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Ohio Laws and Rules
(A) Transportation is a service designed to enable a consumer to gain access to medical appointments specified by the consumer’s plan of care, when medical transportation is not otherwise available or funded by state plan medicaid or any other source. Whenever possible, consumers must use family, neighbors, friends, or community agencies to provide this service without charge.
(B) A unit of transportation service is a one-way trip or a round trip. The unit rate is the price quoted by the provider and approved by the consumer’s case manager prior to the provision of the service. The provider must bill for the original price quote submitted to and approved by the case manager unless a cost revision is authorized by the case manager prior to delivering the service.
(C) Provider requirements include the following:
(1) The provider must be either an ODA-certified long-term care agency or an ODA-certified long-term care non-agency provider.
(2) The provider must furnish evidence of a service back-up plan to provide service when a vehicle becomes disabled.
(3) All vehicle operators and owners must maintain proof of financial responsibility as required in section 4509.101 of the Revised Code.
(4) A copy of the certificate of insurance and the vehicle registration must be maintained in each vehicle.
(5) The provider must have a written plan for regularly scheduled maintenance and safety inspection for the vehicles in service and must document compliance with the plan.
(6) The provider must assure that each vehicle is inspected every twelve months by a certified mechanic, the highway patrol safety inspection unit, or the Ohio medical transportation board, and is certified to be safe. The inspections must include the elements listed in appendix A of this rule.
(7) Vehicles equipped for transporting a passenger who remains in a wheelchair must be equipped with permanently installed floor wheelchair restraints for each wheelchair position used. Providers must inspect their vehicles for compliance with the items listed in appendix B on a daily basis.
(8) The provider must document and maintain a record of each service related consumer contact and each service delivered, including date of contact, type of contact and name(s) of person(s) having contact with the consumer. The provider must maintain documentation for each episode of service that includes a description of the service provided, the date and time of consumer pick-up and delivery, the name and signature of the driver, and name and signature of the consumer to whom transportation services were provided.
(D) Providers must assure that drivers:
(1) Maintain a safety checklist that includes items listed in appendix C of this rule that must be completed by the driver prior to transporting consumer(s) and/or travel attendant(s);
(2) Maintain service logs or trip sheets daily that include the date of service, the consumer’s name, the pick-up point and destination point for each consumer, and the driver’s and consumer’s signatures. An exception to the requirement for consumer signature is allowed for ADS transportation providers who may use the consumer’s signature for attendance in ADS services that includes transportation to and from ADS; and,
(3) Assist in transfer of the consumer, as necessary, safely from the consumer’s door to the vehicle and from the vehicle to the entrance of the destination point. The provider must perform the same transfer assist service when transporting the consumer back to the consumer’s residence;
(E) The provider must assure and document that prior to transporting consumers, each driver meets all of the following requirements:
(1) A current and valid driver’s license with fewer than six points against the driver issued under Chapters 4506. or 4507. of the Revised Code, or their equivalent, if the operator is a resident of another state;
(2) A valid copy of a signed statement from a licensed physician acting within the scope of the physician’s practice declaring that the applicant does not have a medical or physical condition, including vision impairment, that cannot be corrected and could interfere with safe driving, passenger assistance, and emergency treatment activity, or could jeopardize the health and welfare of a client or the general public.
(3) The results of a chemical test or tests of the driver’s blood, breath, or urine conducted at a hospital or other laboratory licensed by the Ohio Department of Health for the purpose of determining the alcohol or drug content of the applicant’s blood, breath and/or urine;
(4) A certificate of completion of a training course in first aid and cardio-pulmonary resuscitation (CPR) offered by the American red cross, the American heart association, the national safety council, or an equivalent course approved by the Ohio department of aging;
(5) A course of instruction in consumer assistance and transfer techniques, lift operation and how to properly secure a wheelchair, if applicable, prior to transporting consumers;
(6) At least two years of licensed driving experience; and,
(7) The driver has the ability to understand written and oral instructions and document services delivered.
(F)
(1) The provider must assure and document that each driver obtains the following:
(a) A certificate of completion of an introductory defensive driving course sponsored or endorsed by the national safety council or the Ohio department of transportation, and completion of a four hour refresher course every three years thereafter.
