Current through March 20, 2024
Transportation service is transporting an eligible recipient
to and from allowable community resources when the recipient has no other
transportation. Service may be provided by an individual, exempt provider, or
by common carrier .
005.01
TRANSPORTATION DEFINITIONS. The following definitions
apply to Transportation services :
005.01(A)
COMMON CARRIER. Common carrier means any person who
transports passengers by motor vehicle for hire and is licensed as such with
the Public Service Commission.
005.01(B)
ESCORT
SERVICES. Escort Services means an attendant or caregiver
accompanying a minor or person who is physically, mentally, or developmentally
disabled and unable to travel or wait without assistance or
supervision.
005.01(C)
EXEMPT PROVIDER. An exempt provider means the carriers are
exempted from Public Service Commission licensure by law including those that:
(i) Transport for hire persons who are aged
and their spouses and dependents under a contract with a municipality or
county;
(ii) Are owned and operated
by a nonprofit organization which has been exempted from the payment of federal
income taxes as provided by Section 501(c)(4), Internal Revenue Code, and
transporting solely those persons over age 60, their spouses and dependents, or
persons experiencing disabilities;
(iii) Are operated by a municipality or
county as authorized by law in the transportation of persons who are
aged;
(iv) Are operated by a
governmental subdivision or a qualified public purpose organization having
motor vehicles with a seating capacity of 20 or less and are engaged in the
transportation of passengers in the state;
(v) Are operated by a governmental
subdivision or a qualified public purpose organization having motor vehicles
with a seating capacity of 20 or less and are engaged in the transportation of
passengers in the state;
(vi) Are
engaged in the transportation of passengers and are operated by a transit
authority created under and acting pursuant to the laws of the State of
Nebraska; and
(vii) Provide escort
services under contract with the Department or with any agency organized under
the Nebraska Community Aging Services Act.
005.01(D)
INDIVIDUAL
PROVIDER. An individual provider is a person who is not in the
business of providing transportation for hire for example, a friend, neighbor
or non-legally responsible relative.
005.01(E)
MEDICAL ESCORT.
A medical escort is an attendant or caregiver accompanying a minor
or persons who are physically, mentally, or developmentally disabled and unable
to travel or wait without assistance or supervision to receive a Nebraska
Medicaid coverable service.
005.01(F)
NEBRASKA MEDICAID
COVERED SERVICE. This is a medical service that could be covered
by the Nebraska Medical Assistance Program as specified in Nebraska
Administrative Code Title 471.
005.01(G)
TARIFF.
Tariff is the geographic and rate parameters of operation assigned to a
particular carrier by the Public Service Commission.
005.02
NEED FOR
SERVICE. Transportation services are not provided based on the
demand of the recipient. Need for a service implies that the provision of that
service will assist the recipient in achieving program outcomes. Eligible
recipients are required to have the following conditions:
(1) Have no access to a working licensed
vehicle or a valid driver's license;
(2) Be unable to drive due to physical or
cognitive limitation;
(3) Be unable
to secure transportation from relatives, friends, or other organizations at no
cost; or
(4) Require transportation
to receive a Nebraska Medicaid covered service. Transportations services cannot
be authorized if the recipient is eligible for Medicaid .
005.02(A)
RESIDENTS OF NURSING
FACILITIES OR IMMEDIATE CARE FACILITIES FOR DEVELOPMENTAL DISABILITIES.
Residents of nursing facilities or immediate care facilities for
development disabilities are not eligible to receive transportation through the
Social Services for the Aged and Disabled Program, except for discharge
transportation. All other transportation is the responsibility of the facility.
Transportation, including moving the individual's household goods or personal
property, may not be authorized for these recipients.
005.02(B)
MEDICAL ESCORT
SERVICES. The following conditions must be met for a recipient to
be eligible for escort services:
(i) Be
physically or mentally unable to travel alone or wait alone to obtain a
Medicaid coverable service;
(ii)
Require assistance with personal care; o
(iii) Require supervision; and
(iv) Must not be currently Medicaid
eligible.
