• DSHS HIV/STD Program

    Post Office Box 149347, MC 1873
    Austin, Texas 78714

    Phone: (512) 533-3000

    E-mail the HIV/STD Program

    E-mail data requests to HIV/STD Program - This email can be used to request data and statistics on HIV, TB, and STDs in Texas. It cannot be used to get treatment or infection history for individuals, or to request information on programs and services. Please do not include any personal, identifying health information in your email such as HIV status, Date of Birth, Social Security Number, etc.

    For treatment/testing history, please contact your local Health Department.

    For information on HIV testing and services available to Persons Living with HIV and AIDS, please contact your local HIV services organization.

Medical Transportation Services

Service Standard

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HRSA Definition:

Medical Transportation 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 provide further guidance on this subject);
  • Purchase or lease of organizational vehicles for client transportation programs, provided the recipient receives prior approval for the purchase of a vehicle from DSHS first and HRSA/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.

 

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.

All 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 Texas State 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.

 

Service Standard and Performance Measure

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

Standards
Standard Performance 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 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 Medicaid Transportation cannot be billed to RW unless there is documentation in the client file that the Medicaid Transportation 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. 

 

References

American with Disabilities Act (ADA)

HRSA/HAB Division of Metropolitan HIV/AIDS Programs Program Monitoring Standards – Part A April 2013. p. 38-40.

HRSA/HAB Division of State HIV/AIDS Programs National Monitoring Standards – Program Part B April, 2013. p. 38-39.

State of Texas Transportation Code Title 7, Subtitle C, Chapter 545. Operation and movement of Vehicles.

Texas Department of Public Safety. Classes of Drivers Licenses.

HRSA/HAB Program & Grants Management. Policy Clarification Notice 16-02 - Accessed January 11, 2018


Last updated July 5, 2018