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Medical Transportation
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HRSA/HAB Category Definition:
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Medical transportation services 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.
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
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Source: Definition provided by the U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA), HIV/AIDS Bureau (HAB). 2009. Ryan White HIV/AIDS Treatment Modernization Act of 2006 Definitions for Eligible Services. Rockville, Md.: HRSA HAB, August 20, 2009.
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Category Notes:
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Clarifications
The following definition clarification is a result of a conference call involving representatives of the grantee (BCHD), Greater Baltimore HIV Health Services Planning Council (PC), PC support office (IGS) and HRSA on May 28, 2008 (IGS 2008a).
• Transportation can be provided to access essential support services.
The following clarifications were distributed by HRSA on April 8, 2010 (HRSA 2010a).
Medical Transportation is an allowable support service under the Ryan White HIV/AIDS Program. Funds may be used to provide transportation services for an eligible individual to access HIV-related health services, including services needed to maintain the client in HIV/AIDS medical care. Transportation should be provided through:
• A contract(s) with a provider (s) of such services;
• Voucher or token systems;
• Mileage reimbursement that enables individuals to travel to needed medical or other support services may be supported with Ryan White HIV/AIDS Program funds, but should not in any case exceed the established rates for federal programs. Federal Joint Travel Regulations provide further guidance on this subject;
• Use of volunteer drivers (through programs with insurance and other liability issues specifically addressed); or
• Purchase or lease of organizational vehicles for client transportation programs. NOTE: Grantees must receive prior approval for the purchase of a vehicle.
Maintenance of Privately Owned Vehicles
Funds awarded under the Ryan White HIV/AIDS Program may not be used for direct maintenance expense (tires, repairs, etc.) of privately owned vehicle or any other costs associated with a vehicle such as lease or loan payments, insurance, or license and registration fees. This restriction does not apply to vehicles operated by organizations for program purposes.
Emergency Financial Assistance
Ryan White HIV/AIDS Program funds may be used to provide Emergency Financial Assistance (EFA) as an allowable support service.
The decision-makers deliberately and clearly must set priorities and delineate and monitor what part of the overall allocation for emergency assistance is obligated for transportation, food, essential utilities and /or prescription assistance. Careful monitoring of expenditures within a category of “emergency assistance” is necessary to assure that planned amounts for specific services are being implemented, and to indicate when reallocations may be necessary.
In addition, Grantees and planning councils/consortia must develop standard limitation on the provision of Ryan White HIV/AIDS Program funded emergency assistance to eligible individuals/households and mandate their consistent application by all contractors. It is expected that all other sources of funding in the community for emergency assistance will be effectively utilized and that any allocation of Ryan White HIV/AIDS Program funds to these purposes will be the payer-of-last-resort, and for limited amounts, limited use and limited periods of time.
The following clarification was provided to the grantee by HRSA on October 29, 2010 (Morgan 2010).
Medical transportation is defined as “conveyance services provided directly or through a vendor to a client so that he of she may access health care services”. Medical transportation must be reported as a support services in all cases, regardless of whether the client is transported to a medical core services or to a support service.
History
Medical transportation services are funded in EMA using both contracts with a transportation service and through the provision of tokens, taxi vouchers or bus passes.
Emergency transportation services, formerly tracked under the transportation line item of emergency financial assistance, are now tracked and reported under the medical transportation category.
Current Directives
Ongoing 2006: The administrative agent is to examine why funds have been returned in this essential service and make recommendations to PC for remedying. Ongoing monitoring to determine why funds are returned is STSC transportation (IGS 2011a).
Ongoing 2006: The administrative agent should have providers track and report on the modes of transportation used (e.g., tokens, bus passes, cabs, etc.) and on whether consumers kept appointments for which transportation was requested (IGS 2011a).
Ongoing 2006: The administrative agent is to break out and report costs and clients on the different modes of transportation, e.g., taxi, van, bus for FY 2006 executed service contracts and reported in the ESD narrative. Providers have been notified that they need to begin breaking out the different modes of transportation used in the EMA. A report will be given in July 2007 (IGS 2011a).
Ongoing 2006: The administrative agent is to break out and report separately transportation for primary medical care and transportation for other health and supportive services. Salaries were taken out of EFA under transportation. This directive is being incorporated now, and will be suspended next year (IGS 2011a).
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