(Unedited) Podcast Transcript 534: When You Don’t Really Need an Ambulance

This week we’re joined by Ross Peterson to talk about non emergency medical transportation and his new wheelchair accessible transportation company RIDEtoo. We talk about transportation funding for medical visits and how they can be more efficient.

Also find Ross on Linked In

To listen to this episode, find it at Streetsblog USA! or in our archive.

Below is a full unedited AI generated transcript of this episode:

Jeff Wood: Ross Peterson, welcome to the Talking Headways podcast.

Ross Peterson: Really excited to be here. Thanks. Thanks for being here.

Jeff Wood: Before we get started, can you tell us a little bit about yourself?

Ross Peterson: Yeah. I’m a serial entrepreneur and I think of myself as a social entrepreneur.

I’m launching my fourth business called Ride two. It is a wheelchair accessible transportation service, and I’m really trying to build the transportation service that I wished that I could have accessed when I was running a brokerage or working in what’s called non-emergent medical transportation brokerages.

It’s not my only job. I also am a part-time researcher at Texas a and m. I work with the Texas Transportation Institute on various studies in human service, transportation and mobility management, and also have a consulting firm. [00:03:00] That’s the main thing that pays the bills right now, is consulting with folks that want to understand the medical transportation space better.

So yeah, that’s what I’m up to.

Jeff Wood: Why serial entrepreneurship? It’s like pricking yourself with a pin over and over again, right? Yeah.

Ross Peterson: Yeah. I think I got a, it’s hereditary. My mom was an entrepreneur. My dad has been an entrepreneur. I do think that you learn it when you’re young and maybe that’s when you build the callus to survive some of the painful parts of entrepreneurialism.

I’m seeing my son do it too. My, my son is graduating high school this spring and he already wants to start a business. He’s a mechanic. He went through trade schools and wants to start a mobile mechanic business. So I think you learn it from your family, but you’re right about the pain. And I’ve had some business failures, but you also learn a lot from that and it leads to a different approach next time.

And it’s some of the most valuable learning that you can get. Learning from failures. [00:04:00]

Jeff Wood: Yeah, for sure. This business that I started, podcasts and newsletters and all that stuff, I’d never expected to get into it, so I dropped into it strangely. There’s a whole bunch of stuff that I learned from tax policy to, yeah, all these other things like my aunt was telling me when I started the business.

So you’d have to get your permit from the city of San Francisco, but you also have to like advertise in the newspaper that you’re an actual business. And you exist. And so I would’ve never have known that. Like just those little tiny things that you have to learn in order to start something. It’s, it builds up on itself over time.

And so now I could tell you more about self-employment and the tax code and whatever else, but it’s something that as a planner, they don’t teach you that stuff in planning school, right? They don’t tell you how to start a business. They tell you all the zoning rules and laws and regulations and things like that.

So it’s definitely a different world in entrepreneur land. Also I’m interested in just the idea of medical transportation and we’ve had folks on the show come on from Geisinger Health and some other places who talk about that in more detail. Yep. But there’s a specific connection between transportation and health that I think we don’t talk about enough because it’s a little [00:05:00] bit swept under the rug to a certain extent, or it’s something that’s outside of most transportation, urban planner’s purview.

But it is important. Totally.

Ross Peterson: I think a lot of planners recognize the idea of social determinants of health. That’s a pretty well understood concept. What I think a lot of people don’t realize is that Medicaid has paid for transportation all the way back to the beginning of Medicaid in the mid sixties.

So medical transportation enshrined as part of Medicaid from the very early days. Saying and recognizing that it doesn’t really help people to provide health insurance if they can’t access their doctor. So Medicaid is always paid for non-emergency medical transportation. And so in a way, the NEMT benefit, the non-emergent medical transportation benefit under Medicaid, has been one of the social determinants of health that actually has a funding source tied to it.

I think it’s really good for urban planners to understand that because at the end of the day, we’re always trying to establish what is the ROI of our [00:06:00] transportation investments. Hospitals and healthcare systems really do understand the value of transportation, because if somebody can’t get there for their preventive healthcare, it’s going to turn into an emergency.

