Getting Your Parent to the Doctor in Erie County: PAL Paratransit, Medicaid Rides, and the County's Going Places Van

A parent who stops driving can still get to every appointment, but only if someone has signed up in advance. Here is how NFTA's PAL paratransit, New York Medicaid's prior-approved medical rides, and Erie County's Going Places van each work, who qualifies, what they cost, and how far ahead to book.

By the Buffalo Senior Advisor Care Team · October 14, 2026

The Appointment Problem Nobody Plans For

When families sit down to plan a parent's care, the conversation usually circles around money, medications, and where Mom should live. Transportation tends to come up later, usually after a missed cardiology visit, a daughter leaving work in the middle of a shift, or a parent who quietly stopped driving in the fall and has not said so. In a region where winter can make a ten-minute drive a real hazard, the question of how a person who no longer drives gets to the doctor, the pharmacy, and the grocery store is not a side issue. It decides whether care at home keeps working.

The good news is that Erie County has three separate systems built for this, and they are not interchangeable. One is a federally required public transit service for people whose disability prevents them from using the bus. One is a Medicaid benefit that pays for medical trips only. One is a county van program for older adults. Each has its own application, its own booking window, and its own rules about what trip counts. Knowing which door to knock on first saves weeks.

System One: NFTA's PAL Paratransit

PAL stands for Paratransit Access Line, and it is the Niagara Frontier Transportation Authority's ADA paratransit service. NFTA describes it as a shared-ride, advance-reservation service: you book a pickup and a destination, a lift-equipped accessible vehicle comes, and other riders heading the same direction may share it. Trips can be for medical appointments, work, shopping, errands, or social and community events, so unlike Medicaid transportation it is not limited to health care.

The eligibility test is about disability, not age. NFTA says a person may be eligible if, because of a disability, they cannot get to or from a bus stop or rail station, cannot board, ride, or exit an accessible bus or train, or cannot use fixed-route service for some trips or under certain conditions. A healthy 85-year-old who simply prefers not to drive does not qualify. A 70-year-old with advanced arthritis who cannot walk the six to eight blocks to the nearest bus stop may. The application form itself asks whether the applicant can travel three-quarters of a mile (six to eight city blocks) without assistance, which gives a sense of how the screening thinks.

How the application works

The application has two parts. The applicant (alone or with someone's help) completes Part 1 and signs an authorization to disclose medical information. Part 2 is completed by a licensed or certified professional who currently treats the applicant or evaluates mobility. NFTA's form lists titles such as physical therapist, occupational therapist, licensed social worker, certified case manager, and physiatrist. Both parts are mailed to NFTA Special Services/Paratransit, 181 Ellicott Street, Buffalo, NY 14203. According to the form, NFTA will notify the applicant of the decision in writing no later than 21 days after receiving both parts, and if no decision is made in that window, the applicant is treated as eligible until a denial is issued. A denial letter states the reason and the appeal steps.

One practical tip from families we hear from: ask the physical therapist or social worker already involved in your parent's care to complete Part 2 while you are in the room. It is the piece that stalls most often, simply because it sits on a desk.

Booking, fares, and the limits

Phone reservations are taken seven days a week from 8:00 a.m. to 8:00 p.m. at (716) 855-7239. Next-day trips must be reserved by 4:00 p.m. the day before, and NFTA states plainly that there are no same-day reservations. That single rule is the most common surprise: PAL cannot rescue a morning when a parent suddenly needs a ride. Trips can also be scheduled, confirmed, or canceled around the clock through PAL Direct online or the automated phone line.

As published on NFTA's fare page, a PAL trip is $3.50 with a PAL MetGo card and $4.00 for cash, tokens, or smartphone payment, with 10-trip and 20-trip passes at $35 and $70. A personal care attendant rides free; a companion pays $4.00. Drivers help riders between the vehicle and the outermost door of a building but do not go inside or carry personal items, which matters for a parent who needs hands-on help from the apartment door to the car. In that case a family member or aide usually needs to be the bridge. We could not verify NFTA's exact service-area boundary or its no-show policy from the pages we reviewed, so ask NFTA customer service at (716) 855-7268 whether your parent's home and destination fall within the service area before relying on it.

System Two: Medicaid's Medical Rides

If your parent has Medicaid, New York pays for non-emergency medical transportation, but it works very differently from PAL. The state contracts with a transportation broker, Medical Answering Services, which approves and schedules trips. The state's own overview says all trips must be approved in advance by the broker and that you should contact the transportation manager at least 72 hours before the appointment. Erie County is in the upstate region, whose listed contact number is 866-932-7740.

