173-39-02.13 Non-emergency medical transportation service.

(A) “Non-emergency medical transportation service” means a service that transports a consumer from one place to another for a non-emergency medical purpose through the use of a provider’s vehicle and driver. Examples of places to which the service may transport a consumer are a doctor’s office or a pharmacy. (This service is different than the non-medical transportation service defined in rule 173-39-02.18 of the Administrative Code, which transports a consumer from one place to another for a non-medical purpose.)

(B) Eligibility criteria: A consumer is eligible for a non-emergency medical transportation service if:

(1) The consumer is enrolled in the PASSPORT program;

(2) A case manager authorizes the service;

(3) The service is not otherwise available or funded by Ohio’s medicaid program (i.e., the “Medicaid card”) or another source; and,

(4) The consumer’s family, neighbors, friends, or community agencies are unwilling or not required to provide the service to the consumer free of charge.

(1) In general:

(a) Type of provider: Only an agency provider or non-agency provider who is certified under rule 173-39-02 of the Administrative Code may provide the service. A consumer-directed individual provider shall not provide the service.

(b) Availability: The agency provider shall possess a back-up plan for providing the service when a driver or vehicle is unavailable. A non-agency provider shall possess a back-up plan for providing the service when he/she or his/her vehicle is unavailable.

(c) To and from vehicle: As part of each service provided, the driver shall help the consumer to safely transfer between the pick-up point and the vehicle, to safely enter and exit the vehicle, and to safely transfer between the vehicle and the destination point.

(d) Records: As part of each service provided, the driver shall document the consumer’s name; the pick-up point and the date and time of the pick up; the destination point and the date and time of the drop off; the consumer’s signature, the driver’s name, and the driver’s signature.

(2) Vehicle inspections:

(a) The provider shall create a written plan for preventive maintenance and inspection of each vehicle and wheelchair lift used for this service which shall include the recommended preventive-maintenance schedule of the vehicle or wheelchair lift and the:

(i) “Annual Vehicle Inspection” on form ODA0004 (http://www.aging.ohio.gov/information/rules/forms.aspx): The provider shall only use a vehicle for the service if a mechanic who is certified by the national institute for automotive service excellence (i.e., “ASE-certified”) or another mechanic approved by the PAA inspected it no more than twelve months beforehand and the answers to all questions on the form were “yes”; and,

(ii) “Pre-Trip Vehicle Inspection” on form ODA0008 (http://www.aging.ohio.gov/information/rules/forms.aspx): The provider shall only use a vehicle if, before providing the first service of the day, the driver inspected it and the answers to all questions required by the form were “yes.”

(b) The provider shall deem that a vehicle that holds a current, valid license from the Ohio medical transportation board to operate as an ambulette is a vehicle that complies with paragraph (C)(2)(a)(i) of this rule.

(3) Driver qualifications:

(a) Before providing the first service, the driver shall:

(i) Hold a current, valid driver’s license for at least two years, hold any driver’s license endorsement that is necessary to operate the type of vehicle used for the service, and have fewer than six points issued under Chapter 4506. or 4507. of the Revised Code (or have points issued under statutes of the driver’s home state that are substantially equivalent to six points issued under Chapter 4506. or 4507. of the Revised Code if the driver is a resident of another state);

(ii) Obtain a signed statement from a licensed physician acting within the scope of the physician’s practice that states that the driver has no medical or physical condition, including an incurable vision impairment, that may impair safe driving, passenger assistance, emergency treatment, or the health and welfare of a consumer or the general public;

(iii) Pass drug and alcohol tests. The drug tests check for the use or abuse of amphetamines, cannabinoids (THC), cocaine, opiates, and phencyclidine (PCP). The driver receives a passing score if the drug tests do not find the drugs in his/her blood, breath, or urine. The alcohol tests check blood-alcohol content. The driver receives a passing score if the alcohol tests do not find a blood-alcohol content in the driver’s blood that is higher than Ohio’s maximum blood-alcohol content. The driver shall obtain the drug and alcohol tests from a hospital or another entity that the Ohio department of health permits to conduct the tests;

(iv) Pass a training course in first aid and CPR offered by the American red cross, the American heart association, the national safety council, medic first aid international, American safety and health institute, or an equivalent organization approved by ODA;

(v) Possess the ability to understand written and oral instructions;

(vi) Possess the ability to comply with paragraph (C)(1)(c) of this rule; and,

(vii) Possess the ability to comply with the documentation requirement and the “Pre-Trip Vehicle Inspection” requirement under paragraphs (C)(1)(d) and (C)(2)(a)(ii) of this rule.

(b) No later than six months after a driver provides his/her service or no later than six months after the effective date of this rule, whichever occurs later, the driver shall:

(i) Complete a defensive-driving course sponsored or endorsed by the national safety council or the Ohio department of transportation. The driver shall also complete a defensive-driving course every three years thereafter; and,

(ii) Complete an introductory course approved by ODA on passenger-assistance training that includes the following topics:

(a) Sensitivity to aging;

(b) Overview of diseases and functional factors commonly affecting older adults;

(c) Environmental considerations affecting consumers;

(d) Consumer assistance and transfer techniques;

(e) Management of a wheelchair, including the proper methods for securing a wheelchair;

(f) Inspection and operation of a wheelchair lift and other types of assistive equipment; and,

(g) Emergency procedures.

(i) Any driver for an urban or rural transit system is deemed to comply with paragraph (C)(3)(a) of this rule.

(ii) Any driver who successfully passed the defensive-driving course required under paragraph (C)(3)(b)(i) of this rule no more than three years before the effective date of this rule is deemed to comply with paragraph (C)(3)(b)(i) of this rule. (For example, a driver for an urban or rural transit system may have recently completed a defensive-driving course in order to qualify for his/her job. Therefore, he/she is not required to take another defensive-driving course before transporting a consumer under this rule. He/she is only required to complete a defensive-driving course every three years after the date he/she most recently passed a defensive-driving course.)

(iii) Any driver who successfully passed the introductory course required under paragraph (C)(3)(b)(ii) of this rule no more than three years before the effective date of this rule is deemed to comply with paragraph (C)(3)(b)(ii) of this rule. (For example, a driver for an urban or rural transit system may have recently completed the introductory course in order to qualify for his/her job. Therefore, he/she is not required to take another introductory course on transporting older persons and people with disabilities before transporting a consumer under this rule. He/she is only required to complete the refresher course every three years after the date he/she most recently passed the introductory course.)

(d) The provider shall maintain documentation on the compliance of each driver (or the non-agency provider shall maintain documentation on his/her compliance) with the driver qualifications in paragraph (C)(3) of this rule.

(D) Rates:

(1) One trip, whether a one-way trip or a round trip, constitutes one job of non-emergency medical transportation service.

(2) The per-job rate for a service is negotiable, but is finalized by the consumer’s case manager before the provision of the service. A finalized rate is renegotiable if the case manager revises the rate before the service is provided.

(3) The maximum rates allowable for a one-way trip and a round trip are listed in rule 5101:3-1-06.1 of the Administrative Code.

Effective: 09/24/2009

R.C. 119.032 review dates: 07/10/2009 and 08/31/2013

Promulgated Under: 119.03

Statutory Authority: 173.02, 173.391

Rule Amplifies: 173.39, 173.391

Prior Effective Dates: 03/31/2006, 02/15/2009