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VAMCS DIRECTLY OPERATE VEHICLES In some instances, VAMCs have their own transportation programs. They utilize employee-drivers and VAMC-owned vehicles. VAMCs directly operate transportation programs. Some VAMCs have transportation programs whereby their vehicles are operated by the VAMC employees. Typically they use station wagons and minivans. The majority of the patients are transported from home to the hospital with these vehicles, with pick-ups starting as early as 5 a.m. This was the case for VAMC in Miami, Florida until 2009. More recently, the VAMC in Miami has discontinued its in-house transportation service and now has agreements with local vendors to provide transportation to veterans. VA facilities operate shuttle services between two VA-affiliated locations. It is not uncommon that some veterans travel to another nearby VAMC or VA-affiliated facility for medical treatments. For instance, veterans who have their initial appointments at their local VA clinic may need to be transferred to a larger VA facility for a specialized procedure. In the Brick VA clinic in Ocean County, New Jersey, such a program is available. Some veterans may only have scheduled round-trip rides from their home to specified VA sites. Shuttle services operated by a VA clinic allow veterans to get to another facility in time for the procedure. VAMCS CONTRACT WITH TRANSPORTATION VENDORS Description of Contracted Transportation Services Many VAMCs across the nation contract with private transportation vendors to provide rides to veterans. These vendors include taxicab companies, companies with wheelchair accessible vehicles, ambulance vendors, ambulette services, or Medi-van services. Contracted services from vendors such as taxicab companies may be used for overflow trips or have more significant roles in transporting veterans. Examples of Contracted Transportation Services For more than 20 years, Yellow Cab of Tallahassee, Florida has been working with VAMCs. Veterans contact the local VA Medical Center travel office and the travel office contacts Yellow Cab, which provides demand responsive, prescheduled, and subscription trips to veterans. Yellow Cab delivers veterans to VA facilities in Tallahassee, Lake City, Gainesville, and Marianna and picks 36