PATERSON-PASSAIC COUNTY-BERGEN COUNTY
HIV HEALTH SERVICES PLANNING COUNCIL
TRANSPORTATION MINIMUM STANDARDS OF CARE
(Revised February 20, 2006)
Revised February 2009
Goal
The goal of the Bergen-Passaic Eligible Metropolitan Area is to ensure a system of quality services that is consumer-centered, efficient, and effective in assisting the consumer in supporting adherence to medical care. (Medical care is defined, at minimum, as one of the following: an HIV/AIDS related medical visit every six months, T-cell and viral load count every six months, or being prescribed antiretroviral medication every six months, unless otherwise determined by the medical provider).
Transportation Definition
Transportation is a conveyance service of last resort provided to PLWH/A, may be accompanied by affected individual, as defined by HRSA, to provide access to health care and/or support services. This service may be provided routinely or on an emergency basis. It will be provided in accordance with confidentiality guidelines as per N.J.S.A. 26:5C-1-14.
A1: Transportation Standards
Standard A1-1: Safety/Vehicle Maintenance: Transportation services are safe.
Indicator A1-1.1: Vehicle Maintenance.[(]
¨ Vehicles are in good repair and equipped for adverse weather conditions.
Examples of evidence:
· Review of vehicle service records.
· Ryan White Part A contracted drivers complete daily vehicle maintenance check list.
· Seat Belts/Restraint Systems are operational.
· Valid NJ vehicle registration.
· Child car seats are available and operational under NJ state law.
02/18/09
801-ppc-14\cm train-standards\Priscilla\Trans-Rev Feb09 - 9 - New Solutions, Inc.
Paterson-Passaic County-Bergen County
HIV Health Services Planning Council
Transportation
Minimum Standards of Care (Revised February 2009)
Indicator A1-1.2: Driver Qualifications.*
¨ Transportation drivers are safe, licensed, and insured.
Examples of evidence:
· Proof of safe driving record on file.
· Proof of valid driver’s license on file.
· Proof of current automobile liability insurance on file.
· Driver has no more than 4 points against driver’s license.
· Reference check/check completed, if available.
· First Aid and CPR Training, HIV education, Defensive Driving Course.
Indicator A1-1.3: Emergency Procedures.*
¨ Transportation Emergency procedures are in place (e.g., breakdown of agency vehicle, medical emergency).
Examples of evidence:
· Written procedures developed and implemented to handle emergencies.
· Evidence of cell phone or communication availability.
Indicator A1-1.4: Behavior Emergencies.
¨ Harassment, disrespect or abuse of any kind will not be tolerated by either passenger or driver and will be grounds for immediate suspension or termination from transportation services or employment.
Example of evidence:
· Written procedures developed and implemented to handle abusive behavior.
Standard A1-2: Eligibility, Screening and Referral: Transportation services are offered to PLWH/A and affected individuals as defined by HRSA.
Transportation, a support/non-core service, is to be accessed after verification by the non-medical case manager of the consumer’s enrollment in medical services. This verification will need to take place every 6 months.
In the event of an extreme consumer emergency, it is acceptable for the support/non-core service provider to deliver a support service one time only without a referral from a non-medical case manager. The support/non-core service provider must document the urgency of delivering services without a proper referral. It is required that the consumer obtain a proper referral for any subsequent request for that same support service.
Transportation, a support/non-core service, requires only an initial non-medical case manager referral. The initial referral is valid for the fiscal year. Subsequently, at the request of the referral agency, the non-medical case manager will need to provide written documentation that the consumer remains eligible for Ryan White Part A services (i.e., active in medical care every six months).
All support/non-core service workers need to do an eCOMPAS(e2) look up to verify service and review other support services providers.
Indicator A1-2.1: Screening Referral.
¨ An initial referral is received from the non-medical case manager stating that the consumer has been screened. The screening certification is on agency letterhead and has been signed and dated by the non-medical case manager.
Example of evidence:
· The signed and dated screening certification and referrals on agency letterhead, from the non-medical case manager are in the consumer’s file, as well as documentation of electronic referral and/or electronic verification of “in medical care.”
Indicator A1-2.2: Medicaid.
¨ Agency documents client’s eligibility for Medicaid Transportation.
Example of evidence:
· Documentation of the referral and the status of referral are maintained in client’s record.
Indicator A1-2.3: Voucher Guidelines.