(b) A certificate of completion of an introductory training course approved by ODA, addressing the transport of older persons and people with disabilities, and a refresher course every three years thereafter, both of which must include:
(i) Sensitivity to aging training;
(ii) An overview of diseases and functional factors commonly affecting older adults;
(iii) Environmental considerations affecting passengers;
(iv) Instruction in consumer assistance and transfer techniques;
(v) Training on the management of wheelchairs, and how to properly secure a wheelchair;
(vi) The inspection and operation of wheelchair lifts and other assistive equipment; and,
(vii) Emergency procedures.
(2) The certificates of completion to which this rule applies must be received as follows:
(a) For all new drivers, the certificates of completion must be for training received by the driver within the first six months following the date on which the driver is hired or retained by the provider.
(b) For all drivers hired or retained by a provider prior to the effective date of this rule, the certificates of completion must be obtained for training received in the first six months following the effective date of this rule, unless the provider can verify that the driver successfully completed the required training at some time within the three year period immediately preceding the adoption of this rule. Drivers who successfully completed one or both of the introductory training courses required by this rule within the three years immediately preceding the adoption of this rule shall be deemed to have complied with the requirement for the introductory training course(s) for which the training was received, and will only be required to complete the required refresher course(s) every three years after the date the certificate(s) of completion was received.
(G) ODA and its designee must deem those vehicles licensed as ambulettes by the Ohio medical transportation board as complying with paragraph (C) of this rule.
(H) ODA and its designee must deem those drivers employed as drivers of urban or rural transit systems as meeting the requirements in paragraph (E) of this rule.
APPENDIX A
Required Annual Inspection Elements for vehicles equipped to concurrently transport five or more participants.
A. Seating
1. All seats must be securely fastened to the floor.
2. No broken tubing or protruding pieces of metal should be around seats.
B. Defrosters & Heaters
1. Must operate as designed.
2. Heater cores must be clean and free of leaks and obstructions to the flow of air.
3. Hoses must not have cracks or leaks and must otherwise be in good condition.
4. Fan guards must be metal or plastic.
C. Windshield Wipers/Washers
1. Must operate as designed.
2. Wiper blades in the vehicle operator’s field of vision must be clean.
3. Wiper blades must not be brittle or badly worn.
D. The Floor Must Be Metal and Intact Without Holes
E. Mirrors
1. Must have at least one rear view interior mirror that is properly secured and in proper placement.
2. Must have at least one mirror on each side of the vehicle that is properly secured and in proper placement.
3.Prismatic lens must be properly installed.
4. All mirrors must enable vehicle operators to see a clean image (i.e., without cloudiness, cracks, or other obstacles on the mirror to interfere with reflection).
F. Emergency Equipment
1. Three red reflectors must be stored in the vehicle.
2. The vehicle must have a five pound dry chemical fire extinguisher with the minimum rating outlined in section 20.b.c. of the Ohio fire code and based on section 10 of the National Fire Protection Association. The fire extinguishers must be securely mounted near the vehicle operator for easy access.
3. The vehicle must be equipped with a first aid kit.
G. Brakes
1. Properly located and free of crimps, rust, breaks in integrity, and not in contact with inappropriate vehicle components.
2. Tail exhaust pipes are properly secured to prevent dropping on brake lines.
3. Vehicles using vacuum-assisted brakes: wheel cylinders, master cylinders, hydrovac, and hose connections must be free of fluid leaks.
4. Vehicles using air brakes: reservoirs, chambers, valves, connections, and lines must be free of air leaks.
5. During inspections, brake pads must be checked against the vehicle manufacturer’s specifications.
6. All moisture ejection valves must be free of leaks and in proper working order.
H. Emergency Brake
1. The vehicle must have a functional emergency brake that is capable of stopping or holding the vehicle in an emergency or while parked. The emergency brake shall hold the vehicle on any grade and under all conditions of loading on a surface free of snow, ice, or loose material.
2. If the emergency brake is located on the drive shaft, the brakes shall:
a. Hold the vehicle in parked position;
b. Be properly mounted; and
c. Have cables that are properly lubricated and not hazardously worn.