005.03
NON-MEDICAL
TRANSPORTATION. The services are authorized for the following
needs:
(A)
APPLYING FOR BENEFITS
AND SERVICES:(i) Public
assistance
(ii) Social Security;
or
(iii) Veteran's benefits ;
or
(B)
SHOPPING FOR FOOD AND ESSENTIAL ITEMS:
(i) Shop for food;
(ii) Receive commodities or food pantry
services;
(iii) Obtain clothing or
personal care items;
(iv) Obtain
legal services, receive legal counsel from legal aid societies, private
attorneys, county attorneys and other professional legal sources; or
(v) Allow the recipient to obtain financial
services and to take care of financial matters; or
(C)
SECURING
HOUSING. A recipient may be approved to locate, secure or retain
adequate housing or independent living arrangement. Transportation may be
provided for a recipient to return home from a hospital or nursing home;
or
(D)
RECEIVE SOCIAL
SERVICES FOR THE AGED AND DISABLED. Transportation to allow the
transporting of a recipient to and from congregate meals and adult day
services; or
(E)
ARRANGE EDUCATION OR TRAINING. The recipient may make arrangements
for participation in a formal educational or employment skill training program
directed toward a self-support goal; or
(F)
SECURE EMPLOYMENT.
The recipient is allowed transportation to locate, apply for or
secure paid employment or training leading to paid employment, but they are not
allowed transportation to and from employment.
005.04
TRANSPORTATION SERVICE
PROVIDER STANDARDS. The Department approves provider agreements
with common carriers, exempt providers, escort providers, and individual
providers. To be approved, providers must meet all general provider standards
in addition to the service specific standards. Annual reviews for provider
agreements are required to renew the agreement. The provider must continue to
meet all provider standards and service specific standards.
005.04(A)
COMMON CARRIER
STANDARDS. Public Service Commission certifies common carriers.
Taxis and van companies are certified by the Public Service Commission as
common carriers.
005.04(B)
EXEMPT PROVIDER STANDARDS. Exempt providers must
ensure that their employees meet the individual provider standards.
005.04(C)
ESCORT PROVIDER
STANDARDS. The provider must;
(1)
Be an individual aged 19 or older;
(2) Have training or experience in working
with persons who are aged or who have a disability;
(3) Have training or experience in providing
personal assistance;
(4) Agree to
have his or her driving records reviewed, if the escort will drive;
(5) Maintain information on specific needs of
each recipient served; and
(6)
Report all changes observed to the recipient's services coordinator.
005.04(C)(i) The escort provider who
personally drives the recipient must also meet all individual provider
standards. The escort provider is required to complete the individual
transportation provider self-certification.
005.04(C)(ii) If the recipient requires an
escort and the escort will not drive, sufficient transportation units for both
the recipient and the escort are authorized with another suitable
transportation option.
005.04(D)
INDIVIDUAL PROVIDER
STANDARDS. Provider agreements with individual providers by Neb.
Rev. Stat. §
75-303.03
can be authorized only if the driver and vehicle standards are met at all times
when the individual is providing transportation for a client.
005.04(D)(i)
DRIVER
STANDARDS. The individual provider requirements include:
(1) Have been chosen by the recipient or the
usual caregiver to provide transportation;
(2) Be age 19 or older;
(3) Possess a current and valid driver's
license;
(4) Have no more than
three points assessed against their Nebraska driver's license, or meet a
comparable standard in the state where they are licensed to drive;
(5) Currently have no limitations that would
interfere with safe driving;
(6)
Personally drive their own vehicle to transport the recipient;
(7) Use seat belts and child passenger
restraint devices as required by law;
(8) Not smoke while transporting the
recipient;
(9) Not transport the
recipient while under the influence of alcohol or any drug that impairs the
ability to drive safely;
(10) Not
provide transportation if they have a communicable disease which poses a threat
to the health and well-being of the recipient;
(11) Have and maintain the minimum automobile
liability and medical insurance coverage as required by law; and
(12) Report disqualification from any
Department program for intentional program violation.
005.04(D)(ii)
VEHICLE STANDARDS.
The individual provider's vehicle requirements are:
(1) Currently licensed and registered as
required by law;
(2) Kept at all
times in proper physical and mechanical conditions;
(3) Equipped with operable seat belts, turn
signals, lights, and horn;
(4)
Equipped with proper child passenger restraint devices as required by law when
transporting children; and
(5)
Equipped to provide comfortable temperature and ventilation
conditions.