¨ Transportation providers utilize the following guidelines:
Bus Tickets: To be used for minimal service, as needed.
Bus Pass: To be used for ongoing service, as needed.
Taxi Voucher: To be provided as a last resort.
Example of evidence:
· Client’s record indicates guidelines were followed.
Indicator A1-2.4: HRSA allowed transportation services.
¨ EMA priorities for transportation provisions will meet the following criteria:
1. Health Care Services
2. Non-recreational support services
Example of evidence:
· Transportation Log Sheets will include trip purpose.
Standard A1-3: Rights and Responsibilities: Before the consumer is provided with transportation services, he/she must be notified in writing of his/her rights and responsibilities, of the transportation service provider’s rights and responsibilities, and the transportation service provider’s grievance policy.
Indicator A1-3.1: A Management Information System (MIS) consent form shall be signed by the consumer, witnessed, dated and included in the consumer’s file this form shall be updated annually.
Example of evidence:
· A MIS consent form is found in the consumer’s file.
Indicator A1-3.2: A Consumer Bill of Rights form shall be signed by the consumer, witnessed, and dated. A signed copy shall be given to the consumer, and a copy shall be included in the consumer’s file. This form must include policy statements on:
· Privacy
· Confidentiality
· Self-determination
· Non-discrimination
· Compassionate non-judgmental care
· Dignity and self respect
· Quality day and respite care
· Change or discontinue service
· Grievance procedure written at a no higher than 8th grade reading level
· Verbal and written consumer appeal process.
This form shall be updated annually.
Example of evidence:
· A Consumer’s Bill of Rights shall be found in the consumer’s file.
Standard A1-4: Confidentiality: Within the coordination of service delivery, all agencies providing transportation and their workers need to ensure the consumers they serve that the information provided by the consumer or information obtained on the consumer’s behalf by the transportation agency/worker is confidential.
Indicator A1-4.1: Referrals from one agency to another will be made only with an individual’s written consent, as documented in the Consent to Release Information Form, and will be found in the consumer’s file.
Example of evidence:
· Signed and dated releases are found in the consumer’s file.
Indicator A1-4.2: All records and files with identifying information will be locked or in a restricted access computer system.
Example of evidence:
· Records and files are locked or in a restricted access computer system.
Standard A1-5: Cultural/Language/Reading Level Access/Facilitating Sign Language: Agencies will ensure culturally and linguistically appropriate services for all consumers.
Indicator A1-5.1: The agency shall have written policies in place for responding to cultural and linguistic diversity, including services for hearing impairment and translation services.
Examples of evidence:
· The agency has a written policy on file detailing the process for language translation.
· The agency has documentation confirming that each staff member has received cultural diversity training within the first year of hire and every two years thereafter.
Standard A1-6: American Disabilities Act (ADA) Compliance: All agencies must be in compliance with the ADA.
Example of evidence:
· Agency demonstrates that the needs of disabled consumers are met.
Standard A1-7: Access. Transportation services are offered to simplify access and maximize utilization of services.
Indicator A1-7.1: Notification of Service Availability.
¨ Prospective and current clients are informed of service availability and eligibility and caps implemented, where applicable.
Example of evidence:
· Program information and eligibility are clearly disseminated throughout EMA.
Indicator A1-7.2: Direct Access.
¨ Once client has been referred by the non-medical case manager, direct access by client may be obtained through available transportation services.
Example of evidence:
· Agency’s policies and procedures for transportation services describe how the client can access the service.
Indicator A1-7.3: Handicap Accessible.
¨ Transportation services are handicap accessible within the EMA.
Example of evidence:
· Agencies will have procedures for access to such services (i.e., referrals).
Indicator A1-7.4: Service Availability.
¨ EMA-wide services are coordinated in such a way to be available between 6:00am-11:00pm seven days a week; appointments where applicable and 24-hour notice recommended. Special arrangements required for weekend and Holiday transportation needs.
Example of evidence:
· Each agency will have available hours of operation and plans for back-up service when not available (part of EMA transportation directory).
· Each agency will participate on Advisory Board to work towards a coordinated service delivery system.
Indicator A1-7.5: Service Capacity.
¨ Agency Management Information System (MIS) data entries will notify the Grantee of capacity status.
¨ Agency will maintain documentation of clients who were refused services.
Example of evidence:
· Grantee will follow MIS to verify service capacity from agencies or service category.
· Transportation log to maintain tracking system which shall include clients who have not been served and reason for denial.
