Medical Transportation Services

Service Standard

Medical Transportation Services Service Standard print version

Subcategories	Service Units
Medical Transportation Services	Per one way trip

Health Resources & Services Administration (HRSA) Description:

Medical Transportation (MT) is the provision of nonemergency transportation services that enables an eligible client to access or be retained in core medical and support services.

Program Guidance:

Medical Transportation may be provided through:

Contracts with providers of transportation services, including ride share service providers;
Mileage reimbursement (through a non-cash system) that enables clients to travel to needed medical or other support services, but should not in any case exceed the established rates for federal Programs (Federal Joint Travel Regulations);
Purchase or lease of organizational vehicles for client transportation programs, provided the recipient receives prior approval for the purchase of a vehicle from the Administrative Agency (AA), DSHS, and HRSA HIV/AIDS Bureau (HAB) as applicable;
Organization and use of volunteer drivers (through programs with insurance and other liability issues specifically addressed); and/or
Voucher or token systems.

Language assistance must be provided to individuals who have limited English proficiency and/or other communication needs at no cost to them in order to facilitate timely access to all health care and services.

Subrecipients must provide easy-to-understand print and multimedia materials and signage in the languages commonly used by the populations in the service area to inform all individuals of the availability of language assistance services.

All AAs and subrecipients must establish culturally and linguistically appropriate goals, policies, and management accountability, and infuse them throughout the organizations’ planning and operations.

Limitations:

Unallowable costs include:

Direct cash payments or cash reimbursements to clients;
Direct maintenance expenses (tires, repairs, etc.) of a privately-owned vehicle; and
Any other costs associated with a privately owned vehicle such as lease, loan payments, insurance, license, or registration fees.

Medical Transportation cannot be used to transport a client in need of emergency medical care.

Services:

Services include transportation to public and private outpatient medical care and physician services, case management, substance abuse and mental health services, pharmacies, and other services where eligible clients receive Ryan White/State Services-defined core or support services, and/or medical and health-related care services, including clinical trials, essential to their well-being.

Organization and volunteer drivers must have a valid Texas Driver’s License. The contractor must ensure that each driver has or is covered by automobile liability insurance for the vehicle operated as required by the State of Texas and that all vehicles have a current State of Texas vehicle registration.

Medical Transportation must be reported as a support service in all cases, regardless of whether the client is transported to a core or support service.

Telemedicine/telehealth can be used to arrange the medical transportation service.

Telehealth and Telemedicine is an alternative modality to provide most Ryan White Part B and State Services funded services. For the Ryan White Part B/SS funded providers and Administrative Agencies, telehealth and telemedicine services are to be provided in real-time via audio and video communication technology which can include videoconferencing software.

DSHS HIV Care Services requires that for Ryan White Part B or SS funded services providers must use features to protect ePHI transmission between client and providers. RW Providers must use a telehealth vendor that provides assurances to protect ePHI that includes the vendor signing a business associate agreement (BAA). Ryan White Providers using telehealth must also follow DSHS HIV Care Services guidelines for telehealth and telemedicine outlined in DSHS Telemedicine Guidance.

Service Standard and Measure

The following Standards and Measures are guides to improving health outcomes for persons living with HIV throughout the State of Texas within the Ryan White Part B and State Services Program.

Standard	Measure
Client Education Regarding Services Available and Limitations: Clients are provided with information on transportation services and instructions on how to access the services. General transportation service hours should correspond with the business hours of local core medical and support services that the clients access. Clients must be able to confirm their transportation arrangements to core or support service appointments at least two business days in advance for medical transportation services offered via van, ride share, or volunteer-operated vehicles. This does not apply to transportation solutions relying on fare media (e.g., bus passes, bus tokens, taxi vouchers). The agency provides clients with information on transportation limitations, clients’ responsibilities for accessing the receiving transportation, and the agency’s responsibilities for providing transportation.	Percentage of clients accessing Medical Transportation services that have documented evidence of education provided regarding services available and limitations in the primary client record.
Screening for Other Transportation Resources: Client shall be screened for other transportation resources (e.g., Medicaid-eligible clients using DSHS Medicaid transportation program). Sub-recipients must enforce Payor of last resort requirements for transportation. Clients eligible for State of Texas Medicaid Transportation (MTP) cannot be billed to RW unless there is documentation in the client file that the State of Texas MTP program cannot meet the need for the needed transportation event (e.g., not available for the date and time of the scheduled OAHS appointment).	Percentage of clients accessing Medical Transportation services that have documented evidence of screening completed of other resources for transportation services in the primary client record.
Client Signed Statement: A signed statement from the client consenting to transportation services and agreeing to safe and proper conduct in any vehicle is documented in the client’s primary record. This statement is to include the consequences of violating the agreement such as removal, suspension, and/or possible termination of transportation services (not applicable to fare media-supported services such as bus passes or tokens).	Percentage of clients accessing Medical Transportation services that have documented evidence of a signed statement agreeing to safe and proper conduct in the primary client record.
Use of Agency Vehicles: When Agency Conveyance is used for medical transportation, clients and agencies are made aware of problems immediately (e.g. vehicle breakdown) and notification documented. The Agency shall ensure that the transportation program has the capability to provide alternate transportation (e.g. taxi, ride share) to eligible clients in, at a minimum, the following situations: Service is unavailable due to primary transportation vehicle breakdown, driver unavailability, or inclement weather; Client’s non-emergency medical need requires immediate transport; Scheduling conflicts; and/or Other locally determined events where missing an appointment may impose significant hardship upon a client (e.g. missing a Social Security Disability hearing).	Percentage of clients accessing Medical Transportation services that have documented evidence, as applicable, of issue reported to the client and other arrangements are made to accommodate the client need in the primary client record.
Documentation of “No Shows”: Client “no shows” are documented in either a transportation log and/or the client’s primary record where an agency’s conveyance or contracted transportation service provider (such as taxi services, ride share providers, etc.) is transporting clients from their home to necessary core and/or support services. Core medical and support service providers are promptly notified by the Medical Transportation agency regarding client “no shows.”	Percentage of clients accessing Medical Transportation services that have documented evidence where a client does not show for an agency conveyance or contracted service scheduled appointment.
Access to Care: Clients accessing Medical Transportation services have evidence of attendance to their core and/or support services where Medical Transportation services were required to access and retain a client in care.	Percentage of clients who access Medical Transportation services have documentation of evidence of access and retention in medical care, other core services, and/or support services in the primary client record.