The broker matches the mode of transport to the person's need. The state lists public transit, taxi or livery, ambulette, ambulance, and mileage reimbursement for use of a personal vehicle. A parent who walks with a cane and is dropped at the curb may get a taxi; a parent in a wheelchair may need an ambulette, a wheelchair-accessible van. The benefit covers medical trips only. It does not pay for a trip to the pharmacy or the supermarket, and in an emergency the instruction is simply to call 911.

Two cautions. First, the state overview we reviewed does not address managed long-term care members. If your parent is enrolled in an MLTC plan, ask the plan's care manager how transportation is handled for that plan rather than assuming it works the same way. Second, the 72-hour window is a minimum. Specialist appointments are often scheduled weeks out, so the sensible habit is to request the ride the moment the appointment is booked. Families who call two days ahead tend to discover the system cannot always find a vehicle. If you are still sorting out whether your parent is on MLTC, our managed long-term care walkthrough explains the enrollment path.

System Three: The County's Going Places Van

The third option is the Going Places Transportation Program, run by the Erie County Department for the Aging with community partners. It is a curb-to-curb van service for county residents age 60 and over who cannot use conventional transportation, and a brief registration is required. Rides are requested at (716) 858-RIDE, which is (716) 858-7433, Monday through Friday from 8:30 a.m. to 4:20 p.m.

Going Places is the only one of the three that explicitly covers everyday life. The county ranks trips in priority order: health-related trips first (doctor, clinic, hospital, counseling, therapy, prescriptions), then food and nutrition (senior dining sites and grocery stores), then personal business such as banking, bill-paying, and benefits appointments, then social and recreational trips. Health trips need about two weeks' notice, and other trips one week. Wheelchair-accessible vans may be available if you ask when booking. The suggested donation is $8 each way, donations are voluntary and confidential, and no one is turned away for being unable to pay.

The catch: it depends on your town

Going Places is organized town by town, with different service days and hours. The county's published schedule lists, for example, the City of Buffalo from 8:30 a.m. to 3:15 p.m., Cheektowaga from 8:15 a.m. to 3:00 p.m., Lancaster from 8:30 a.m. to 3:00 p.m., West Seneca from 9:15 a.m. to 3:30 p.m., and Orchard Park and Boston from 9:00 a.m. to 3:15 p.m. with no Monday service. Other communities have limited days: Clarence runs Monday, Wednesday, and Thursday, and the City of Tonawanda is Monday mornings only. A parent in a town that is not on the list is directed to the county's NY Connects line at (716) 858-8526. Because schedules change, treat these as a snapshot and confirm the current one when you register. Our guide to rural Erie County senior care covers what that gap looks like in practice south of the city.

Choosing Which One to Use

A simple way to sort it: start with the trip, then the person. A recurring dialysis or radiation schedule for someone on Medicaid belongs with the Medicaid broker, set up once and repeated. A parent with a mobility disability who wants to keep going to a senior center, a church, or a barber should look at PAL, because it is not limited to medical trips. A parent over 60 who is not disabled enough for PAL but cannot drive, and who needs to get to a doctor or a grocery store, is the person Going Places was built for.

Many households end up using two or all three, because each fails in a different way. PAL has no same-day booking. Medicaid transportation requires approval and covers only medical trips. Going Places runs limited hours and needs a week or two of notice. The family that registers for all of them before a crisis has a backup for every scenario; the family that waits tends to learn the rules on the worst possible morning.

What to Do Before Winter

Lake-effect season is when transportation plans get tested. Registering takes time, and the PAL application alone can take up to three weeks to decide, so the practical window to act is now, not during the first storm. Do three things this month: submit the PAL application if your parent has a mobility disability, ask your parent's Medicaid or plan contact how to schedule medical rides, and call (716) 858-RIDE to register for Going Places if they live in a covered town. Then write the three phone numbers on one sheet and put it on the refrigerator. Also confirm that any ride vendor will wait through an icy, slow exit from the house; ask directly how the program handles a rider who is not ready at the door, because we could not verify each program's no-show policy.

Finally, remember that rides are one piece of a larger picture. If getting out is increasingly the barrier, it is worth asking whether the home itself needs changes, and whether free county services or an adult day program, which often arranges its own transportation, would solve more than one problem at once. Verify those details with the program directly.

Questions Worth Asking Before You Rely on Any of Them

Whichever system you use, ask the same short list: how far ahead must I book; what happens if the appointment runs long and the return ride has to be rebooked; what happens in a storm; does the driver help beyond the curb; can an aide or family member ride along, and at what cost; and who do I call if the vehicle is late? Write the answers down. A ride that is reliable on paper and unreliable in February is worse than no plan, because it creates confidence nobody has earned.

Common Questions