And something that I guess really struck me early on when thinking about Medicaid in particular is that if you’re enrolled in Medicaid, you can call 9 1 1 at any point. And get a free ride. Immediately a free on-demand ride to the doctor and it costs you nothing but it’s in an ambulance and that ride is gonna cause taxpayers quite a bit.

So it does make sense that health plans invest in non-emergency medical transportation. And I think that I’ve been really interested in understanding how that works. Where does it not work? Because if you Google non-emergent medical transportation, you’ll get a lot of, I would say there are some horror stories of folks that have been stranded for hours waiting for their rides.

It’s a really mixed bag in terms of the level of quality of services that people get. So what’s striking is that as a planner, you think about medical [00:07:00] transportation is something that can help address the social determinants of health, and that makes a lot of sense, but it’s also a really challenging service to provide.

The passengers are some of the most vulnerable passengers out there. They really need their rides to go well, and when they don’t go well, it can be a really terrible experience. So non-emergent medical transportation has these two sides to the coin. One is we recognize that it’s a very valuable service, but two, it’s also one of the hardest types of transportation to provide.

A lot of folks don’t want to touch it. There’s a lot of complaints associated with it. People don’t understand it and they often will almost look at it as, Hey, how can we confine this benefit or reduce the amount of it that we have to provide? And so it gets a bad rap.

Jeff Wood: You’re talking about under resourcing and that’s what we do for transit as well in this country.

That’s right. And it’s frustrating. And this is actually more life and death than, transit is life and death ’cause people need to get access to places. But this is more life and death than that. If you [00:08:00] can’t get to, like you said, your care visits and then otherwise people are taking the ambulance.

I am curious about the EMT system and how people are currently using it, abusing it. The reason why you need non-emergent medical transportation. It’s interesting to think about how there’s almost like a series of steps that go up to when you actually need an ambulance, but before that, it’s being abused to a certain extent.

Ross Peterson: Keep in mind non-emergent medical transportation. Is distinct from emergency medical transportation and they’re intentionally kept separate. That non-emergency medical transportation has different training requirements and that keeps the cost a lot more affordable. We’re not driving people in ambulances with lights on, but non-emergency medical transportation can mean a lot of different things.

The brokers that manage it can use their funds to buy bus passes. They can buy somebody a bus pass if that’s the most cost effective way to get somebody to their treatment. They can even pay for mileage reimbursement. So if you’ve got a car but you can’t afford to [00:09:00] operate your car, an NEMT broker can give you money to operate your car and drive yourself to your appointment.

They can also authorize basic life support, level of service if you need that. If you’re in a stretcher or you need to oxygen during transport, or maybe you’re being transferred from one hospital to another. So there’s a whole spectrum of types of transportation that are covered under NEMT, and I don’t think people realize that a big part of that is actually public transit.

Most rural transit agencies use Medicaid money as match for their federal FTA funds.

Jeff Wood: That’s interesting. And so how does that work in terms of how those kind of overlap and like how they sell each other on the idea that, oh yeah, we should use this one federal funding pot for a match for this one, or we should use this one for a match for this one.

And they’re both, federal funds, they’re both coming from the same place. But it’s interesting the purposes and, end goals of each organization.

Ross Peterson: Yep. There have been volumes and volumes written [00:10:00] about this topic. I think it was ice tea. It was one of the kinda late nineties, early two thousands highway authorization bills that explicitly said you can match your FTA money with Medicaid money.

Medicaid didn’t say the same thing, and so there’s always been a little bit of a, I don’t know, consternation from the CMS side that gave rise to a whole bunch of policy work. Have you heard of CAM, the Council on Coordinated Access and Mobility?

Jeff Wood: I should have that. It’s a

Ross Peterson: cabinet level effort to coordinate across all of these different federal funding sources that are paying for rides for seniors, for people with disabilities, for people with low income.

I think the last government accountability office study, I could be off ’cause they’ve published five or six of these over the last two decades, identified over 130 different federally funded programs that pay for rides for seniors, for people with disabilities and people with low incomes. The other part of those studies have also [00:11:00] said these programs are not coordinated.

