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Equitable Solutions to Transportation Barriers

By December 4, 2025No Comments

Bridging Gaps in Substance Use Care:

Advocating for Equitable Solutions to NYS Transportation Barriers for Treatment Access

By: Raven Manchester

       Accessing treatment for substance use is often daunting due to many factors, such as stigma, limited provider availability, and general accessibility (Kruger et al., 2024). For rural New York State (NYS) residents, this process is a major challenge, one that extends beyond clinical capacity. According to the NYS Association for Rural Health’s 2025 Statewide Aggregate Rural Health Needs Assessment (SARHNA), transportation is a major barrier due to factors such as limited public transport, travel time, and overall access to personal transportation. Of the rural counties listed in the SARHNA (2025), 4-8% of households reported not having access to a reliable vehicle, with Broome, Schenectady, and Tompkins counties exceeding 10%. In areas where public transportation is available, options are often sparse, infrequent, and stigmatized (Grove & Coates, 2025).

       The NY Association for Rural Health states “for residents managing mental health or substance use disorders, the inability to travel for services translates directly into delayed treatment, worsening symptoms, and greater reliance on emergency care” (Grove & Coates, 2025, pg. 55). Transportation barriers are even more prevalent for people of color in rural areas due to inequalities in infrastructure, policy, and economic opportunity. Nationally, CDC data have shown that American Indian and Alaska Natives are at an increased risk of not having access to reliable transportation when compared to other groups (Ng, Adjaye-Gbewonyo, & Dahlhamer, 2024). Another study by Park et al. (2010) found that 24.7% of Black male elderly rural residents reported transportation difficulty when compared to their White counterparts (11.6%). These disparities are troubling due to the disproportionate increase in overdose deaths for Black and Native communities (Smith et al., 2025).

       While NYS has made investments into harm reduction, naloxone distribution, and peer support, substance use services are not always accessible due to transportation barriers. Those working within this space understand how complex this issue is: 

”Transportation barriers in the Capital District continue to limit access to essential services, especially for individuals in recovery or those living in outlying areas. Public transit routes can be infrequent or disconnected, making it difficult for residents to reach medical appointments, employment, and community programs on time. Many neighborhoods lack reliable evening or weekend service, and the cost of private transportation options can be prohibitive for low-income individuals. As a result, transportation remains a significant obstacle to stability, recovery, and long-term well-being for many Capital District residents. Having drivers that are trained peers helps people overcome anxiety and fear, it is an important component of our success in assisting people going to treatment.”

Kellie RoeChief Executive Officer, Second Chance Opportunities

”In our rural region, transportation remains one of the most significant barriers to accessing treatment, recovery support, and essential services. With little to no public transportation available, many individuals face long distances and limited options for getting to appointments, programs, and community resources. This barrier often leads to inconsistent engagement, missed opportunities for support, and increased challenges in maintaining long-term recovery. Peer-led programs are especially vital in this environment. Peers provide not only lived experience and meaningful connection, but also the flexibility to meet individuals where they are, both geographically and emotionally. Their ability to offer outreach, accompany individuals to services, and provide ongoing encouragement helps bridge the gaps created by transportation limitations. In rural communities like ours, peer support is a critical lifeline, ensuring that people can access the care, hope, and stability they need on their recovery journey."

Ginger Cato, CRPA, PSPDirector, Rob Constantine Recovery Community and Outreach Center

       For-NY, an organization dedicated to advocacy in the recovery space, has listed transportation as a priority for its efforts. In their provided policy statement they list the following guidance: “The development of statewide non-clinical, recovery supportive transportation services program; ensuring peer-led transportation is reimbursable under the Medicaid 1115 waiver in all social care networks; and expanding sustainable transportation opportunities within Rural Communities” (Friends of Recovery – New York, 2023, “Priority #4. Access to Transportation” section). To discuss this topic with your local representative, locate your official and ask about expanding access to transportation in your region.

       The MATTERS program has tried to address these barriers for individuals referred through its referral platform by providing transportation vouchers to assist individuals in getting to initial appointments and prescription pick-up. These rides are available all across NYS through both local peer-led partnerships and Uber Health. MATTERS is continuously trying to expand transportation accessibility for those referred through its program to foster care continuity and equity. Additional services offered to support treatment engagement include medication cost assistance, telehealth evaluations for MAT, follow-up support, and rapid connections to both local peer agencies and treatment providers. If you have any questions or would like to become a partner of MATTERS, please visit mattersnetwork.org

References

  1. Friends of Recovery – New York. (2023). Policy statement: Racial justice, harm reduction and all pathways of recovery [Policy statement]. Friends of Recovery – New York. https://for-ny.org/policy-statement/
  2. Grove, J.G., Coates, A. (2025). Statewide Aggregate Rural Health Needs Assessment: Mental  Health and Wellbeing. New York State Association for Rural Health. https://nysarh.org/wp-content/uploads/2025/09/SARHNA-Mental-Health-and-Wellbeing-Final-9-15-25.pdf
  3. Kruger, D. J., Kirk, H. M., Leonard, K. E., Hogue, A., Lynch, J. J., Nielsen, N., Collins, R. L., & Clemency, B. M. (2024). Assessing experts’ perspectives on challenges in substance misuse prevention, harm reduction, and treatment to shape funding priorities in New York State. Harm Reduction Journal, 21(1), Article 134. https://doi.org/10.1186/s12954-024-01045-3
  4. Ng, A. E., Adjaye-Gbewonyo, D., & Dahlhamer, J. (2024). Lack of reliable transportation for daily living among adults: United States, 2022 (NCHS Data Brief No. 490). National Center for Health Statistics. https://dx.doi.org/10.15620/cdc:135611
  5. Park, N. S., Roff, L. L., Sun, F., Parker, M. W., Klemmack, D. L., Sawyer, P., & Allman, R. M. (2010). Transportation Difficulty of Black and White Rural Older Adults. Journal of applied gerontology: The official journal of the Southern Gerontological Society, 29(1), 70–88. https://doi.org/10.1177/0733464809335597
  6. Smith, M. K., Planalp, C., Bennis, S. L., Stately, A., Nelson, I., Martin, J., & Evans, P. (2025). Widening Racial Disparities in the U.S. Overdose Epidemic. American journal of preventive medicine, 68(4), 745–753. https://doi.org/10.1016/j.amepre.2024.12.020
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