ELDERLY SERVICES PROGRAM

MEDICAL TRANSPORTATION SERVICE SPECIFICATION

Warren County

Effective October 1, 2026

1.0 OBJECTIVE

1.1 Medical Transportation is a service designed to enable a client to gain access to medical appointments specified by the client’s plan of care when medical transportation is not otherwise available or funded by state plan Medicaid or any other source. Whenever possible, clients must use family, neighbors, friends or community agencies to provide this service.

a. Transportation may be provided to the pharmacy after the completion of a medical appointment.

b. Transportation services are not provided when a client has been under anesthesia or when a client is being admitted to or discharged from a hospital or rehabilitation facility.

2.0 UNIT OF SERVICE

2.1 A unit of service is a "one-way" trip.

2.2 The unit rate is the price quoted for the “one-way” trip.

2.3 The unit rate must include but not be limited to all administrative costs, training and other costs associated with maintaining a fleet of vehicles.

2.4 The Provider will consult with the client's Care Manager regarding any temporary increase or decrease in service delivery units authorized. No permanent change in service delivery can be made without consultation with the Care Manager.

2.5 Transportation of a companion/assistant with advance notice to the provider is to be accommodated with no cost for the companion/assistant

3.0 PROVIDER REQUIREMENTS

Provider requirements include the following:

3.1 The Provider must furnish evidence of a service back-up plan to provide service when a driver is unavailable or when a vehicle becomes disabled.

3.2 All vehicle operators and owners must maintain proof of financial responsibility as required in Section 4509.101 of the Ohio Revised Code 4509.101-9-30-2025.pdf.

3.3 A copy of the certificate of insurance and the vehicle registration must be maintained in each vehicle.

3.4 The Provider must have a written plan for regularly scheduled maintenance and safety inspection for the vehicles in service and must document compliance with the plan.

https://codes.ohio.gov/assets/laws/revised-code/authenticated/45/4509/4509.101/9-30-2025/4509.101-9-30-2025.pdf

3.5 The Provider must ensure that each vehicle is inspected every twelve months by a certified mechanic, the state highway patrol, or the Ohio Medical Transportation Board, and is certified to be safe. The inspections must include the elements listed in Form ODA0004 (Rev.

02/01/2025) Annual Vehicle Inspection of this rule, as applicable to the vehicle inspected.

3.6 The Provider must ensure that all vehicles are easily identifiable with the Provider's name.

3.7 The Provider must ensure that all vehicle drivers have identification badges or uniforms identifying them as employees of the Provider.

3.8 Service Delivery

a. Assist in transfer of the client, as necessary, safely from client’s door to the vehicle and from the vehicle to the street level entrance of the destination point. The driver must perform the same transfer assist service when transporting the client back to the client’s residence. All hands-on escorting of all passengers including entry and exit of the vehicle must be done in compliance with training received.

b. Transfers of a passenger who remains in a wheelchair must be conducted in a safe manner.

c. Vehicles equipped for transporting a passenger who remains in a wheelchair must be equipped with permanently installed floor wheelchair restraints for each wheelchair position used. Providers must inspect their vehicles for compliance with the items listed in Form ODA0008 (Rev. 07/01/2023) Daily Vehicle Inspection on a daily basis.

d. All transportation providers/drivers are expected to arrive at the pick-up/drop-off location at the predetermined time with the correct vehicle type. All transportation services are expected to have on time arrivals and departures. Acceptable limits for the service are +/- 10 minutes.

e. There is to be no smoking, vaping, or use of smokeless tobacco in any vehicle transporting customers or clients.

f. Transportation is to be conducted in a manner that is safe and courteous. Any reported aggressive driving behaviors including speeding, cell phone usage while driving, or tablet usage while driving will be investigated and logged. Substantiated reports may result in corrective action.

g. The Provider must participate in Care Manager and Provider problem resolution to promote continuing service delivery prior to discharging a client (i.e., client-initiated service changes).

h. The Provider must maintain accurate and dated documentation regarding contact with clients and service delivery, and contacts with Care Managers regarding client.

