counties that felt they would be able to keep up with demand for dialysis services in the future tended to invest in more technologies.]]></description>
      <pubDate>Tue, 10 Jul 2018 17:42:13 GMT</pubDate>
      <guid>https://trid.trb.org/View/1517553</guid>
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      <title>Evaluation Framework for Non-Emergency Medical Transportation Services for Patients with End-Stage Renal Disease</title>
      <link>https://trid.trb.org/View/1473674</link>
      <description><![CDATA[The objective of this project is to design a framework that could be used to evaluate the effectiveness and efficiency of non-emergency transportation services (NEMT) for better livability. In addition to the development of the framework, this project aimed to establish connections between Portland State University (PSU) researchers with regional connections involved in public health research, non-emergency medical transportation, medical services, and medical insurance provision. With the rising costs of transportation and medical costs generally in the United States, it is increasingly important to develop new tools and strategies to reduce these costs while maintaining and improving upon the level of care provided. Ultimately, the inability to afford NEMT can lead to missed appointments and reduced access to medical care for vulnerable populations, which in turn can lead to more trips to the emergency room and reduced quality of life. This impacts not only individuals, but the communities that these individuals are a part of. A robust literature review and background research laid the groundwork for this project. This literature review provides an overview of the body of literature that analyzes how non-emergency medical transportation is provided in the United States and also highlights gaps in the existing research. Special attention is paid to the challenges of patients with end-stage renal disease (ESRD), who require routine NEMT service for dialysis appointments. The emerging focus on community-based participatory research (CBPR) is also discussed as a potential tool for better incorporating qualitative data into future analyses of the costs and benefits of providing NEMT. In this process, the authors identified key strategies for improving NEMT, including better coordination between dialysis clinics and NEMT providers, consideration of fixed-route transportation and improvements in dispatch technology.  The authors developed a framework for evaluating NEMT program changes that centers on a hybrid cost-benefit analysis matrix, modeled on a CBPR approach developed by Stevens et al. for their 2008 evaluation of an Australian childcare strategy. The matrix was refined via feedback from Ride Connection’s advisory committee, and is tailored to many of the unique challenges facing NEMT programs. In conjunction with the hybrid cost-benefit analysis framework, a preliminary patient survey instrument was developed to facilitate the collection of data to evaluate transportation policy or program changes for NEMT providers. These tools represent the first steps to researching, evaluating and improving NEMT for healthier and more livable communities.]]></description>
      <pubDate>Mon, 24 Jul 2017 16:46:30 GMT</pubDate>
      <guid>https://trid.trb.org/View/1473674</guid>
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      <title>Pickup and Delivery Service with Manpower Planning in Hong Kong Public Hospitals</title>
      <link>https://trid.trb.org/View/1466830</link>
      <description><![CDATA[This paper deals with a real-life healthcare problem derived from the Non-Emergency Ambulance Transfer Service for Hong Kong public hospitals which provides transportation services for disabled or elderly patients between their residences and clinics. The problem is modeled as a multitrip pickup and delivery problem with time windows and manpower planning (MTPDPTW-MP) that not only needs to design and schedule ambulance routes satisfying a series of constraints but also requires staff scheduling. Because of the strict limits on route duration, each ambulance traverses several routes per day, which, starting and terminating at the depot, complete a series of pickup and delivery operations to serve the clients. A feasible route demands a driver and several assistants to serve the clients and needs to satisfy some constraints, such as capacity, pickup before delivery, time windows, etc. The objective is hierarchical in that it primarily serves as many clients as possible, then minimizes the operational cost, and finally strikes a balance for the staff workload. Theoretically, MTPDPTW-MP, which is a combination of two well known