Medical Transportation. Transportation To and From a Medical Facility or Provider

Transcription

1 Medical Transportation : Today Overview of Medical Transportation Today and the Important Role played by Medicaid Rex Knowlton, CCTM Coordination Ambassador Regions 3 & 8 Executive Director Wheels of Wellness

2 Medical Transportation Transportation To and From a Medical Facility or Provider

3 Components Non Emergency Medical Transportation-Overview Medicaid Public Transportation Answer to Medicaid Transportation? Current Means of Addressing Medicaid Transportation

4 Non Emergency Medical Transportation Overview Class Types Means Modes Limiting Factors

5 Class Invisible Performed Independently Part of the General Public Ridership Visible Funded through on of 11 Federal fund streams; 62 agencies Medicaid; Aging; Medicare

6 Types General Disease Specific Kidney Dialysis HIV Cancer Age Specific Medicare Economic Medicaid Health Related Physical Behavioral Mental Under the Radar of Any Specific Funding

7 Private Automobile Yours, Paid, or Volunteer Public Fixed Route Transit Public Paratransit ADA or Specialized Private Paratransit Community based fee or no fee Taxi Public Ambulance Community based fee or no fee Private Ambulance Means

8 Modes AMBULANCE AMBULATORY STRETCHER NON AMBULATORY PUBLIC TRANSPORTATION TAXI

9 Limiting Factors Degree of Assistance Required Door to Door vs. Curb to Curb Escorts Attendants Mobility Limitations Shedding

10 Medicaid Program Transportation Deficit Reduction Act of 2005 Challenges

11 Transportation: Definition Medical Transportation Transportation to any Medical Assistance reimbursable service for the purpose of receiving treatment, medical evaluations or purchasing prescription drugs or medical equipment.

12 Transportation: Assurance and Elements 42 CFR Section Assurance of Transportation means: A state plan must specify that the Medicaid agency will ensure necessary transportation for recipients to and from providers; and describe the methods that the agency will use to meet this requirement. Transportation includes: Expenses for transportation and other related travel costs determined to be necessary by the Medicaid agency to secure medical examinations and treatment for a recipients.

13 Program Title XIX of the Social Security Act Federal / State matching program Nationally, 14% of the population receives Medicaid assistance Medicaid services are provided annually to more than 38.5 million people at a cost of nearly $179 billion

14 Transportation: Extent of Program Medicaid Non-Emergency Transportation Funding Annually, Non-Emergency Medical Transportation (NEMT) provides more than 111 million trips at a cost of nearly $1.8 billion, for an average cost of $16 per trip 10% of Medicaid-eligible population uses NEMT services By 2010, Medicaid NEMT expenditures are projected to double

15 Deficit Reduction Act of 2005 Signed by President Bush February 8, 2006 States no longer required to obtain a Section 1915 (b) Waiver Can provide NEMT through a contracted broker Must select brokers through a competitive procurement process States must submit a State Plan Amendment

16 Challenges State based (50 Different Programs) Funding-reality of state budget pressures Eligibility Varies

17 Public Transportation Answer to Medicaid Transportation? COORDINATION OF EXISTING PROGRAMS CRITICAL SAFETEA LU ENCOURAGES UNITED WE RIDE

18 Coordination of Existing Programs Critical Confusing Array of Programs & Funding Medicaid Program Substance Abuse Mental Health Health Resources & Services Head Start Assistant Secretary Planning Evaluation Centers for Independent Living Rehabilitation Services Administration Office of Special Education Programs Office of Disability Employment Policy Development Disabilities HHS Temporary Assistance for Needy Families Aging Disability Rehab and Research Education Labor Child Care Bureau Community Services Family Assistance Office of the Secretary Children & Families Medicare & Medicaid Svcs Soc. Services Block Grant Federal Agencies & Grant $ ABC s Transit State Governors & Cabinet Secretaries Local Government Clayton School District Rural Transit Operators Ride Inc??? United Methodist Church Family Health Care Education Employment Shopping Employment Training Agency Medicaid Recreation Office of the Secretary Transportation Urbanized Grant Program Elderly & Disability Program Blue Top Taxi Independence National Highway Traffic Safety Administration Departmental Office of Civil Rights Federal Transit Administration Assistant Secretary for Transportation Policy Rural Grant Program Job Access Reverse Commute Program Metro Access Early Learning Center DART Easter Shows

19 SAFETEA-lu Encourages Coordinated Planning Locally Developed Self Assessment Tool Questions to Ask: Is there a mechanism for coordinating funding for cost-effective service delivery? Are local funding allocations based on demonstrated evidence of coordinated activities? Are there consistent cost reporting procedures across programs and agencies? Are human service transportation expenditures isolated from other program expenditures and easily identified? Is there a method for defining allocated transportation costs across programs and agencies?

20 Promotes SAFETEA-lu Encourages Promotes a seamless transportation system in which transportation modes are efficiently connected; Continues a major emphasis on improving public transportation Encourages private sector participation Continues Encourages Expands the sources of funds for the non-federal match to include amounts a grantee receives under a service agreement with a social service agency Expands

21 United We Ride Legislative Proposals Transportation Equity Act-21 Older American Act Workforce Investment Act

22 Current Means of Addressing Medicaid Transportation Regions 3 (Mid Atlantic) and 8 (Upper Midwest; West) Twelve States Five no coordination with PT; no brokerage One limited coordination with PT; no brokerage Two totally separate statewide system; statewide brokerage One totally separate statewide system; no brokerage Three local coordination; local or regional brokerage Fully coordinated statewide Medicaid integrated with PT Florida Emerging coordination of Medicaid with PT Texas

23 Today NMET a Major Opportunity