i. The Provider must maintain dated documentation to support services delivered and billed that includes:

i. A description of the service provided

ii. The date

iii. The location of the pick-up

iv. The time of the pick-up

v. The location of the delivery

vi. The time of the delivery

vii. The name and signature of the driver

viii. Name and signature of the client to whom transportation services were provided https://dam.assets.ohio.gov/image/upload/aging.ohio.gov/rules/Form_ODA0004_2025-02-01.pdf https://aging.ohio.gov/wps/wcm/connect/gov/de45ef53-dd2e-4ea5-ae22-94383f8578c2/Form-ODA0008-%282023-07-01%29.pdf?MOD=AJPERES&CVID=oV2feWG

j. The agency must have documentation in the client’s record when a client is unable to sign for service delivery with a reason client is unable to sign. Provision is then to be made for acceptance of the client’s initials or signature of choice identified in the client’s record.

An exception to the requirement for client signature is allowed for Adult Day Service (ADS) transportation Providers who may use the client’s signature for attendance in ADS services that includes transportation to and from ADS.

4.0 DRIVER REQUIREMENTS AND TRAINING

4.1 The provider must maintain records on every staff member and volunteer who provides services to ESP clients which includes:

a. A resume or application outlining work history and training

b. A signed and dated job description

c. Evidence of qualifications/certifications including verification of previous experience

d. Results of free database and BCII/FBI checks (An applicant/employee with a valid ambulette license or EMT/First responder certification is deemed to meet the requirements in Sections 4.0 and the ESP Free Database Reviews and Criminal Records

Check rules. The Ohio Medical Transportation Board verifies the above requirements every three years.)

e. Skills Testing and return demonstration

i. Client transfers

ii. Wheelchair lift operation; and

iii. Restraint application

f. Current certificates of completion of training courses in first aid and cardio-pulmonary resuscitation (CPR) offered by the American Red Cross, the American Heart Association, the National Safety Council, or an equivalent course approved by Council on Aging

g. Evidence of performance appraisals, signed and dated by the staff member

h. Evidence of annual in-trainings/continuing education

i. Documentation signed and dated by each staff member indicating completion of orientation prior to providing service to ESP clients. Orientation must include:

i. Receipt of an employee handbook

ii. Overview of agency personnel policies

iii. Incident reporting procedures and policies

iv. Training on Emergency procedures

v. Training on Universal precautions for infection control

vi. COA ESP Code of Ethics(signed and dated)

j. At least two years of verified licensed driving experience; and the driver has the ability to understand written and oral instructions and document services delivered.

k. A current and valid driver’s license with fewer than six points against the driver issued under Chapters 4506 or 4507 of the Ohio Revised Code or their equivalent if the operator is a resident of another state.

l. Assurance that drivers:

i. Maintain a safety checklist that includes items listed in Form ODA0008 (Rev.

07/01/2023) Daily Vehicle Inspection of this rule that must be completed by the driver prior to transporting client(s).

ii. Maintain service logs or trip sheets daily as defined in Section 3.7.i.

iii. Hands-on assistance as outlined in Section 3.7 (a-b).

m. Furnish documentation to verify an annual Bureau of Motor Vehicle check is completed on each driver.

n. Provide a valid copy of a signed statement from a licensed physician acting within the scope of the physician's practice declaring that the applicant does not have a medical or physical condition, including vision impairment, that cannot be corrected and could interfere with safe driving, passenger assistance, and emergency treatment activity, or could jeopardize the health and welfare of a client or the general public.

o. Provide the results of a chemical test or tests of the driver's blood, breath, or urine conducted at a hospital or other laboratory licensed by the Ohio Department of Health for the purpose of determining the alcohol and drug content of the applicant’s blood, breath and/or urine.

4.2 Within six months of hire, all drivers must have one of the following passenger assistance training courses:

a. A certificate of completion of the Passenger Assistance Safety and Sensitivity (PASS)

Training https://ctaa.org/pass/. A refresher course is required every three years thereafter.

b. A certificate of completion of the DRIVE Training DRIVE Training. A refresher course is required every three years thereafter.

https://aging.ohio.gov/wps/wcm/connect/gov/de45ef53-dd2e-4ea5-ae22-94383f8578c2/Form-ODA0008-%282023-07-01%29.pdf?MOD=AJPERES&CVID=oV2feWG https://ctaa.org/pass/ https://coaaa.org/cms/education/drive-training https://coaaa.org/cms/education/drive-training