There’s 130 of them. They all have different requirements. They all have idiosyncratic methods for how funds are used. They’re all serving the same customers. So if we just go back to what we were talking about between FTA and Medicaid, those findings were originally published in, like I said, at the early part of the aughts.

This is like two, I think it was 2003 when the first government accountability office report was published saying, Hey, we need to coordinate these programs better. It wasn’t until 2023, so that’s literally 20 years later that Medicaid came out. The Center for Medicare and Medicare Services published a, what they call a guideline telling recipients of Medicaid funds that it is okay to work with local transit agencies, that it’s okay to coordinate your services.

They provided some very specific guidelines, but that guidance, it took [00:12:00] 20 years to get that guidance. People are still hesitant to braid their federal transit money and their Medicaid money, but there are a ton of opportunities in bringing those programs closer together. If you think about everything that’s happening with micro transit right now, right?

You’ve got a lot of experimentation happening in suburban areas with micro transit where we’re able to do more on demand response type services, very flexible services in suburban low density communities, where fixed route just doesn’t really make a lot of economic sense. Those same services are a really good fit for providing these kinds of rides to local clinics and getting people to their doctor’s offices.

I think we’re on the cusp of some really interesting opportunities to coordinate micro transit with these traditional human service transportation programs. So anyway, I’m excited about talking about that. We can get into it a little bit more, but I see some big opportunities on the horizon.

Jeff Wood: Yeah, I just think it’s so fascinating.

We’ve covered in the [00:13:00] newsletter and on the show how Medicaid is now being used in places like California for housing. And like I said, we talked with Geisinger about how they use it for transportation and what happens when somebody misses their appointment. That’s actually money lost for the health.

Agency, but also, it’s an appointment lost for the person who can’t get their cancer screening or can’t get, their dialysis or whatever it is. There’s missed opportunities on both sides and it’s expensive. That’s the thing too, is like we need to provide people with care and care infrastructure, but it’s all in these disparate pots of money housing and Medicaid and transportation and, all these things, but they’re all intertwined and the silos that we sit in often are really frustrating.

Ross Peterson: If you miss your dialysis appointment, people go to dialysis three days a week. If you miss one of those, the chances of getting admitted to the emergency room go way up. If you miss two, the chances of fatality become very real. I. That’s all very expensive. It’s a, when you look at it that way, this kind of transportation makes a [00:14:00] lot of sense to get right.

Jeff Wood: Yeah. I mean they were talking about I dunno the exact numbers, but I’m just spitballing here. But if you can keep somebody out of the emergency room who would stay there for a week, you could pay for six months of their rent. That’s how expensive it is to stay in emergency room. It’s very intensive in that way.

Yep. So recently you made this giant leap and you started this company that focuses on wheelchair accessible rides. Can you tell us more about what you’re trying to do? We talked about the non-emergency medical transport in general, but I want to hear what you’re working on.

Ross Peterson: Yep. The aha moment was when I was at Motive Care.

I was responsible for managing our relationships with Uber and Lyft. And to give you an idea, so Automotive Care does about 40 million rides a year, and all major medical transportation brokers use Uber and Lyft. We. I need to be careful what, not going into too much detail here, but we made some adjustments to how we were using those services to make sure that we were assigning them when it was appropriate.

It’s really easy to use those types of services, like an [00:15:00] easy button, quote unquote, and we wanted to be able to use them more, but we did not want to use them in any way that would be inappropriate. And so once we had fine tuned the algorithms to make sure we were using them when it was appropriate, we were able to really maximize the use of Uber Lyft when it was appropriate.

And it had some pretty profound impacts on time performance improved significantly by almost a 10 percentage point improvement

Jeff Wood: on time. For who? For the person getting to their appointment, the passenger.

Ross Peterson: Okay. We measure that as a leg drop off. Getting to your appointment on time, which is what people care about.

