1. Transportation Services: Introduction Need for Transportation Services Adults with Disabilities & Elderly Transportation or Escort

2. Types of Providers  Exempt  Certified  Individuals

3. Social Services Block Grant (SSAD/SSCF) Medicaid & Aged and Disabled Medicaid Waiver “Right Service, Right Amount” Eligibility -- Program Guidelines  SSAD/SSCF  AD Waiver  Medicaid –Plan Amendment –Managed Care

4. For this service, one item in each number must have a “yes” response. The client’s functional criteria/assessment includes information that justifies the need for this service. Transportation Service - Adults

5. 1A. The client does not own a vehicle; orYesNo 1B. The client has an inoperable vehicle (repairs are required) or a vehicle which cannot be driven long distances (25 miles); or YesNo 1C. The client has a vehicle which is not licensed or registered;orYesNo 1D. The client is not able to drive due to physical or cognitive limitations; orYesNo 1E.The client does not have a valid driver’s license or has a license which restricts where she can drive. YesNo Functional Criteria/Assessment for Transportation Services

6. 2A. There are no other resources who will provide transportation at no cost to the client (relatives, friends, responsible adults, neighbors, or other agencies); or YesNo 2B. Other resources are not always available.YesNo

7. Note  Use less costly provider (such as a bus, handi-van, or other exempt provider) when possible.  Individual transportation providers cannot be used when a certified carrier is available.

8. Transportation Payment is not Available for  Employment  Volunteer Opportunities  Training/schooling  Church  Visiting friends or relatives  Beauty Shop appointments  Visiting spouse or others in a nursing facility, hospital or other living arrangements  Socialization activities

9. The client’s functional criteria/assessment includes information that justifies the need for this service. Determining the Need for Escort for Adults

10. 1A. The client is unable to travel by himself/herself without supervision or personal assistance; orYesNo 1B. The client is unable to wait by himself/herself without supervision or personal assistance; orYesNo 1C. The client needs someone to communicate and understand his/her needs and doctor’s orders. This refers to communications due to cognitive limitations. It does not include language translation which is the responsibility of the medical professionalYesNo 1D. There is no other source who will provide escort services at no charge to the client (relative, neighbor, responsible adult, friend, other program or agency). YesNo Sample Items from the Functional Criteria/Assessment

11.  Is the escort willing to drive the client?  Is the escort the PAS provider? Escort Considerations