Non-Medical Transportation 525-05-30-40

(Revised 1/1/19 ML #3543)

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Purpose

The purpose of HCBS Non-Medical Transportation service is to enable individuals to access essential community resources/services in order to maintain themselves in their home and community.

Service Eligibility, Criteria for

The individual receiving non-medical transportation service will meet the following criteria:

1. Must be eligible for the Medicaid Waiver for Home and Community Based Services, Technology Dependent Waiver, SPED, or ExSPED.

1. Clients receiving Transitional Living services are limited to eligibility for Non-medical Transportation Driver with Vehicle.
2. Clients who are receiving Non-Medical Transportation Service under the Technology Dependent Waiver are limited to eligibility for Driver with Vehicle.
3. Is unable to provide his/her own transportation.
4. Needs a means of obtaining basic necessary community resources and/or services (i.e. grocery, pharmacy, laundromat).
5. Transportation alternative is NOT available such as through the informal network.

Service Activities

HCBS Non-Medical Transportation can ONLY be authorized for the client to access basic necessities (which are non-medical related) required in order for the client to remain in their own home. If a provider will be using another individual's vehicle to provide this service, the owner of that vehicle must provide proof of insurance and a written statement that they have given the provider permission to use the vehicle for this purpose.

1. Driver with Vehicle

HCBS Non-Medical Transportation service is to be provided from the client's place of residence to the essential service need/access point(s) and/or return.

Local round trip is for transporting the client to and from his/her home for essential services as is limited to flat rate per round trip of one (1) unit per calendar day.

2. Authorization of Escort

An escort may be authorized to accompany a client who uses public transportation IF the client requires assistance in boarding and exiting as well as while being transported AND the escort must be needed by the client in completing the activity.

3. Authorization of Driver with Vehicle and Escort

An individual providing transportation may also be compensated as an escort IF the escort is needed by the client in completing the activity for which the HCBS Non-Medical Transportation is authorized. Compensation for escort must be separate from the per mile compensation for the transportation (driver AND vehicle). Example: A single provider provides both Driver with Vehicle and Escort. The billing time for the escort starts when the vehicle reaches the destination and stops when the client enters the vehicle to return home. A QSP cannot be reimbursed for escort services while driving.

Unallowable Service Activities

• HCBS Non-Medical Transportation CANNOT be used to transport a client to and from work/or school or to facilitate socialization or to participate in recreational activities, (i.e. wellness programs, church activities, etc.).
• HCBS Non-Medical Transportation CANNOT be used to transport a client to and from a health care provider or medical facility (doctor, dentist, hospital, physical therapy, etc.).
• If the client is not able to be transported or participate in the activity, this cannot be billed under Non-Medical Transportation. The service may be covered under Homemaker.

Clients receiving Transitional Living Services are exempt from this limit, service tasks would include transporting clients to/from work or school or to facilitate socialization, or to participate in recreational activities, escort to accompany the individual while they are being transported is not allowed, as it is a component of transitional living services.

This service is not available when transportation is provided as a component part of another service.