I need to get to my appointment on time. Customer satisfaction went through the roof, so complaints dropped by an order of magnitude, but more interestingly, even with those quality improvements. Cost dropped significantly. We were able to do a lot more rides for the same amount of money. So here’s what the aha moment was.

That worked as long as the passenger only needed curb to curb ambulatory [00:16:00] transportation. If the passenger needed a wheelchair, there was nothing like that available. There is not a nationwide fleet of wheelchair vans. It doesn’t exist. So that’s what I’m building at Ride two. Is to grow this company eventually to be a nationwide platform for providing wheelchair accessible rides that major payers can plug into with one API, and have that same sort of transformative experience that I saw happening with Rideshare, but for wheelchair accessible rides.

I realize it’s a super ambitious plan and we can talk more about the mechanics of how I wanna build it. Right now I’m in very early stages. I’m building the prototype. Eventually, my goal is to expand that prototype through essentially what is a franchise business model. Each territory is basically a self-contained business that can then be replicated following certain principles and standards of operation with [00:17:00] multiple territories being implemented in parallel.

That’s how we get to that national footprint.

Jeff Wood: I’m wondering why wheelchair accessibility is harder for these companies to provide.

Ross Peterson: Securing a wheelchair is a physics problem, and it’s a treacherous legal territory. So your listeners probably have a pretty good understanding of the Americas With Disabilities Act.

You can’t deny transport to somebody based on the device that they use. It’s a violation of the Americas With Disabilities Act. But not all mobility devices have been crash tested, and not all mobility devices are designed to be secured properly in a vehicle. So your driver needs to understand, how do I secure this three wheeled scooter in a way that if there’s an accident, the passenger is still gonna be safe.

You’re on this razor’s edge where on the one side, if you get it wrong, you’re violating somebody’s civil. On the other side, if you get it wrong, you could have an [00:18:00] injury or some kind of an accident on your hands with significant liability. So you can’t rely, I don’t think. On 10 99 independent contractors doing that work.

So the gig economy model for scaling, I don’t think it works in this context. You need to train your drivers to such a high level of proficiency that if you were to do that under a 10 99 model, you would essentially be inheriting the employer’s liability because you wouldn’t be able to pass the tests for, is this truly an independent contractor?

That’s why I don’t think this has been done at scale through traditional gig economy models.

Jeff Wood: Do you think the gig economy, and this is a general question too, do you think the gig model works for even like taxi seasons and ride hailing as it is now? There was this article I’m gonna talk about on the Monday show tonight probably.

There’s just an article in San Francisco Chronicle about the people who are renting scooters. I. To deliver goods for Uber Eats or DoorDash and that type of stuff, and the exploitation that happens for those folks. And the model that only works if you’re [00:19:00] in a dense area, right? And not like these rural areas, suburban areas, et cetera, and things like that.

So I know that’s going outside of our conversation generally, but it’s still, I feel like matters to a certain extent,

Ross Peterson: keeping it focused on the passengers that I’m most familiar with. And trying to tie it back to some of the things we’ve talked about. We’ve been talking about the social determinants of health.

We’ve been talking about getting people to healthcare. When you actually go see your doctor, they might spend 15 minutes with you, but your ride is probably 45 minutes just to get there. So you’re spending more time with your driver than you’re spending with your doctor. I think it’s important that those drivers have very high qualifications for the work they’re doing.

So I won’t comment on is the gig economy appropriate for other modes of transportation? I think in the kind of transportation that I’m trying to do and the types of problems I’m trying to solve, traditional employment is the right model. The W2 model makes a lot of sense. So yeah, I’ll leave it at that

Jeff Wood: here in Denver.

Is Denver like an [00:20:00] ideal place to start this up?

Ross Peterson: It’s an interesting place to start this business. I moved to Denver to join the Mode Care executive team three years ago. Got my kids into some really good schools. I have three boys. I mentioned one of them is graduating, one of them is a freshman. The other one’s just about to start middle school.

We’re a fantastic school district. I don’t wanna move again. I’m rooted at least until I graduate, and so whatever business I start is gonna be in Colorado by default. I think Colorado has a lot going for it, but I think there are some real disadvantages of starting a business like this in Colorado right now.

