HRSA Definition: Conveyance services provided, directly or through voucher, to a client so that he or she may access health care services.

ORLANDO EMA HIV/AIDS RYAN WHITE PART A PROGRAM MEDICAL TRANSPORTATION Services STANDARDS OF CARE HRSA Definition: Conveyance services provided, directly or through voucher, to a client so that he or she may access health care services. Orlando EMA s Definition: Medical Transportation & Dispatching services include conveyance services provided, directly or through bus passes, to a consumer so that he or she may access core and support services. Transportation services are not provided in emergency situations in which 911 emergency services would be normally used. Transportation Services provided by the Orlando EMA include: A. Dispatching services, which, according to the Federal Transit Administration (FTA) Mobility Management practices, include: brokering, facilitating, encouraging, coordinating and managing both traditional and non-traditional transportation service to expand the array of transportation services to diverse consumer groups. B. Supporting and expanding transportation services that enhance the ability of people with HIV/AIDS to obtain health and support services (e.g. transporting affected children with the infected caregiver). C. Providing urgent transportation to assure timely access to needed HIV Health related services to low income and/or physically disabled residents of the EMA, who have HIV-related illnesses or AIDS. D. Offering transportation through available bus passes, van, or taxi. E. Making special consideration for HIV/AIDS-disabled consumers needing assistance in navigating stairs, getting in/out of vehicles and folding wheelchairs. F. Making services available and accessible 24 hours a day 7 days a week and access shall be made available for urgent medical, pre-op appointments, or out of town medical appointments. Page 1 of 8

The Orlando EMA recognizes the need for coordinated human services transportation dispatch services that eliminates duplication of services and maximizes resources, while ensuring quality transportation services. In the Orlando EMA Dispatch service is designed as the communication hub (link) for transportation services provided to PLWH/A within the four counties (Lake, Seminole, Osceola and Orange Counties). Dispatch is a method for identifying and engaging resources and managing them effectively. Transportation Dispatch services include: 1. The provision of efficient transportation throughout the use of a dispatch system. 2. Availability and accessibility for eligible individuals in need of transportation in all four counties (Lake, Orange, Osceola and Seminole Counties). Mode of availability shall be determined by the dispatch provider. 3. Availability of services through a toll free number in all four counties. 4. Identifying consumer needs from a centralized intake point and assigning the appropriate transportation service. Coordination includes: Determining eligibility and managing referral documents Scheduling, assigning confirmation numbers and verifying reservations 5. Dispatch management should be marked by a strong consumer focus and recognizes that different transportation options may be necessary for different trips. 6. Dispatch agency shall be available to consumers 24 hours a day 7 days a week. Reservations shall be scheduled during normal business hours. An afterhours toll free number shall be made available for special medical circumstances or need. 7. The Dispatch Agency shall provide on time Quality Assurance monitoring during transport service to assure timely pick-up, arrival at facility and return ride home for all consumer transport services. 8. The Dispatch Agency shall provide weekly survey calls to follow up on services provided to at least 10% of consumers to verify that services were rendered as requested while meeting consumer s needs. Eligibility: Consumers accessing transportation must meet eligibility standards as described in the system wide Standard of Care. Page 2 of 8

Prioritized Transportation Services Standard #1 Transportation services shall be provided according to prioritized services as approved by the Orlando EMA, 1.1 1.1 Ryan White is the Payer of last resort and as Documentation in the consumer file: such Transportation Services shall be provided only to consumers who can demonstrate that all other non-ryan White transportation service alternative have been exhausted Documentation that the Consumer has exhausted alternative means of obtaining transportation services. (e.g. Denial of Medicaid or Medicare). including Medicaid, Medicare and Access a. Access Lynx application and/or signed Lynx. statement confirming application was denied b. Letter from Access Lynx describing eligibility status of the consumer. 1.2 1.2 A bus pass is the first choice of conveyance for Documentation in consumer files of consumers accessing Ryan White eligibility, record of scheduled appointment Transportation. Consumers must demonstrate and/or completed eligibility verification form having at least two core medical or support and documentation should reflect the type of service appointments in order to receive a bus medical and/or support service appointment pass. Bus passes shall be issued per the Ryan for each authorized trip (bus pass/taxi/van). White Bus Pass guideline. Bus passes shall be issued to provide transportation to core and support services which may include medical appointments, eligibility appointments, pharmacy, case management and other support services Page 3 of 8

