A HART Failure

A recent experience caused me to gain some insight into the process the local transit authority, HART (Hillsborough County, FL) for those with medical requirements needing their door-to-door services. It is, as it turns out, way more complex than it should be, and likely makes flat impractical from some people who need the service on a shorter-term basis to be able to use it.

Let me start with some background. I have received physical therapy at a rehabilitation facility on South Dale Mabry Hwy. (I drive, and this really isn’t about me, but there was a situation that caused me to be aware of your current process.) Earlier this week, there was an older lady there receiving therapy for her knee. As I was leaving, she was limping along up the service road, so I stopped to offer her a ride. She said she was just going to the bus stop, but that was in front of the Lowes (at least a block from the facility), and across the very busy highway. It would have taken her some time at her pace, at midday, to make it to the stop.

I ended up giving her a ride to Britton Plaza, but after dropping her off, I recalled there might be a HART service for people in her situation. So, I called you customer service number.

The woman I spoke with this morning didn’t sound exactly thrilled to be taking calls, but my call was answered, but that’s a different discussion. I explained the situation, and she advised me they do offer such a service, and explained the process thusly:

1. A doctor has to provide a written statement via mail (email and faxes are not acceptable);
2. The applicant must come in for a scheduled interview;
3. The process takes 3 to 4 weeks.

My response was, “Wow!, could you possibly make the process a little more cumbersome.” The representative’s response was, “Everyone goes through the same process, and this is the way it’s been done for 15 years.”

Allow me respond to that comment. First, just because everyone ever has done something a particular way does not mean it is the best process. It might have been when it was initiated, but the world changes. Second, and similarly, just because that’s the way we’ve always done it is always a questionable justification in the world of business process and records analysis where I work.

I recognize that people could abuse the service. I see people abusing handicapped placards often, and it kind of makes my blood boil. I wouldn’t want these services abused in the same way, so I understand why HART would need to be thorough.

However, while I don’t know the condition of the lady I mentioned, let’s use my case. Some accountant at my insurance company decided that my back problems would be all taken care of after 20 rehab visits (and I’m sure he was an expert). But if I did three a week, that is seven weeks. If I needed the HART service, I’d have to wait in pain (and believe me, walking was hard when I first went) for three to four weeks for their process to complete, or I’d be nearly done with my rehab by the time your process completed.

Since business process is one of my “things,” I proposed the following revision to their current process. Commonly, there are three broad categories of physical impairment/disability: long-term; short-term; and permanent. I recommended they consider these classifications in their process.

The vetting process for those needing long-term or permanent access to the service could be the current four-week process, though I hope they take a look at even that process. How very antiquated to accept only a “mailed in” application from the doctor…I recently financed a car, and not a single piece of physical paper was created in the process.

I suggested a modified process for those requiring a short-term use of the service. Something like a 10 or 12 week period. Here’s how that might look:

1. The rider provides a doctor’s order for the rehab services and/or a statement of need for the door-to-door service (on a prescription document) this could be faxed, emailed or called in by the Doctor’s office (you can get prescriptions without a wet-signature);
2. The rider schedules the first ride;
3. The rider could give original documents to the driver if someone in their organization can prove an actual need for originals;
4. The driver could assess the mobility of the person. (are they walking normally or experiencing a slower gait or have a limp, or need other help) I’m not expecting the driver to make a medical judgment, but only to report it if they believe the person might not qualify, and then the more thorough vetting process could be invoked.

This would allow people with a shorter term, and often more immediate need, the ability to use the service without waiting until their therapy or other needs have passed. The current application process is too long and cumbersome for all the parties involved, especially for these shorter term requirements, and I believe my proposal is reasonable.

I sent a letter to the CEO, Katharine Eagan, and the COO, Ruthie Reyes Burckard, along with the City and County Commissioners on the Board of Directors: Patricia Kemp; Leslie Miller; Sandra Murman; and Mike Suarez. Let’s see if they make any changes.