So the main thing is there is a moratorium on new Medicaid providers providing medical transportation in Colorado. Normally a business like mine would get most of its brides from the Medicaid NEMT broker. I don’t have that option right now. I am prohibited from entering the market along with anybody else that wants to become a new provider in Colorado.[00:21:00]

So I look at it as if I can make this work here, it’ll be much easier everywhere else. But it does force me to focus on things like private pay. It really focuses my energy on some of the new types of providers and brokers that are out there that are trying to solve these problems. So really exercising all of my networking tools to find alternative sources of rides.

And then when the Medicaid program opens back up, that should just be one more additional source of rides that will keep us afloat. But this is a difficult environment to be building this company for sure.

Jeff Wood: Who are your customers aside from, they’re wheelchair customers, but, yep.

Ross Peterson: So rehab clinics are very interested in what we do.

A rehab clinic, like an inpatient rehab clinic is where you would go after surgery while you’re still recuperating, and typically you’re transferring from a hospital to an offsite rehab clinic where you’re getting rehab. They’re very protective of those patients, and they wanna make sure that the quality of transportation they’re getting is top.[00:22:00]

So rehab clinics, I would say, are among the top customers right now. Private pay rides from assisted living centers, dialysis clinics, folks that don’t have insurance coverage to pay for wheelchair accessible rides. Not all insurance. Medicaid covers it. Some Medicare plans cover it. If you don’t have one of those types of plans, your rides aren’t covered.

And if it’s important to you or important to your healthcare provider, either your healthcare providers figure it out or you’re figuring it out. So we do a lot of outreach, those types of organizations to get that type of work. Medicare has relatively new NEMT benefit before the pandemic. It was around 2017, and again, it was actually tied to something we talked about earlier.

Medicare was trying to understand how do we address the social determinants of health allowed NEMT under its value added services benefit. So now Medicare is a fairly significant payer of [00:23:00] NEMT sources and I work with a couple of different brokers that pay for those types of rides. So that gives you a feel of who the customers are.

That’s interesting.

Jeff Wood: I’m wondering if you would have to go through like doing Google ads or handing out your card in a place that might have users and like what the kind of the slog is of trying to gin up customers as a startup? It’s always hard.

Ross Peterson: It is. It’s retail level business development.

I am literally taking a box of cards around. I built a list of leads from different databases and I put my uniform on in the morning and. I head out and I go knock on doors and talk to folks.

Jeff Wood: We’ve talked about the funding and the landscape a little bit, but I wanna understand the edges of the, of funding and like how far you can possibly go with it.

Ross Peterson: Yeah. Like I said, there’s 130 different federal funding sources, and that’s just at the federal level, paying for rides for seniors, people with disability and people with low incomes. So there, there’s a lot of surface area there. The big [00:24:00] ones are Medicaid, a d, a, paratransit. FDA section 53 10 program.

The older Americans Act vocational rehab, the Veterans Administration. So take that list of a handful of fairly big programs. Those combined are over $10 billion in annual spending, and that doesn’t even get into the more traditional public transit services. When we start talking about things like micro transit.

So I, I think the edges, this is my opinion, I don’t think the edges of where the funding might be should be defined by those funding sources. The way I think about it is who needs wheelchair accessible rides? What is the population derived demand for this stuff? And so for that, I go look at the National Household Transportation survey and there was one done pretty recently.

And I look at that and figure out how many people with disabilities. Living in areas that can reasonably serve by a program like this are there and [00:25:00] almost ignore what color of money they have access to. Let’s design the service. And maybe this is the urban planner in me thinking about universal design principles, but the way I wanna design my driver training program is to train my drivers to take all flavors of money that whether it’s a veterans grant that you have, whether it’s an Older Americans Act grant that you have.

Maybe you’ve already cobbled together a couple of funding sources and you’ve thought through what your driver training standards need to be. We will train our drivers to the highest standard across the board so that we can accept all flavors of money, and there’s a lot of intention behind that. If you go back to those government accountability office reports that I was telling you about, where they keep pointing to the lack of coordination across these programs, I think that companies like mine need to play a role in coordinating them.

