1. Sheryl S. Woolsey November 29, 2007 Texas Department of Transportation (TxDOT) Medical Transportation Program (MTP)

2. 2 MTP’s Goal and Purpose To provide cost-effective non- emergency transportation to clients who do not have any other means of transportation to access necessary health program allowable services.

3. 3 MTP can arrange a free ride, via –Contracted demand response providers –Mass Transit –Mileage reimbursement –Meals & lodging for overnight stays Available Services

4. 4 For Medicaid under 21 only –Advance funds for mileage –Advance funds for meals & lodging Additional Services

5. 5 Three call centers Dallas San Antonio McAllen Central Office Program Management Contract Monitoring Claims MTP Structure

6. 6 Medicaid Children with Special Health Care Needs (CSHCN) Transportation for Indigent Cancer Patients (TICP) Clients Served

7. 7 Medicaid –4,197,997 Trips CSHCN –18,905 Trips TICP –2,824 Trips Services Provided

8. 8 FY 2005 FY 2006 FY 2007 Call Volumes

9. 9 In 2003, legislation mandated that HHSC contract with TxDOT for the provision of transportation services. Shortage in General Revenue may have driven the change with State Highway Funds paying for transportation services of Health and Human Services programs. How Did We Get Here?

10. 10 September 2003 – HHSC signed agreement with TxDOT March 2004 - Staff and MTP operations transitioned from Texas Department of Health to TxDOT When Did We Arrive?

11. 11 March 2004 - Successful transition to TxDOT –No interruption of client services Feb 2005 – New Advance Funds contract Accomplishments

12. 12 June 2005 - Started reporting for Frew v. Hawkins lawsuit –Settled in 1996, access to care –April 2005, Attorney General recommended changes –Within 6 weeks, TxDOT was ready Accomplishments 2

13. 13 June 2006 – New contracts –Difference in perspective Transportation Services/Social Services –Focus on coordination –Demand Response contractors 52 to 15 –Streamlined rate structure Accomplishments 3

14. 14 June 2006 – Consolidation –From 9 call centers to 3 –Automated Claims Processing –Created 9 positions for contract monitoring –Centralized non-call center functions Accomplishments 4

15. 15 For 5 months in FY 2007, met Frew requirements –Average wait in queue 60 seconds (or less) –Abandon rate of 10% (or less) Accomplishments 5

16. 16 Rules, Medicaid authority, and reporting reside at different agency Separating transportation services from social service functions Frew lawsuit Varying monthly call volumes Constant change since March 2004 Challenges

17. 17 Review & revise program rules prior to transition Consider moving authority of rules to receiving agency if possible Review operations Look at existing locations and structure prior to transition Suggestions

18. 18 Consult call center experts about design and technology Be ready for increased visibility Recognize differences between transportation models Suggestions 2

19. 19 Understand cost of delivering services Pilot ride-sharing programs Notify Centers for Medicaid & Medicare Services (CMS) Suggestions 3

20. 20 Legislation in 2007 transferred MTP to HHSC. Why? Speculatively: –Greater focus on Frew compliance –CMS deferral What is Next for MTP?

21. 21 Transition to HHSC by August 31, 2008 MTP will be part of a new Associateship at HHSC What is Next for MTP? 2