Greater Baltimore HIV Health Services Planning Council

Transcription

1 Greater Baltimore HIV Health Services Planning Council Service Category Standards of Care Medical Transportation Originated Revised Ratified September 1997 August 1999 August 1999 September 2000 September 2000 June 2010 October 2010 November Service Definition Medical transportation services enable an eligible individual to access HIV-related health and support services, including services needed to maintain the client in HIV medical care through direct transportation services, tokens, or vouchers. Services may include contracts with providers of transportation services, use of volunteer drivers (through programs with insurance and other liability issues specifically addressed), and purchase or lease of organizational vehicles for client transportation programs, provided the grantee receives prior approval for the purchase of a vehicle. (HRSA, 2013) are conveyance services provided, directly or through a voucher, to a client so that he or she may access health care services. Medical transportation is classified as a support service and is used to provide transportation for eligible Ryan White HIV/AIDS Program clients to core medical services and support services. Medical transportation must be reported as a support service in all cases, regardless of whether the client is transported to a medical core service or to a support services. 1 As used herein, the term client is interchangeable with the terms patient and service consumer, and the term agency is interchangeable with the term provider. Note: Within these standards there is mention to indirect transportation, in which providers, such as case managers, use vouchers to hire a taxi, ambulance, or other commercial transportation provided on behalf of clients, or furnish clients with tokens or passes for public transportation. At provider discretion, where appropriate and where other transportation is unavailable, medical transportation services may include transportation to planning council and related committee meetings 1.1. Key Services (Direct Transportation Services) Transportation can be provided through: 1 Department of Health and Human Services, Health Resources and Services Administration (HRSA0, HIV/AIDS Bureau Ryan White HIV/AIDS Treatment Modernization Act of 2006 Definitions for Eligible Services. Rockville, Md.: HRSA HAB, August InterGroup Services, Inc. for the Greater Baltimore HIV Health Services Planning Council 1

2 Provision of transportation services: taxi, sedan, or van; by an agency approved by the Maryland Public Service Commission Allocation of funding to support purchase or lease of organizational vehicles used solely for the provision of allowable transportation services Key Services (Indirect Transportation Services) Transportation can be provided through: Monthly mass transit passes Daily mass transit passes or single-use tokens Taxi vouchers. 2. Service Standards of Care The following are minimum standards for the provision of these services. Agencies and individuals may exceed these standards Baseline Evaluation Eligibility Agencies shall, upon intake, document in the client s chart proof of HIV status, including but not limited to: a diagnosis note signed by a physician; an HIV-positive Western Blot or IFA result with client s name; or a copy of a viral load test with client s name. Agencies also shall, upon intake and biannually thereafter, document in the client s chart all of the following with regard to client eligibility: Proof that the client resides in the Baltimore EMA, including but not limited to: (1) a copy of a signed lease with client s name and address; (2) a copy of a current or previous month s utility bill or rent receipt with client s name and address; (3) a copy of an SSI award letter with client s name and address; (4) a notarized letter from a friend or family member, naming the client and attesting to his or her address; or (5) a support letter on official letterhead from a shelter, recovery house, transitional housing facility, or other similar housing facility Proof of annual income that is no more than 300 percent of the federal poverty level, including but not limited to: (1) a copy of a current pay stub with the client s name; (2) a copy of the client s most recent W-2 form; (3) a copy of the client s SSI award letter; (4) a signed, notarized letter of support from someone providing the client with financial support; or (5) documentation of active Medicaid benefits, such as the client s Managed Care Organizations (MCO) card An assessment by the intake staff of the client s third-party payer capacity, including but not limited to: (1) a copy of the client s insurance card; or (2) documentation, with initials/signature, that provider staff have checked the InterGroup Services, Inc. for the Greater Baltimore HIV Health Services Planning Council 2

3 InterGroup Services, Inc. for the Greater Baltimore HIV Health Services Planning Council 3 client s status in the Eligibility Verification System (EVS) of the State of Maryland. For Medicaid-billable services only: Alternatively: Documentation, with initials/signature, that provider staff has checked the client s status in the Eligibility Verification System (EVS) of the State of Maryland In the case of a referral, a signed eligibility form on the referring agency s letterhead attesting to the client s HIV status and eligibility under items (as applicable). Biannual documentation of items (as applicable) is still required, although this requirement also can be satisfied with an updated eligibility form on the referring agency s letterhead Assessment This service category involves the subsidizing of clients use of public or other transportation, principally by the following means that is the most cost effective to the provider: Plan Monthly mass transit passes, for use: (1) where mass transit systems exist; or (2) by clients who have multiple appointments with several different providers during a short period of time and for whom the scheduling of multiple taxi rides in short succession would not be practical. Where applicable, consumers who appear to qualify for a MTA Reduced Fare Disability ID card should be assisted by their health care professional with completing and submitting an application through the Maryland Transportation Authority for approval Daily mass transit passes or multi-use fare cards, which are used for clients that have several stops to make during any one day Mass transit tokens, multi-use, or single-use fare cards, for use: (1) when the client is going only to single destinations; or (2) when the providing agency determines that the client s eligible trips are not of such frequency as to merit a monthly bus pass Taxi vouchers, for use: (1) when the client is not physically capable of utilizing mass transit systems; or (2) when the client s destination is not on a mass transit route. 3. Administrative Standards of Care This section describes the agency s minimum administrative requirements. Agencies and individuals may exceed these standards.