005.04(D)(iii)
REGISTRY
CHECKS. The following registries are checked:
(a) Adult Protective Services Central
Registry;
(b) Central Register of
Child Protection Cases; and
(c)
Nebraska State Patrol Sex Offender Registry.
005.04(D)(iii)(1) If the potential provider
does not reside in Nebraska, or has resided in Nebraska for less than one year,
the Department must check registries in the state of residence or previous
residence.
005.04(D)(iii)(2) The
Department will not approve a provider agreement with the potential individual
provider if a report of abuse or neglect concerning the individual provider has
been determined to be Court Substantiated or Department Substantiated on the
Adult Protective Services Central Registry or Court Substantiated, Court
Pending, or Inconclusive on the Central Registery of Child Protection
Cases.
005.04(D)(iii)(3) The
Department will not approve a provider agreement with a potential individual
provider if the individual's name appears on the Nebraska State Patrol Sex
Offender Registry.
005.04(D)(iv)
CRIMINAL BACKGROUND
CHECKS. The Department is required to:
(a) Obtain a criminal history statement from
the potential individual provider; and
(b) Perform a criminal history check of the
potential individual provider.
005.04(D)(iv)(1)
GENERAL CRIMINAL
HISTORY. The Department must not approve a provider agreement with
a potential individual provider if a history of convictions for misdemeanor or
felony actions that endanger the health and safety of any client is indicated.
This includes crimes against a child or vulnerable adult, crimes involving
intentional bodily harm, crimes involving the illegal use of a controlled
substance, and crimes involving moral turpitude on the part of the potential
provider, or any major traffic violations.
005.04(D)(iv)(2)
SPECIFIC
CRIMINAL HISTORY. A provider agreement will be denied or
terminated when conviction has occurred in the following areas:
(a) Child pornography;
(b) Child or adult abuse;
(c) Driving under the influence: a driving
under the influence conviction within the past eight years;
(d) Domestic assault;
(e) Shoplifting after age 19 and within the
last three years;
(f) Felony fraud
within the last 10 years;
(g)
Misdemeanor fraud within the last five years;
(h) Termination of provider status for cause
from any Department program within the last 10 years;
(i) Possession of any controlled substance
within the last five years;
(j)
Possession of a controlled substance with intent to deliver within the last 10
years;
(k) Felony or misdemeanor
assault without a weapon in the last 10 years;
(l) Felony or misdemeanor assault with a
weapon in the last 15 years;
(m)
Prostitution or solicitation of prostitution within the last five
years;
(n) Felony or misdemeanor
robbery or burglary within the last 10 years;
(o) Rape or sexual assault; or
(p) Homicide.
005.04(D)(iv)(3) Pending charges are reviewed
by the Department to determine whether the recipient's safety is in jeopardy.
Other convictions are weighted to similar offenses included in the
aforementioned list .
005.04(D)(v)
INDIVIDUAL PROVIDER
APPROVAL PROCESS. A copy of the individual's current driver's
license, insurance card, and vehicle registration is required. The provider
must complete and sign the provider self-certification and the provider
agreement. In addition to having no more than three points assessed against
their driver's license, each provider's past eight-year driving history must be
considered. If a license has been suspended or revoked, the provider must not
be approved for eight years from the date of suspension or revocation.
005.04(D)(v)(1)
RENEWAL. The provider self-certification and the provider
agreement is renewed annually. The registry checks and criminal history checks
will be completed for each renewal. Department staff must obtain a copy of the
individual's current driver's license, insurance card, and vehicle
registration. No provider agreement with a provider whose name appears on the
registries, or whose criminal history check indicates any convictions, will be
renewed.
005.04(D)(v)(2)
TERMINATION. The provider agreement will be terminated
if the individual provider is found to be in violation of any of the regulatory
standards. Any provider agreement with a provider whose name appears on the
registries or whose criminal history check indicates any convictions will be
terminated.
005.05
AUTHORIZATION
PROCEDURES. Before authorizing transportation or escort services,
the use of family, neighbors, friends, or community agencies that will provide
this service without charge, whenever possible, will be explored .