non-deterministic polynomial-time (NP)-hard problems (i.e., the pickup and delivery problem with time windows and the staff scheduling problem), is difficult to solve. In this study, the authors propose an iterated local search metaheuristic that uses a variable neighborhood descent procedure in the local search phase. The authors use a modified regret insertion method to construct solutions; a heuristic backtracking algorithm is designed to schedule staff. To speed up the process, the authors adapt the segment-based evaluation for moves and reduce the neighborhoods explored based on the characteristics of the problem. The effectiveness of the proposed algorithm was tested in real-world instances. Results showed that it can serve more requests than the manually designed plans. In addition, the performance of the proposed algorithm was evaluated on a simplified problem: the multitrip vehicle routing problem with time windows.]]></description>
      <pubDate>Tue, 27 Jun 2017 16:10:48 GMT</pubDate>
      <guid>https://trid.trb.org/View/1466830</guid>
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      <title>Medicaid: Efforts to Exclude Nonemergency Transportation Not Widespread, but Raise Issues for Expanded Coverage</title>
      <link>https://trid.trb.org/View/1398800</link>
      <description><![CDATA[Medicaid, a federal-state health financing program for certain low-income individuals, offers nonemergency medical transportation (NEMT) benefits to individuals who are unable to provide their own transportation to medical appointments. This benefit can be an important safety net for program enrollees as research has identified the lack of transportation as affecting Medicaid enrollees’ access to services. Under the Patient Protection and Affordable Care Act (PPACA), states can opt to expand eligibility for Medicaid to certain adults. However, some states have excluded the NEMT benefit for these newly eligible enrollees by obtaining a waiver of the requirement under the authority of a Medicaid demonstration project. The Government Accountability Office (GAO) was asked to explore state efforts to exclude the NEMT benefit for newly eligible Medicaid enrollees, and the potential implications of such efforts. This report examines (1) the extent to which states have excluded this benefit for newly eligible enrollees, and (2) the potential implications of such efforts on enrollees’ access to services. GAO contacted the 30 states that expanded Medicaid under PPACA as of September 30, 2015; reviewed relevant documents and interviewed officials in the 3 states that have taken efforts to exclude the NEMT benefit; reviewed prior research on transportation for disadvantaged populations; and interviewed officials from the Centers for Medicare & Medicaid Services (CMS), the federal agency that oversees Medicaid, and 10 research and advocacy groups based on referrals from subject-matter experts and knowledge of the NEMT benefit. The Department of Health and Human Services (HHS) provided technical comments on a draft of this report, which GAO incorporated as appropriate.]]></description>
      <pubDate>Wed, 16 Mar 2016 09:35:50 GMT</pubDate>
      <guid>https://trid.trb.org/View/1398800</guid>
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      <title>A branch-and-cut algorithm for a realistic dial-a-ride problem</title>
      <link>https://trid.trb.org/View/1373857</link>
      <description><![CDATA[In this paper the authors study a realistic dial-a-ride problem which simultaneously considers multiple trips, heterogeneous vehicles, multiple request types, configurable vehicle capacity and manpower planning. All of these features originate from practical applications in recent years. To formulate the problem, the authors propose two mathematical models that use different methods to deal with requests associated with the depot. To further strengthen the models, the authors propose eight families of valid inequalities, and based on them, the authors propose a branch-and-cut algorithm to solve the problem. The branch-and-cut algorithm was extensively tested on a set of instances generated according to the data of a real world application. The computational results showed that seven families of inequalities can improve the lower bounds substantially and the branch-and-cut algorithm can solve instances with up to 22 requests within 4 h.]]></description>
      <pubDate>Wed, 25 Nov 2015 09:14:40 GMT</pubDate>
      <guid>https://trid.trb.org/View/1373857</guid>
    </item>
    <item>
      <title>Ride Connection: Portland’s Hidden Transportation Gem</title>
      <link>https://trid.trb.org/View/1371856</link>