I think the way we can do that is by setting higher standards for how we train our drivers so that we can accept [00:26:00] funds from all of these different programs, and I call it coordination at the bottom of the funnel. So the rides are coming in. I can provide a ride to a veteran, I can provide a ride to a senior, I can provide a ride to a Medicaid beneficiary all in the same vehicle.

And the benefit to the payers and ultimately the taxpayers that are. Supporting these programs is that if I accept all of the different funding sources, I can serve a much higher ride density, and if I can serve a higher ride density that’s more rides per hour, and given that most of these costs are variable, that means that I can charge a lower cost per trip.

If I have more rides per hour, I can charge a lower fare per trip because I’m spreading costs out across more trips. So if the objective of coordinating across all these different human service programs is to stretch dollars further, then providers like me who are thinking about all these different funding sources and intentionally designing our services to [00:27:00] meet their requirements, we can be part of the solution.

We can be part of making it easier for all these different agencies to indirectly pool their resources and break their funding and achieve that goal of stretching dollars further.

Jeff Wood: I think that’s one of the big frustrations with demand response and some of the stuff that, you know, via or other companies are trying to work with is just the high cost per trip for those services.

Fixed transit is one thing and fixed transit in a urban core is a whole other thing. You can get down to a dollar 50 cents per ride if you have good service, but some of the demand response stuff goes 30, 40, $50 per ride and it gets really insane. So like just. Going those two levels is really crazy and making it more efficient, which is something that people always talk about with government services.

They want ’em to be more efficient. And so I think that’s something that’s laudable for sure.

Ross Peterson: Yeah, so much of demand response comes down to vehicle productivity. How many trips per hour can you do with that asset? And the more trips per hour you can do the lower the cost. If you’re [00:28:00] only able to do one type of funding, if you can only do Medicaid rides, then your trip density is just defined by your Medicaid rides.

Jeff Wood: Yeah. Another thing that’s popped up recently, and there’s an item in Streets Bog USA last week with Kia Wilson and Greg Shill wrote a piece about the silver tsunami and now that people are living longer, they’re outliving their ability to drive. And so there’s a 10 year extra gap between when people, lose the ability to drive and maybe it should be even lower versus when they pass away.

And so it’s interesting to address that gap, right? That the gap is getting bigger and the number of people that are in that level of need of service is getting larger as well. And I imagine you’ve thought of this, but just the aging population in the United States and the ability to drive versus the ability, to need rides.

Ross Peterson: Yeah, you’ve got the silver tsunami, which you pointed out, but then you also have aging in place. How many folks do you know that bought a house that maybe had a really low interest rate 10 years ago, and they’ve got that [00:29:00] locked in and they don’t want to sell it, but now they’ve aged to the point that they’re not as mobile as they used to be, but they’re in a low density suburban neighborhood.

I think the aging in place and the silver tsunami, those two mega trends elevating the need for high quality, accessible wheelchair transportation in suburban areas. That’s a big part of it. But I think the other factor is folks that were paying into Social Security who are expecting a certain level of benefits.

If you look at the population pyramid, there aren’t as many payers coming in paying into Social Security anymore. So you have all of these big demographic driven trends and yes, I have thought about it. I think it’s a huge problem and we need to really think about how are we going to provide rides for all these folks and how are we gonna do it in the most cost-effective way possible?

Because I just, the resources aren’t going to be as abundant as they were because the demand is up and the amount of funding going into these programs is down.

Jeff Wood: You’re the driver, I imagine, [00:30:00] for a lot of these rides because you are a startup. What’s that like?

Ross Peterson: For one thing, that’s very intentional. I’m a driver by choice.

I want my drivers as I hire them to see that I’m part of the driver brew and it’s part of building a driver centered culture and it’s super rewarding. I’ve been a professional most of my career. I’ve worked behind a computer. It’s refreshing to, to get out from behind a computer and go out and actually help people.