4 3.1. Licensing, Knowledge, Skills and Experience (Direct Transportation Services) Agencies shall document in either employee/volunteer records or agency policies, as appropriate the following staffing procedures: Van Services A copy of their current driver s license Evidence of current automobile insurance coverage A copy of Maryland Motor Vehicle Administration driving record of all drivers, that is no more than two-years old, showing no more than four points over the past three years Documentation that the vehicle is serviced, according to applicable standards from the licensing agency, and has passed any required safety inspections for vehicles that convey commercial passengers The agency is licensed or approved for operation by the Maryland Public Service Commission and has a copy of its charter to operate Vehicles are routinely serviced and inspected in compliance with standards that apply to commercial vehicles used to convey disabled persons Program staff will possess the knowledge, skills, and experience necessary to competently deliver expected services The agency must show evidence that drivers can read regional maps The agency must show evidence that drivers receive training and are knowledgeable regarding HIV/AIDS The agency must document that agency drivers have successfully completed a defensive driver s course The agency must document if any drivers have completed CPR (cardiopulmonary resuscitation) and/or first aid courses Licensing, Knowledge, Skills and Experience (Indirect Transportation Services) Agencies must have procedures and a secure location for storage of mass transit passes, tokens, and taxi vouchers Staff authorized to issue passes, tokens, or taxi vouchers must be fully trained in the security procedures within the agency The agency must provide on-going supervision appropriate to the professional level of the staff providing transportation assistance Staff must be fully trained regarding the documentation needed to account for disbursed passes, tokens, and vouchers as well as client eligibility and assessment processes The agency must show evidence that staff is knowledgeable about HIV/AIDS, at a minimum through in-service training. InterGroup Services, Inc. for the Greater Baltimore HIV Health Services Planning Council 4

5 The agency must show evidence that in-service staff development is available and that staff have opportunities to attend other professional development training or seminars related to HIV/AIDS services Client Rights and Confidentiality Agencies shall document in the client s chart that the client has been provided with the following items regarding client rights and confidentiality. The agency s documentation must include the signature of the client (or person designated as medically responsible for the client), indicating that the documents have been received and explained A list of the Ryan White Part A services available through this agency A list of the categories of Ryan White Part A services available in the EMA The agency s referral process, which shall explain how referrals to other providers are made The agency s procedures for: intake, transfer, and discharge of clients; scheduling appointments; and managing waiting lists (if applicable), including a plan to regularly communicate with clients on the wait list A complete care/action plan, to be entered in the client chart within one week after the initial case conference and except in extenuating circumstances, with written justification no later than one month after services commence The agency s policy on the confidentiality of client information, which shall comply with HIPAA regulations The agency s policy on the security of client records, including but not limited to: how staff access to records is restricted (such as by secured areas, locked filing cabinets, or password protection) and how electronic records are backed up The agency s policies regarding client consent for requesting or releasing information A schedule of hours of operation, including a list of holidays on which the agency will be closed; the procedures for notifying clients of unscheduled closings, such as for inclement weather; and the procedures for after-hours emergencies The agency s fee structures The process by which clients may file a grievance Statement of patient s rights and responsibilities Agency expectations of clients, including the circumstances under which client services will be terminated, such as (1) for client s deviation from the care plan or failure to uphold patient responsibilities; (2) at the patient s request; or (3) when the agency determines that the services being provided are no longer appropriate Information for accessing the agency s community advisory board (CAB). InterGroup Services, Inc. for the Greater Baltimore HIV Health Services Planning Council 5

6 3.4. Access, Care and Provider Continuity Agencies shall document the following items regarding access to and continuity of care: The referring agency has a care/action plan that includes an end date for delivery of direct transportation services (copy placed in the transportation agency s client chart) Procedures for referrals to other agencies, including follow-up procedures (described in an agency policy) Agency Responsibilities Agencies shall document the following regarding adherence to certain administrative and/or service standards: The agency has researched and obtained all applicable licenses and/or certifications required to provide transportation services and (1) displays them (as applicable); or (2) produces them upon request by the oversight agency. All such licenses and certifications must be current The agency has an active community advisory board (CAB) with majority representation from clients receiving services, as documented by quarterly meeting minutes The agency makes complete and timely data and narrative reports as required Agency staff is linguistically and culturally competent for the populations served The agency acquires all required eligibility documentation (see section 2.1.1) before providing services, or in the case of a documented emergency, following the provision of temporary services The agency has a formal policy regarding the establishment of linkages with other agencies, maintains copies of all linkage agreements, and maintains a list of agencies with which it has linkage agreements Quality Assurance Agencies must participate in Clinical Quality Management (CQM) Program assessments and in CQM-provided/sponsored technical assistance and capacity-building sessions addressing categories of care for which the agency is funded. In addition, agencies shall document in client charts or agency policies or records, as appropriate the following quality-assurance items: A plan designed to monitor both appropriateness and effectiveness of all services provided, as well as to identify areas for improvement and document improvement efforts The most recent site-visit report issued by the Grantee For any deficiencies identified in the Grantee s site visit report, a written correctiveaction plan including implementation and evaluation activities. InterGroup Services, Inc. for the Greater Baltimore HIV Health Services Planning Council 6

7 For any deficiencies identified by fiscal and program monitoring by the Grantee, a written corrective-action plan including implementation and evaluation activities For any deficiencies identified by CQM vendor reports, documentation that written corrective-action plans addressing improvement options and activities have been forwarded to the CQM office Participation in the Grantee s annual client satisfaction survey 4. Summary 5. Recommendations Not applicable 6. References 7. Appendices InterGroup Services, Inc. for the Greater Baltimore HIV Health Services Planning Council 7