Current through Register Vol.. 38, No. 17, April 11, 2022
Service description. This service is
offered in order to enable individuals to gain access to an individual's place
of employment or volunteer activity, other community services or events,
activities and resources, homes of family or friends, civic organizations or
social clubs, public meetings or other civic activities, and spiritual
activities or events as specified by the support plan and when no other means
of access is available. The goal of this service is to promote the individual's
independence and participation in the life of the individual's community. Use
of this service shall be related to the individual's desired outcomes as stated
in the ISP. This service is offered in addition to medical transportation
required under 42 CFR 431.53
and transportation services under the State Plan,
defined at 42 CFR 440.170(a)
, and does not replace them.
Criteria and allowable activities.
1. The service may include transportation in
a private vehicle by a person such as a coworker or other community member or
the purchase of tickets for public transportation such as bus or subway. In
either case, an administering agency shall coordinate and bill DMAS.
2. Up to three individuals may be transported
in a single, private vehicle per trip.
3. The administering agency will ensure that
pertinent information about the individual is relayed to the driver.
Service units and limitations.
1. This service shall not be authorized or
reimbursed for individuals who can access transportation through the State Plan
or other waiver services that include a transportation component. The
individual or legal guardian shall attest that he does not have sufficient
personal financial resources (e.g., through wages) to cover the cost of the
transportation is reimbursed according to a "trip," which is reimbursed for the
round-trip, and the number of individuals being transported to the location
(maximum of three). There are three trip rates depending on the one-way
a. Less than 10
b. Between 10 and 20
c. Over 20 miles.
3. When a private driver is
transporting more than one individual to a single destination, the trip rate
for all individuals is the same and is determined by the distance between the
first individual picked up and the final destination.
4. The purchase of tickets for public
transportation and dissemination to the individual is coordinated by the
5. A provider
delivering other waiver services to an individual may not utilize staff to
provide Employment and community transportation (ECT) and may only bill ECT if
the transportation would not be a normally required element of service
qualifications and requirements.
service may be provided by the individual's family member or legally
responsible person, but may not be the guardian, parent, step-parent of an
individual younger than 18 years of age, or spouse of an adult who is receiving
2. The service shall
be offered through an administering agency that possesses any DBHDS license to
provide services to individuals with developmental disabilities, an employment
service organization, or a center for independent living. Administering
agencies shall be enrolled with DMAS through a participation agreement, to
provide these services.
3. In the
case of private transportation, the administering agency shall be responsible
for screening community persons to drive the individual to designated locations
according to the ISP.
private driver shall:
a. Be 18 years of age
b. Possess a valid
driver's license; and
and maintain at a minimum:
(1) A satisfactory
driving record defined as no reckless driving charges within the past 24
(2) Proof of general
liability insurance coverage in compliance with federal or state statutory
requirements The insurance shall insure the driver or the passengers (i)
against loss from any liability imposed by law for damages; (ii) against
damages for care and loss of services because of bodily injury to or death of
any person; (iii) against injury to or destruction of property caused by
accident and arising out of the ownership, use, or operation of such motor
vehicle within the Commonwealth, any other state in the United States, or
Canada; (iv) subject to a limit or exclusive of interest and costs, with
respect to each motor vehicle of $25,000 because of bodily injury to or death
of one person in any one accident and, subject to the limit for one person, to
a limit of $50,000 because of bodily injury to or death of two or more persons
in any one accident; and (v) subject to a limit of $20,000 because of injury to
or destruction of property of others in any one accident.
The administering agency shall
be responsible for screening community persons to drive the individual to
designated locations according to the ISP. This includes verification of the
a. Possession of a current,
valid driver's license and no reckless driving charges within the past 24
b. Possession of car
c. Ensuring that the
driver meets the minimum age requirement of age 18; and
d. Completion of an attestation signed by the
private driver, the individual, and the individual's guardian or authorized
representative, as appropriate, that the driver has disclosed any relevant
felonies and if listed on any registry. The administering agency shall ensure
that the driver is not listed on the Virginia Sex Offender Registry.
6. Initially and annually the
administering provider shall verify and document that each private driver
possesses a current, valid driver's license, and car insurance.
Documentation requirements for
Providers shall include
in each individual's record:
A copy of the
completed, standard, age-appropriate assessment form as described in
b. The provider's
plan for supports in the form of the ECT Trip Plan form.
c. Documentation of the trip distance
estimate in the form of a MapQuest, Google Maps, or similar printout with point
of origin, destination, and mileage.
d. Documentation to support units of service
delivered in the form of a monthly trip log signed by the individual recording
trips taken that shall correspond with billing. Providers shall maintain
separate documentation for each type of service rendered for an
e. A written review,
supported by documentation in the individual's record, shall be submitted to
the support coordinator quarterly, during any quarters in which the service was
provided and if modified, with the plan for supports. This written review shall
list the dates and destinations of trips taken and a statement about the
individual's satisfaction with the service.
f. For private drivers, (i) copies of valid
drivers' licenses, (ii) copies of the automobile insurance policies, (iii)
copies of driving records, and (iv) criminal records attestations and Virginia
Sex Offender Registry record checks. The driver is responsible for notifying
the agency if there are any changes to previously submitted attestations or
significant driving record changes, versus requiring the agency to have to
obtain these every year (or whatever time period).
g. For public transportation, receipts for
purchases of bus tickets, or fare cards.
h. All correspondence to the individual and
the individual's family/caregiver, as appropriate, the support coordinator,
DMAS, and DBHDS.
documentation of all contacts with family/caregiver, physicians, formal and
informal service providers, and all professionals regarding the
j. The written
attestation by the individual or legal guardian that the individual does not
have sufficient personal financial resources (e.g., through wages) to cover the
cost of the transportation himself.
2. Provider documentation shall support all
claims submitted for DMAS reimbursement. Claims that are not supported by
appropriate documentation shall be subject to recovery by DMAS as a result of
utilization reviews and audits.