Valley Area Stretcher Transport (VAST), a Rockbridge County– based nonprofit that provided nonemergency stretcher transportation, will dissolve its 501(c)(3) operations following a decision by its leadership and board of directors, according to an announcement released last week.
Executive Director Michelle Watkins said the decision was driven by ongoing financial and structural challenges within the non-emergency medical transportation (NEMT) industry, including difficulty securing consistent trip volume through transportation brokers, declining reimbursement rates, and rising insurance and operational costs.
“This was not a decision made lightly,” Watkins said in the announcement. “After careful review of our financial position and the current environment within the non-emergency medical transportation industry, we have concluded that we are no longer able to sustain operations.”
Founded to address a gap in local medical transportation services, VAST officially began operations in January 2025 after several years of planning, fundraising, and regulatory hurdles. The nonprofit focused on non-emergency stretcher transport for patients who could not safely travel by wheelchair or standard vehicle, a service that Watkins said was largely unavailable locally.
In an interview with The News-Gazette, Watkins shared that roughly 90 percent of VAST’s patients were Medicaid recipients, and the organization was created specifically to serve people who often fell “between the cracks” of existing transportation systems.
While demand for the service increased steadily through much of 2025, VAST lacked the financial reserves needed to withstand sudden drops in trip volume. In recent weeks, scheduled transports declined sharply, making it impossible to meet payroll and insurance obligations.
Watkins also cited instability among transportation brokers — the intermediaries that contract with insurance companies — as a growing problem for small providers. Mergers, shutdowns, and shifts toward lowercost alternatives have made credentialing and reimbursement increasingly unpredictable, she said.
VAST was the first nonprofit non-emergency stretcher transport provider based in Rockbridge County, and its closure leaves the service largely in the hands of out-ofarea, for-profit providers.
Despite the closure, Watkins remains active in community support work through Rockbridge Connect And Nourish (CAN), a program she founded to address food insecurity, social isolation, and access to services in rural parts of the county. The initiative hosts free community meals and brings service providers directly into underserved areas.
The CAN network experienced huge success last fall with their inaugural “Friendsgiving” event, bringing together hundreds of volunteers and local citizens to enjoy a Thanksgiving meal. Watkins says plans are already in place to repeat the event, again at the Virginia Horse Center, on Nov. 19.