I. Steering Gear
1. The steering shaft must have no more than one half-inch upward motion when the steering wheel is pulled upwards.
2. The steering gear assembly, power steering unit, brackets, and mounting bolts must be securely fastened.
3. If installed, power steering must be operative, properly mounted, and have correct fluid levels and belt tensions.
4. Tie rod ends must function properly.
5. Tires must not rub any chassis or body component in any position.
J. The Horn Must Operate As Designed
K. Windshield/Windows
1. Window glass must be free of chips or cracks and be securely mounted without exposed edges.
2. Plexiglas may not be used to replace safety glass.
L. Emergency Door (Applicable to Bus-Type Vehicles)
1. The door must be able to open to its maximum width without catching or binding.
2. All handles must be permanently installed.
3. Operating instructions for the emergency door must be lettered or decaled inside the emergency door.
4. The safety buzzer must operate as designed, and be placed in the vehicles operator’s area to warn passengers that the emergency door is opened..
5. The door must be free of temporary or permanent obstructions.
6. No padlocks or other added security devises are to be used to secure the door while the vehicle is in motion.
M. Springs/Shocks Must Be Intact and Properly Mounted
N. Tires
1. Must have no less than two sixteenth inch tread pattern measured anywhere on the tire.
2. Retread tires should not be located on the steering axle.
3. Must be free of irregular wear, cuts, bruises, and breaks.
4. Must be balanced and in proper alignment.
5. All lugs must be present and fitted tightly on tires.
6. All tread types must match mated tires.
O. Exhaust System
1. Must be intact and operating as designed.
2. All pipe and muffler joints must be properly welded or clamped.
3. Exhaust manifolds must be free of cracks and missing bolts.
P. Lights must operate as designed and meet ORC and OAC requirements for vehicle lighting.
Q. The vehicle body condition must be intact and free of broken parts that can cause injury.
R. Gas Tank Must
1. Be free of rust/damage and /or leaks.
2. Be securely mounted.
S. The seating area and aisle must be free of debris.
APPENDIX B
Required Daily Wheelchair Lift Inspection Elements
For each day services are provided, providers must complete and document an inspection of the wheelchair lift prior to any participant service that day according to these specifications:
1. Run the lift through one complete cycle to be sure that it is operable.
2. Check for any signs of seal leaking or binding or hardware.
3. Check for frayed or damaged lift cables, hydraulic hoses, or chains.
4. Check for physical damage and jerky operation.
5. Check for hazardous protrusions and exposed edges. Assure that all protrusions are adequately padded and protected.
6. Check all fasteners and assure that all bolts are snug.
7. Make sure the lift is properly secured to the vehicle when stored.
8. Clean the lift completely of dirt, mud, gravel, and corrosive elements such as salt.
9. Lubricate the lift in compliance with the manufacturer’s requirements.
10. Providers shall not use the lift any time repairs are necessary.
APPENDIX C
REQUIRED VEHICLE SAFETY CHECKLIST ELEMENTS
Vehicle ID: Odometer: Date:
Interior:
Clean Appearance
Seats (tears, loose armrests, etc.)
Seat Belts
Wheelchair Restraints
Wheelchair Lift Ramp (good condition & secure)
Cargo Barriers (secure & in place)
Floor Coverings (safe & clean)
Electrical/Mechanical:
Brakes
Heater/Air Conditioning/Defroster
Horn
Gauges (oil, fuel, temperature, etc.)
Two-way communication device
Windshield wipers & washers
Jack & tire tools
Emergency Brake
Lights:
Headlights: high & low beams
Tail Lights, Marker Lights
Brake Lights
Turn Signals (front and rear)
Backup Lights
4-Way Hazard (front and rear)
License Plate Light
Interior Lights
Exterior:
No Body Damages
Clean Appearance
Mirrors (Adjusted and Clean)
Windows (Clean)
Doors (Operable In/Outside
Door Locks (Operable)
Winter:
Shovel
Non-Corrosive Traction Material (Sand or clay litter)
Blankets
Fluids:
Engine Oil
Brake Fluid
Engine Coolant
Power Steering*
Automatic Transmission*
Fuel
Windshield Washer
Battery
Belts & Hoses:
Fan
Alternator
Heater Hose
Radiator
No Leaks under Vehicle
Tires:
Inflation
Wear
Sidewall or Tread
Damage
Spare
Emergency Equipment Available:
Biohazard Kit
First Aid Kit
Flares or Reflector Triangles
Fire Extinguisher
*Must Be Checked At Operating Temperature
Effective: 03/31/2006
R.C. 119.032 review dates: 10/15/2010
Promulgated Under: 119.03
Statutory Authority: 173.02, 173.391
Rule Amplifies: 173.39, 173.391