· Grantee will notify Planning Council when funding for service category is depleting so alternatives can be explored.
Standard A1-8: Service Delivery: Transportation services are provided in a timely manner.
Indicator A1-8.1: Timeliness
¨ There is a minimal waiting time for vehicles and vans; appointments are kept.
Example of evidence:
· Review of Transportation Logs, voucher documentation indicates agency compliance.
· Regular schedules are in place.
Indicator A1-8.2: Immediate Service Problems.
¨ Clients are made aware of problems immediately (e.g., vehicle breakdown, driver no show).
Example of evidence:
· Review of Transportation Log and Transportation Refusal Log indicates agency compliance.
Indicator A1-8.3: Future Service Delays.
¨ Clients are notified of future service delays, changes in appointments or schedules as they occur.
Example of evidence:
· Review of Transportation Log and Transportation Refusal Log indicates agency compliance.
Indicator A1-8.4: Client No Shows.
¨ Passengers who do not cancel scheduled rides for three (3) times or who are “no show” for three (3) times may be removed from the van/vehicle roster for 30 days. In order to be reinstated, client must be reassessed for transportation need.
Example of evidence:
· Review of agency’s transportation policies and procedures.
· Transportation log indicates client no show as per agency’s policy and procedure.
Standard A1-9: Service Coordination: Cooperation and Collaboration are essential between all service provider agencies providing services to a consumer. Cooperation enhances the range of services and expedites their delivery to the consumer. It shall also serve to reduce duplication of services.
Indicator A1-9.1: Transportation provider will have active communication with the non-medical case manager regarding usage and issues of transportation services.
Example of evidence:
· Client record documents consumer usage and issues regarding transportation services, and worker contact with the non-medical case manager.
Standard A1-10: Records Administration. Transportation services are documented appropriately, consistently and securely.
Indicator A1-10.1: Record Administration.
¨ Transportation provider shall maintain all client files in locked area (i.e., room, file cabinets).
Example of evidence:
· Review of agency’s policy and procedure for records administration.
Indicator A1-10.2: Intake/Application.
¨ Prior to initiating transportation services for client, agency must access the Electronic Comprehensive Outcomes Management Program for Accountability and Success (eCOMPAS(e2)) to confirm if client is in system. If not, intake/application needs to be completed to ensure appropriateness and coordination of service.
Example of evidence:
· Review client record and/or transportation agency log.
Indicator A1-10.3: Van/Vehicle Transportation.
¨ Agency must document daily transportation services on the Transportation Log.
Example of evidence:
· Review of agency files indicates compliance.
Indicator A1-10.4: Voucher Transportation.
¨ Agency must document and identify by category all voucher services provided in the client’s record.
¨ Voucher Categories are: Bus passes, bus tickets and taxi vouchers.
Example of evidence:
· Review of agency’s files indicates compliance.
Indicator A1-10.5: Job Descriptions.*
¨ Job descriptions are mandatory for all transportation personnel. Agency’s driver’s job descriptions must include that drivers must be certified or have received inservice in First Aid, CPR, HIV, and Defensive Driving Course.
Example of evidence:
· Agency files will include job descriptions.
Standard A1-11: Data Entry: Transportation services are entered in a timely manner on the transportation database.
Indicator A1-11.1: Voucher Data Entry.
¨ Follow Grantee guidelines and MIS data entry reporting system.
Example of evidence:
· Review of voucher documentation and the transportation database indicates compliance.
Indicator A1-11.2: Van/Vehicle Data Entry.
¨ Follow Grantee guidelines and MIS data entry reporting.
Example of evidence:
· Review of Transportation Log and the transportation database indicates compliance.
Indicator A1-11.3: Utilization Review.
¨ Prior to releasing bus passes, bus tickets and taxi vouchers, agency must query MIS to look up the transportation service received by the client. If client has received a bus pass for the current month, bus tickets and taxi vouchers are not to be distributed unless it is deemed an emergency.
Example of evidence:
· Review of voucher documentation and MIS indicates compliance.
Standard A1-12: Quality Assurance: Monitor both appropriateness and effectiveness of transportation services delivered within the EMA.
Indicator A1-12.1: Advisory Board.
¨ EMA-wide advisory committee, which is part of the subcommittee of support services, to monitor both appropriateness and effectiveness of transportation services within the EMA. Advisory Board Membership is to be comprised of representative(s) of Voices, Transportation providers, and interested individuals.