005.05(A)
NON-MEDICAL
TRANSPORTATION. For areas where exempt providers are available, or
the recipient has chosen to use an individual provider, the recipient will not
be allowed to use common carriers unless the exempt, or individual provider,
cannot provide the service.
005.05(A)(i)
AUTHORIZATION OF EXEMPT PROVIDERS. The Department will
approve a provider agreement with, and authorize services for a provider who is
exempt from Public Service Commission licensure as appropriate to meet a
recipient's needs. The availability of a common carrier does not limit the use
of an exempt provider.
005.05(A)(ii)
MEDICAL
ESCORT. The following is the criteria to determine when to
authorize an hourly rate for medical escort services:
(a) The escort is not a legally responsible
member of the recipient's family;
(b) The recipient is not able to secure an
escort at no cost; and
(c) The
escort is not receiving payment from another source.
005.05(A)(ii)(1)
UTILIZATION OF
EXEMPT PROVIDERS AS THE DRIVER. When transportation is provided by
an exempt provider, the cost of the escort's transportation is authorized only
if there is an extra charge for the escort's transportation, such as with air
fares, rural transit system, or city bus systems.
005.05(A)(ii)(2)
UTILIZATION OF
COMMON CARRIER. When transportation is provided by common carrier
provider, the provider may not charge an extra cost for transporting the
escort.
005.05(A)(ii)(3)
UTILIZATION OF INDIVIDUAL PROVIDERS AS THE DRIVER.
When transportation is provided to a recipient and an escort by an individual
provider, the provider will not be paid an additional amount for transporting
the escort.
005.05(B)
INDIVIDUAL
PROVIDERS. An individual can be authorized as the provider if the
following criteria are met:
(i) The recipient
has chosen the individual provider;
(ii) The individual will personally drive the
vehicle; and
(iii) The individual
meets provider standards.
005.06
TRANSPORTATION SERVICES
RATES, FREQUENCY, AND MAXIMUM ALLOWABLE UNITS. The following
regulations apply to transportation services:
005.06(A)
CONDITIONS FOR
PAYMENT. The Department will pay for transportation services only:
(i) When the recipient is actually in the
vehicle; and
(ii) Using the most
direct and logical route from the recipient's residence to the service
location.
005.06(B)
UPPER LIMITS. The Department establishes
transportation rates according to the following limits:
005.06(B)(i)
COMMON
CARRIERS. Neb. Rev. Stat. §
75-303.02
limits the distance rates for common carriers at a rate no greater than three
times the state employee mileage rate. The maximum reimbursement rate does not
apply when the carrier:
(1) Transports the
recipient wholly within the corporate limits of the city or village where the
transportation of the recipient originated; or
(2) Transports a disabled person as defined
by the federal Americans with Disabilities Act of 1990 in a vehicle that is
compliant with the regulations for the transportation of the disabled
person.
005.06(B)(ii)
TAXIS. Taxi rates may be no greater than 95% of
published rates.
005.06(B)(iii)
EXEMPT PROVIDERS. The Department will establish rates
for exempt providers.
005.06(B)(iv)
ESCORT PROVIDERS. The mileage rate for escort
providers must not exceed the state employee mileage rate unless the escort is
a certified carrier. The hourly rate is set by the Department.
005.06(B)(v)
INDIVIDUAL
PROVIDERS. As provided in Neb. Rev. Stat. §
75-303.03,
the Department will reimburse the individual provider for costs incurred in
transportation at a rate no greater than that paid for reimbursement of state
employees under Neb. Rev. Stat. §
81-1176.
005.06(C)
FREQUENCY. The frequency for medical and non-medical
transportation is by miles or trip. The frequency for medical escort services
is by:
(i) The hour(s) and miles;
or
(ii) The hours and
trip.
005.06(D)
MAXIMUM ALLOWABLE UNITS. Transportation units must be
authorized based on the recipient's need not to exceed the following limits:
(i) Non-medical Transportation:
(1) 50 miles per one way trip;
(2) One round trip per week for shopping for
food and essential items;
(3) Two
round trips per month for necessary business; or
(4) One round trip per day for congregate
meals.
(ii) Medical
Transportation: Based on needed treatment and care.