Around 300 Spokane County residents receive more than 4,000 rides to their medical appointments each year courtesy of Care Cars, a program here that is seeking to increase significantly its number of volunteer drivers by January.

The program is operated by Elder Services, a department of nonprofit Frontier Behavioral Health, and currently relies on about 35 volunteer drivers. With recent additional funding, it expects to increase that to 50 drivers so that Care Cars can serve up to 450 people who live independently in homes or apartments, says Pam Sloan, Elder Services director.

Care Cars relies on trained volunteers driving their own vehicles to transport adults who are usually 60 years old and older, disabled, or in need of special assistance to get to health-care services. The drivers receive some mileage reimbursement, and current volunteers range from college students to retired people, as well as some working at jobs that offer the flexibility to serve a few hours, Sloan adds.

Typically, the free service assists people with low incomes who for various reasons can't use public transportation to get to their appointments, perhaps because of frailty or because they live in areas outside of Spokane Transit Authority's service territory, she says.

"We really try to use the service for those who would literally become disconnected from medical care if we didn't provide them the service," Sloan says.

She adds, "Many of the people we serve are extremely elderly, 80-years-old plus. They typically live alone because they've either outlived their spouse, or they've become isolated over the years. If we weren't taking them to appointments, they wouldn't have any other way to access medical help."

Sidney Sklar, an 89-year-old resident of Canterbury Court Apartments on the South Hill, says he started using Care Cars two years ago because he couldn't drive himself to doctors' offices and needs assistance to walk. The program also ensures that he arrives on time to the appointments, he adds.

"I don't know what I'd do without the service," Sklar says. "It would be a hell of a thing to get to the doctors on my own. I use the walker, and they take care of putting the walker in the vehicle. I started using the service when I realized I had reached a point that I wasn't safe to drive any more. When I got rid of my car, I still needed to get to the doctors."

Care Cars volunteer Sharon McGrew has served as a driver for about four years. She says another benefit to passengers is that volunteers can help them get to medical offices in busy hospital complexes.

"I do this because it makes me feel useful, but I enjoy it because each person is an individual, and I love to hear their stories," McGrew says. "Some of the doctors' offices at hospitals are like mazes, and I think it works better when there are two of us."

Elder Services is a 35-year-old service and resource center that promotes independence and quality of life for Spokane County home-dwelling older adults, especially those who are at risk and isolated. The department also serves some younger adults who have long-term care needs.

Care Cars, which has two full-time employees, operates along with Elder Services out of a branch of Frontier Behavioral Health that is located at 5125 N. Market in the Hillyard neighborhood. The program's employees include a scheduler and a volunteer training specialist who provides backup for scheduling.

Sloan says Care Cars earlier this year secured two-year funding totaling $184,000 from the Washington state Department of Transportation, with some allocation beginning this summer. The funding is to be split between two fiscal years, which for the state agency runs July 1, 2013, through June 30, 2014, and then July 1, 2014, to June 30, 2015.

The funding enables the program to serve more clients, including those 18 and older who are physically or cognitively impaired. For about three years now, Care Cars has operated with income mainly from smaller grants, and by scaling back its services, Sloan says.

Care Cars is matching the WDOT funds with a mixture of donations, city of Spokane funding, and money from other sources such as fundraising to pay toward the overall cost of running the program, which is nearly $200,000 a year, Sloan says.

She says a recent example of a person helped by the program was an 83-year-old woman who needed physical therapy treatments and couldn't drive herself. However, after a Care Cars driver took her to physical therapy for three months, she was able to drive herself to the sessions, Sloan says.

"She was advised of Care Cars by her physician," Sloan says. "She is a proud and independent woman who loves living in her own home (and) needed assistance in accessing physical therapy two times a week due to a hip replacement and arthritic knees, making it very difficult for her to navigate the physical therapy office."

She adds, "Care Cars volunteer drivers helped her access the care she needed to gain back the mobility and strength to complete the activities of daily living. Within three months, she regained the ability to drive herself to and from her appointments."

Sloan says Care Cars began in 1984 in response to long-term care agencies and health-care providers here seeing a rise in cases of homebound isolated seniors losing access to medical services. Many of those residents ended up in emergency rooms, or with prolonged hospital visits, because they waited too long before seeking care, she adds.

While the program doesn't have dollar threshold for what qualifies as low income to receive the service, Sloan says the program screens candidates to determine if they can afford to pay for a private transport service instead.

"We do have a donation policy, and we do get donations from people sometimes," she says, referring to passengers having the option if they choose to donate an amount to help support the program costs.

"We're still serving high-risk and low-income individuals who have one or more functional challenges that don't allow them to use other transportation to access medical care," Sloan adds. "It could be anyone who has a difficult time walking and they need assistance. They need someone to escort them right up to a doctor's office, or they have a cognitive dysfunction and would get lost."

The volunteer drivers receive the Internal Revenue Service's standard mileage reimbursement rate of 55.5 cents per mile to offset the transportation costs, she says.

The volunteers also must undergo a background check, have a valid driver's license and safe driving record, and proof of insurance. They complete an initial training session of a few hours that includes safety guidelines.

"We do a routine vehicle check to make sure they're sound and safe for the client," Sloan says.

"The driver makes sure to pick them up at the door and makes sure they're OK to go to the medical appointment, and remains with them and waits in the waiting room during the appointment," Sloan adds. "A lot of the time, the driver escorts them into their home after the appointment."

She says the medical appointments for Care Cars' passengers typically last about an hour or two, but some need a driver who is available for four or five hours if the passenger is going in for a medical procedure.

"A lot of our folks go to kidney dialysis or cancer treatment, and when they're done, they're totally exhausted," Sloan says. "They need help. Some people may need to go to an appointment every week. Our goal is to get them stabilized."

Care Cars started under the umbrella of Spokane Mental Health, which merged with Family Service Spokane in 2011 to form Frontier Behavioral Health. Spokane-based Aging & Long Term Care of Eastern Washington significantly funded the program in its early years, but when state and federal dollars became limited, the agency had to use its funding toward higher-priority services, Sloan says.

"Care Cars has relied on other funding sources for about seven years now," Sloan says, including grants and donations. "County Commissioners provided some funding several years ago."

Many of the program's drivers have volunteered for 10 years to 15 years, Sloan says.

Volunteer drivers who can devote only a little bit of time such as one day a month are still valuable, she adds.

"Once they see the need and put a real face on it, the volunteers stay," she says. "We try to match a driver with a client, and maybe that driver is the only one who drives them. That way, they can get to know each other, and that trust can develop."

Sloan adds, "Sometimes that Care Cars driver is the only person they interact with during the week. It's kind of like that human touch that makes them feel they're still important, and they feel better. Even though there is a functional touch to what Care Cars does, there is a human touch also."