      <description><![CDATA[The city of Portland, Oregon offers its local residents a variety of public transit options unrivaled in North America; from buses, light rail and streetcars to an aerial tram. Beyond the downtown core that is served by these services is Ride Connection (RC), which serves the city's other residents. RC offers a more diverse array of people-centered transportation services from travel training to volunteer driving, mobility management to fare relief, and neighborhood shuttles to non-emergency medical transportation. There is above all a strong emphasis on customer service and a culture of collaboration, as this article shows in an in-depth look at Ride Connection.]]></description>
      <pubDate>Fri, 23 Oct 2015 09:26:29 GMT</pubDate>
      <guid>https://trid.trb.org/View/1371856</guid>
    </item>
    <item>
      <title>Medicaid Non-Emergency Medical Transportation (NEMT) Saves Lives and Money</title>
      <link>https://trid.trb.org/View/1318055</link>
      <description><![CDATA[One of the most common barriers faced by low-income populations in accessing timely and necessary medical care has been consistently shown by research to be transportation. The Medicaid non-emergency medical transportation (NEMT) benefit fills the gaps by providing appropriate but least costly methods of transportation services, such as taxis, vans and public transit, for Medicaid beneficiaries to transport them to and from medical services. The details of this benefit are presented here.]]></description>
      <pubDate>Thu, 07 Aug 2014 09:41:51 GMT</pubDate>
      <guid>https://trid.trb.org/View/1318055</guid>
    </item>
    <item>
      <title>Medicaid Expansion and Premium Assistance: The Importance of Non-Emergency Medical Transportation (NEMT) To Coordinated Care for Chronically Ill Patients</title>
      <link>https://trid.trb.org/View/1318129</link>
      <description><![CDATA[Millions of chronically ill Americans relied on the Medicaid program in 2013 for transportation to life-sustaining medical care, such as kidney dialysis and treatment for severe mental illnesses, as shown by new data. The non-emergency medical transportation program (NEMT) provides crucial access to healthcare for millions of Americans, the importance of which is delineated in this article; however, its funding is currently being threatened in some states (such as Iowa, Pennsylvania and New Hampshire) as they are proposing to waive the NEMT assurance requirement in premium assistance plans.]]></description>
      <pubDate>Thu, 07 Aug 2014 09:41:49 GMT</pubDate>
      <guid>https://trid.trb.org/View/1318129</guid>
    </item>
    <item>
      <title>NEMT Coordinators in Minnesota: A Survey of How Minnesota Counties Use Coordinators to Deliver Non-Emergency Medical Transportation</title>
      <link>https://trid.trb.org/View/1265102</link>
      <description><![CDATA[Within their Medicaid programs states are generally required to provide Medicaid recipients transportation assistance to obtain health-care services. This assistance is commonly referred to as non-emergency medical transportation (NEMT). In Minnesota, NEMT is provided through the state’s version of Medicaid, Medical Assistance (MA). The most common form of NEMT in Minnesota, in terms of usage, is known as access transportation services (ATS). Though overseen by Minnesota’s Department of Human Services (DHS), counties have the primary responsibility for delivering ATS to MA recipients under the fee-for-service MA program operated by DHS. The manner in which counties provide ATS and manage the program varies depending upon the differences among the counties (e.g., number of MA recipients; available transportation resources; rural v. urban). This report documents how seven counties and groups of counties in Minnesota organize the delivery and administration of ATS under the state’s fee-for-service MA program, and examines the role transportation coordinators play in delivering and administering ATS. (The report does not cover ATS provided through managed health care plans and does not include the NEMT service known as special transportation services.)]]></description>
      <pubDate>Fri, 18 Oct 2013 16:18:08 GMT</pubDate>
      <guid>https://trid.trb.org/View/1265102</guid>
    </item>
    <item>
      <title>Missed or Delayed Medical Care Appointments by Older Users of Nonemergency Medical Transportation Services</title>
      <link>https://trid.trb.org/View/1241713</link>
