Transit Agency Participation in Medicaid Transportation Programs (2006) / Chapter Skim
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Pages 22-30
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Service standards -- There are significant differences in the service quality requirements of Medicaid contractors. In some cases, those state and local standards are less stringent than the standards typically employed by public transit operators.
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-- Vermont's Medicaid agency uses the state transit association to administer the Medicaid transportation program. Contracts are local and typically with transit agencies.
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Typically, the transit agency is given an opportunity to participate. Broward County Transit -- Coordination Efforts BCT, an arm of county government, is the public transit operator for the county.
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There are some regional multicounty transit agencies; however, most service is provided and coordinated at the county level. DHR and public transit are coordinated frequently, yet only 10% of the transit agencies in the state coordinate with NEMT.
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Texas has a long history of coordination at the local level, especially in rural areas, where many of the agencies have a 30-year history of coordinating Medicaid, Title III Aging transportation, job access, and other programs with public transit. Almost all of the rural transit agencies in the state coordinated at least one other human service program, and most more than one.
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State Level Coordination As stated previously, the rural transit agencies have evolved into very highly coordinated transit agencies that compare favorably with other states. TxDOT has recently implemented a planning requirement for 24 designated areas covering the entire state.
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The VPTA brokerage system is the major provider of NEMT for Vermont's Medicaid-eligible citizens. Broker organizations include public transit agencies and paratransit providers.
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Activities That Affect Coordination • The Medicaid agency trust level -- There is a high level of trust between the state Agency for Human Services and VPTA, built over years of cooperation. Their trust level extends to the operators.
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Finally, Georgia has a model that makes coordination difficult to achieve through its large regional brokers. The approach used by each state will help determine coordination potential; however, coordination can still occur even with a model that does not necessarily encourage coordination.
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