Sec. 10.09.19.04. Services to Recipients

A. A grantee is responsible for arranging or providing nonemergency transportation to and from medically necessary covered services to Medical Assistance recipients and, when necessary, their attendants, who have no other means of transportation available. In carrying out this duty, a grantee:

(1) Shall screen recipients' requests for transportation in order to identify whether transportation is available to the recipients from other sources;

(2) When determining the appropriate means of transport for a recipient who appears to have a mental or physical disability which would prevent the recipient from using public transportation, shall request documentation prepared by the recipient's physician which indicates that the recipient's medical condition makes it medically contraindicated for the recipient to use public transportation;

(3) Shall refer recipients to organizations and programs which might be able to provide transportation and otherwise arrange for transportation when appropriate;

(4) Shall encourage the development and expansion of transportation resources such as churches and other community organizations;

(5) Shall provide transportation to recipients for whom there is no other transportation resource available, in the most efficient and cost-effective manner possible, including the use of volunteers and charitable organizations whenever possible; and

(6) May refuse to pay for transportation services if the recipient requests transportation less than 24 hours before the time the transportation is to be provided.

B. Screening referred to in §A(1) of this regulation includes obtaining the information listed below, as appropriate:

(1) Whether a recipient or a member of the recipient's household owns a vehicle;

(2) Availability of vehicles owned by friends or relatives with whom a recipient does not share a household;

(3) Availability of a volunteer using a privately owned vehicle;

(4) Availability of a volunteer from a public or private agency;

(5) Availability of transportation services provided for free by any other city, county, or State agency programs;

(6) Methods by which a recipient previously reached medical services or currently reaches nonmedical services, such as the grocery store;

(7) Whether a recipient can walk to the medical service;

(8) Whether public bus transportation operates between a recipient's home and medical service;

(9) Whether a recipient is mentally or physically disabled;

(10) Whether a recipient is chronically ill or otherwise requires medical services on a frequent and ongoing basis; and

(11) Whether a recipient can reschedule an appointment to a time when transportation would be available.

C. When the recipient is unable without assistance to obtain the documentation referred to in §A(2) of this regulation, and has no family member or other representative who can provide assistance, the grantee shall offer to contact the recipient's health care provider to request documentation of disability.