1.3 1.3 Van rides may be provided for consumers to Documentation of purpose, location and access core medical care or related support reason of trip reflecting core medical services based on documented medical service or related support service that necessity.(refer to Guidelines) cannot be otherwise facilitated by alternate means of transportation. (e.g. bus). Annotated by provider in CAREWare 1.4 1.4 Taxi rides may be used for urgent situations in Documentation of the necessity to utilize a which less than 48 hours notification has been taxi and the purpose and distance of trip. provided by the consumer, or if determined to be more cost efficient or expedient than van rides. Record Review Employment Requirements Standard #2 The Dispatch agency or other selected service providers must ensure the following employment requirements are met. 2.1 2.1 Physical examination must be performed prior Documentation on file of completed Personnel record review to employment and at least annually thereafter. satisfactory physical exam by the conveyance or dispatch employee. 2.2 2.2 Page 4 of 8

Use of certified approved laboratory facility for Personnel record review pre-employment, random, and post-accident drug urine screenings is required. Use of certified approved laboratory facility for pre-employment, random, and post-accident drug urine screenings is required. 2.3 2.3 Department of Motor Vehicles driver s license DMV report on file reflecting that the check with no more than 6 points in a threeyear period checked quarterly. No reckless inclusion. employee met the criteria outlined in 2.3 for driving convictions or driving under the influence of drugs or alcohol allowed regardless of the conviction date. 2.4 2.4 Photocopy of the employee s valid Florida Documentation on file of the employee s driver s license. driver s license. Personnel record review Personnel record review Random review of drivers to ensure identification is properly displayed. 2.5 2.5 Drivers will complete the following training Documentation of training that reflects the within 90 days of hire: minimum requirements in 2.5. A. Passenger Assistance Training (P.A.T.), or equivalent training to ensure staff learns the safe and proper techniques for assisting a consumer in and out of the vehicle, for loading and securing a wheelchair-bound consumer, and for assisting visually impaired consumers, B. A 4 hour Defensive Driving Training Transportation Agency record review Page 5 of 8

Course (D.D.T.C.), including a road test at the end of class, to ensure staff learns to employ safe defensive driving techniques, C. Maintain C.P.R./AED and First Aid Basics Training certification (with appropriate updates), Review and acknowledgement of current OSHA Handbook and US Public Health Service Guidelines. Quality Management Standard #3 The Transportation/Central Dispatch Provider must ensure courteous door-to-door service. 3.1 3.1 Reservations shall be scheduled during normal business hours. An after-hours toll free number shall be made available for special medical circumstances or need. Drivers will be scheduled to make pickups at least one (1) hour prior to scheduled appointment. For trips requiring special scheduling, arrangements will be made by provider based on travel distance and/or special circumstances. Return trips will be scheduled based upon routing priority at completion of appointment. Return pickups will be made Documentation of ride including pick up, arrival, and drop off time is annotated in a log and updated daily. Page 6 of 8

within one (1) hour of call; drivers anticipating longer wait times will need to contact dispatch and make alternate arrangements. Drivers will attempt to contact consumers to confirm appointments and pickup time at least 24 hours prior to scheduled appointment. For trips requiring special scheduling, arrangements will be based upon the provider s travel schedule and case-load. 3.2 3.2 Drivers shall immediately report any type of Documentation of incident report on file and incident or unusual occurrence to dispatcher faxed copy to grantees office at the time the and supervisor. report is made and documented. 3.3 3.3 Drivers are not permitted to transport a Documentation in trip log of the age of each passenger under the age of 18 years old consumer transported after verification on without adult escort, no exceptions. Drivers License. 3.4 3.4 Drivers are only permitted to transport a Documentation of transportation manifest passenger to the destination noted on his/her that will be provided as part of the monthly manifest unless dispatcher grants permission. report to the Grantee. 3.5 3.5 All drivers providing Ryan White Available upon request transportation services shall prominently display agency issued picture identification. Agency ID shall be worn at all time. Visual inspection Page 7 of 8

3.6 3.6 Providers shall insure that consumers accessing transportation services are provided a copy of the Ryan White Consumer s Transportation Service guidelines and the Accessing Ryan White Transportation Brochure. Signed receipt in consumer file that the consumer has received a copy of the RW guidelines and brochure. Page 8 of 8