I love it and I actually think there are a lot of folks like me maybe who have had a successful career. Maybe they’ve retired and they want to get back into the community doing something. I’m hoping that a lot of folks in their kind of late sixties might be interested in being ride to drivers and having a second career doing this stuff before they fully retire and stop working.

Jeff Wood: You haven’t been doing it too long, so I imagine you don’t have any crazy stories yet, but I imagine those are coming at some point.

Ross Peterson: Yeah, and most of them will be HIPAA protected and I won’t be able to tell you about them.

Jeff Wood: That’s true too, i’m [00:31:00] glad you’re following the rules.

Ross Peterson: Of course.

Jeff Wood: What’s something that surprised you about this process of starting a company that you’ve done so many times before, but this one in particular?

Ross Peterson: How hard it is to get the right insurance. More than one insurance broker has told me that now is probably the most difficult time to start a business like this.

The insurance premiums are through the roof. Most NEMT companies spend more on insurance than they do on gas, and a lot of that is driven by the problems I’m trying to address. And so what’s surprising about it is that I’m coming into this with really high standards for how I train my drivers. A lot of risk management protocols built in.

For example, I have five cameras in my vans, two facing inward at the passenger, one facing the driver, and two facing out. That’s all about risk management, but it doesn’t matter that I have 20 years of experience or that I have all these policies and procedures, I pay the same rate that anybody else does that’s starting a company like this.

The reason the rates are so high is that a lot of folks that [00:32:00] came before weren’t, and now I’m not saying everybody in this industry operates this way, but there are some folks that are in this business for the wrong reasons. They cut a lot of corners, and there have been some really big lawsuits. There have been a lot of big claims, and so there’s a lot of risk aversion.

There’s a lot of concern about new entrants into the market, and so it’s hard to get the right insurance and it’s very expensive. I

Jeff Wood: feel like insurance rates are going through the roof in all facets of transportation. Car insurance is going up. Climate change is causing the risk tolerance of companies to go down.

They’re doing way more analysis now about that stuff. And I imagine it’s hitting you as well.

Ross Peterson: Yeah. The silver lining is, I hope that as we get big enough, we’ll be able to create owner controlled risk pools, captive risk pools, and take advantage of some of those structures. Where we can benefit from all of the risk management that we’re doing.

I’m hopeful that we’ll eventually benefit from all of the work we’re doing, but right now it’s just, it’s expensive.

Jeff Wood: If you’re sitting on my [00:33:00] side of the microphone, what would you ask yourself?

Ross Peterson: Oh, that’s interesting. I. I would ask me if I’m crazy. Are you crazy? I don’t know. I hired, so I did the industry standard training for wheelchair securement, and I became a certified train the trainer.

I can train people to secure wheelchairs, but in addition to going through that process, I also hired one of the individuals that serves as an expert witness. So when somebody is suing a transportation provider. The plaintiff’s attorney hires an expert witness to explain to the jury, here’s what should have been done, and here’s footage of what actually was done.

I hired that person to come to Denver and spend a couple days with me and teach me everything they don’t teach you in the class. That was when I really thought, maybe I’m crazy for getting into this. That’s smart,

Jeff Wood: actually.

Ross Peterson: Maybe smart to hire that person, but still crazy to make some big financial bets in entering this industry [00:34:00] as a provider.

I think there aren’t a lot of folks doing it that way, the way that I am. There aren’t a lot of folks out there that are investing heavily in driver training, that are investing in things like five cameras for every vehicle that are riding the policies and procedures before ever doing any rides. Ride two really is a different business in that regard, and I think that maybe that’s what you might call crazy as a fox like.

I definitely am thinking about this from a risk management perspective, and I hope that the folks that are funding these rides and the folks that are really interested in seeing people get high quality transportation and affordable cost, understand that this is how you do it. You focus on risk management, you focus on training, you focus on standards.

Jeff Wood: That’s another thing too, is that you can’t just go out and buy a van and be like, okay, I’m a I’m a serving wheelchairs now. You have one vehicle, you purchased it from a previous system that was already doing this before, and so what’s that process like, sussing out a vehicle and making sure it has all the right things that you need for this type of transportation?

