Health plan members who are eligible for non-emergency medical transportation (NEMT) can get rides to and from healthcare appointments; they are important benefits that can help close healthcare gaps while ensuring better outcomes. But when severe weather or other disasters strike, it takes nimble and concrete policies to ensure that vulnerable populations can still access life-sustaining care.
While some medical care can be postponed during a weather emergency, skipping or pushing back an appointment isn’t an option for those who depend on dialysis treatments, chemotherapy, substance abuse management, or acute care for injuries or wounds.
“These members absolutely have to access care,” said Chris Koenig, SafeRide Health Vice President of Transportation Operations. “If they don’t go, there is a higher likelihood that they will be hospitalized and that their mortality rate increases exponentially after every future missed treatment.”
How NEMT Can Go Above and Beyond When the Worst-Case Scenario Becomes Reality
Whether a region is affected by hurricanes, earthquakes, extreme temperatures, tornadoes, snowstorms, or wildfires like those that devasted Southern California, health plans’ No. 1 priority during a severe weather or other disaster event is maintaining members’ health and safety. Partnering with plans as their NEMT provider, SafeRide can help members who most need coordination for life-sustaining appointments when bad weather or impassable road conditions occur. In the most severe cases, some plans have even allowed members to use their NEMT benefits to evacuate life-threatening situations.
For example, in October 2024, as Hurricane Milton approached the Gulf Coast of Florida, staff at a skilled nursing facility in the path of the storm learned of an evacuation order in their area. More than 100 residents, many of whom were bedbound, needed to be moved to another facility inland. Upon notification of the evacuation order, the impacted residents’ health plans, SafeRide, and transportation providers worked together to coordinate the evacuation—knowing that moving the residents would require extra support. Recruiting dedicated transportation providers from the local community (some of whom had left their own families to pitch in), teams worked tirelessly around the clock to transport all residents safely.
Soon after, in early 2025, as SafeRide staff were tracking forecasted winter snowstorms and plunging temperatures across the country, the California fires began. For nearly a month, flames spread across the Los Angeles region, ultimately resulting in 28 deaths and more than 200,000 evacuations. Health plans in fire zones and surrounding areas again worked with SafeRide and local transportation providers to rally the local community, working to find routes to get members where they needed to go—whether that was to get medical care, to evacuate, or, in some cases, to find temporary housing because they’d lost their home.
Health plans have worked in other ways to expand NEMT access and flexibility in emergency situations, including temporarily pausing advance notice requirements on changes to rides. In some cases, plans even offered rides without counting them toward members’ transportation benefit—no questions asked.
“In all these cases, none of the organizations involved put payment or administrative perspectives first. Instead, SafeRide swiftly led, as area health plans, care teams, transportation providers, and drivers knew we were going to go all in and get members to safety and care because these were people in the most need,” said Mary Clare DuRocher, SafeRide Health Vice President of Account Management.
Preparing for NEMT Challenges Before They Begin: How a Disaster Response Strategy Works
While drivers were on the ground in California getting members to life-sustaining care and helping them flee to safety, SafeRide teams were working behind the scenes 1,300 miles away. Staff at SafeRide’s Operations Center in San Antonio were tracking the fire’s path: Keeping tabs on Southern California roadways, transportation provider availability, and clinic closures; prioritizing evacuations and life-sustaining care; and coordinating rides for as many members as possible, all while communicating updates to their partner health plans several times a day. SafeRide continuously monitors road and weather conditions as well as healthcare facility and transportation closures before, during, and after a disaster event so support staff and plans can quickly jump into action to support members’ care needs.
The first step when severe weather or other disaster strikes, Koenig said, is to identify and prioritize members with life-sustaining transportation needs, and to do whatever is possible to get them that essential care. In cases like the California fires, SafeRide works with case management teams, transportation providers, and medical facilities in the community to find life-sustaining care for as many members as possible. That may involve looking for alternate routes and care locations, rescheduling appointments and, in some cases, even requesting that facilities outside the impacted region extend their hours to accommodate members who can’t access care at their usual clinic.
Close partnership with case management and social worker teams is crucial during a disaster event, said Koenig—especially for members who require life-sustaining trips. SafeRide provides resources that can help those teams connect members to housing and transportation support, government assistance programs, emotional health and substance abuse support, and disaster distress helplines.
All of that behind-the-scenes infrastructure is set up to support health plans long before an event is on the horizon, Koenig said. SafeRide’s Operations Center itself is also prepared for the worst: It is designed and staffed to anticipate severe weather or other disruptions, and to seamlessly support calls even if internet or phone lines should go down. The Operations Center keeps tabs on weather and road conditions throughout the country, alerting health plans as soon as any event that could possibly impact NEMT is detected. Account managers give daily and sometimes hourly updates to plans that have members in the midst of an emergency.
“There are times when multiple events may be happening at the same time in different states, so having quality communication and reporting tool stacks are key to ensuring health plan members in all areas we serve have access to life-sustaining care,” said Koenig, adding that SafeRide’s disaster preparedness plan is exceptionally robust in the NEMT industry.
“We’re in these communities and we have the resources,” DuRocher said, “so we’re going to help.”