      <description><![CDATA[Non-emergency medical transportation (NEMT) can prevent emergency care as a result of delayed or missed medical appointments. Medicaid provides NEMT for low income individuals who have no other means of transportation and this is a critical component of the health care delivery system. This study examined cancelled trips in Medicaid adults age 65+ to explore whether barriers persist for a growing segment of the population who face particular challenges of age-related declines in health and function.  Multivariate logistic regression analyses were conducted using transportation brokerage data for Delaware members who intended to travel during 2008-2010, modeling the odds of all cancellations and then these mutually exclusive types: (1) client cancelled; (2) client obtained alternative transportation; and (3) client cancelled due to health. Over half of the cancelled trips were attributed to client reasons. Black race was associated with client canceling (OR=1.4) and canceling due to alternative transportation (OR=1.9). Compared to dialysis, trips for other medical care were more likely to be cancelled for client and health reasons (ORs ranged 1.6-7.9). Higher levels of service increased cancelling for health reasons (OR=2.9 stretcher; OR=1.8 wheelchair). Finally, pre-scheduled or subscription trips were less likely to be cancelled and client factors differed for the cancellation of trips that were not regularly scheduled. The results of this initial study confirm that for this population additional transportation services are often not available and that more support for utilizing NEMT may be needed. Future research should evaluate persistent barriers, service delivery, and long-term outcomes.]]></description>
      <pubDate>Tue, 19 Feb 2013 08:53:20 GMT</pubDate>
      <guid>https://trid.trb.org/View/1241713</guid>
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    <item>
      <title>The State of Non-Emergency Medical Transportation: A Community Transportation Magazine Essay</title>
      <link>https://trid.trb.org/View/924969</link>
      <description><![CDATA[This article describes how the recent passage of health care legislation creates a climate where community and public transportation must reexamine their current theories and practices concerning the broad series of activities referred to as coordination. In many areas the subject of coordination has become an extremely limited discussion that focuses on the relationship of Medicaid-purchased transportation and coordination with other community based transportation services or traditional public transit funded in part by various revenue from the Federal Transit Administration (FTA). Although there has been greater emphasis the last three years on developing coordination strategies around the FTA-administered JARC, New Freedom, and 5310 activities, Medicaid remains the central focus of this discussion in almost every state and locale.]]></description>
      <pubDate>Mon, 16 Aug 2010 09:11:23 GMT</pubDate>
      <guid>https://trid.trb.org/View/924969</guid>
    </item>
    <item>
      <title>Improving Rural Emergency Medical Service Response Time with Global Positioning System Navigation</title>
      <link>https://trid.trb.org/View/905186</link>
      <description><![CDATA[The expansive areas that rural emergency medical service (EMS) often serves are unfamiliar to many EMS personnel. Increased EMS response time in rural areas has been suggested as a contributing factor to increased mortality rates from motor vehicle crashes (MVCs) and nontraumatic emergencies. The study purpose was to assess the effect of a global positioning system (GPS) on rural EMS response time. GPS units were placed in a rural EMS provider's ambulances. The units were set for fastest route, rather than shortest distance, to the scene, which depends on traffic lights and posted road speed. During a one year period (September 2006 to August 2007), EMS response time and mileage to the scene were recorded for MVCs and other emergencies. There was then comparison of response times and mileage to the scene with data from the same EMS provider during a similar one year period when GPS technology was not used. Because GPS was infrequently used for short travel distances, EMS calls of less than one mile were removed. During the one year period before GPS utilization, 893 EMS calls of greater than one mile were recorded and 791 calls recorded with GPS. The mean MVC EMS response time was 8.5 minutes without GPS and 7.6 minutes with GPS. Mean EMS response time without GPS was 13.7 minutes versus 9.9 minutes with GPS when MVCs were matched for miles traveled. The authors conclude that GPS technology can significantly improve EMS response time to the scene of MVCs and nontraumatic emergencies.]]></description>
      <pubDate>Mon, 30 Nov 2009 08:54:58 GMT</pubDate>
      <guid>https://trid.trb.org/View/905186</guid>
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