Ross Peterson: Yeah. We’ve got three more on the [00:35:00] way, but the first one is special. You probably read my LinkedIn post about it. So a guy named Kirk Foster had a company in Portland, Oregon called Wapa Shores. He ran for about 25 years and he had a fleet of dozens of these vehicles, and Kirk was like me. He had cameras in the vehicles.

He was meticulous about continual improvement. So anytime there was an incident, he and his team would go back and watch the footage, like watching a football game after watching the replays to see what can we do better. And so Kirk was continually tweaking his vans and making small adjustments. He decided to retire right in the middle of the pandemic, but he held onto one of his vans.

His father uses a wheelchair and he thought he might need to use it for his dad. His dad’s now in a assisted living center, and he and I have stayed in touch. So I reached out to Kirk and let him know that I was planning to start this, and he mentioned that his van was available. So I took the opportunity to get his van, and [00:36:00] in a way I think of it as getting my sourdough starter from Master Baker Uhhuh and having that as the seed or the beginning of our fleet.

So the three other vans that we’ve got on order have design elements that are taken from Kirk’s van that I’ve started with. And I do know a lot of folks in the industry and folks like Kirk always catch my attention. People who are doing it well and doing it for the right reasons. So I try to stay in touch with people like that, and it’s helpful to have a network like that you can rely on.

Jeff Wood: What does the vehicle look like, what are the features that it has aside from the cameras, like what are the features that it has that is different than maybe a usual, 10 passenger van.

Ross Peterson: It has grab bars in non-standard places. That’s the main difference. There are places to grab on and have a secure place to hold on that don’t come in normal vans, and that’s a result of watching unfortunate situations when passengers, or in many cases drivers have slipped.

Having something to grab onto nearby would’ve prevented the fall.

There’s [00:37:00] also really thoughtful changes that he’s made to the perimeter around the lift that DeMar, where the edges are so that it’s not like a physical barrier that would prevent you from rolling over the edge, but it’s a visual barrier in addition to the auditory and other barriers that are present as one more reminder to passengers that, Hey, there’s an edge here.

1. Don’t go past this point. So it’s things like that. That’s

Jeff Wood: really cool. So what’s next for you? You’re starting this thing, you’re moving forward, you’ve got your vans coming, you must be very excited, but also, it probably is also stressful. What’s next?

Ross Peterson: I’m looking for a co-founder right now.

I’ve met a couple of great folks. In fact, I had a co-founder, but unfortunately he had a family medical issue come up and early on in the process we just decided now is not the right time. Once I’ve got a co-founder, it’s really just grow the business. We’ve got a number of contracts that are either ready to sign or very close to being [00:38:00] ready to sign.

Having that second senior person on the team gives me the confidence to start executing those contracts. And like I said, we’re trying to build a driver center culture, so it’s important that the early leaders get their hours in behind the wheel so that we can continue that tradition. So once we have that experience, we can start hiring more drivers and we can start training them.

Probably start out with a couple of part-time drivers, but once my co-founders here, we’ll really focus on building up that roster of drivers.

Jeff Wood: That’s awesome. Where can folks find out more about what you’re doing or if they’re in Denver, get a ride?

Ross Peterson: Yeah. We actually are running a program right now called our Early Access Program, and anybody in Denver that uses a wheelchair and needs a ride can sign up for early access.

We still have spots left and we’ll give them two free rides. It’ll also give them the ability to book rides with us, so if they enjoy that experience, they can order more rides. They can also follow me on LinkedIn. I’m telling the story of Ride [00:39:00] two. I’m not sharing all of the details. Any business person wouldn’t.

It wouldn’t be prudent to share everything, but I’m sharing a lot. And if you’re interested in startups or just following along, follow me on LinkedIn, follow Ride two on LinkedIn, and you’ll be able to hear all about it.

Jeff Wood: Awesome. Ross, thanks for joining us. We really appreciate your time.

Ross Peterson: Jeff, this has been awesome. I really appreciate it. You have a great podcast and I really appreciate what you do.

Jeff Wood: Thanks so much.