SECTION 317:40-5-103. Transportation

(a)   Applicability. The rules in this Section apply to transportation services provided through the Oklahoma Department of Human Services (DHS), Developmental Disabilities Services (DDS); Home and Community Based Services (HCBS) Waivers.

(b)   General Information. Transportation services include adapted, non-adapted, and public transportation.

(1)   Transportation services are provided to promote inclusion in the community, access to programs and services, and participation in activities to enhance community living skills. Members are encouraged to utilize natural supports or community agencies that can provide transportation without charge before accessing transportation services.

(2)   Services include, but are not limited to, transportation to and from medical appointments, work or employment services, recreational activities, and other community activities within the number of miles authorized in the Plan of Care.

(A)   Adapted or non-adapted transportation may be provided for each eligible person.

(B)   Public transportation may be provided up to a maximum of $5,000 per Plan of Care year. The DDS director or designee may approve requests for public transportation services totaling more than $5,000 per year when public transportation is the most cost-effective option. For the purposes of this Section, public transportation is defined as:

(i)   services, such as an ambulance when medically necessary, a bus, or a taxi; or

(ii)   a transportation program operated by the member's employment services or day services provider.

(3)   Transportation services must be included in the member's Individual Plan (Plan) and arrangements for this service must be made through the member's case manager.

(4)   Authorization of Transportation Services is based on:

(A)   Personal Support Team (Team) consideration, per Oklahoma Administrative Code (OAC) 340:100-5-52, of the unique needs of the person and the most cost effective type of transportation services that meets the member's need, per (d) of this Section; and

(B)   the scope of transportation services as explained in this Section.

(c)   Standards for transportation providers. All drivers employed by contracted transportation providers must have a valid and current Oklahoma driver license, and the vehicle(s) must meet applicable local and state requirements for vehicle licensure, inspection, insurance, and capacity.

(1)   The provider must ensure that any vehicle used to transport members:

(A)   meets the member's needs;

(B)   is maintained in a safe condition;

(C)   has a current vehicle tag; and

(D)   is operated in accordance with local, state, and federal law, regulation, and ordinance.

(2)   The provider maintains liability insurance in an amount sufficient to pay for injuries or loss to persons or property occasioned by negligence or malfeasance by the agency, its agents, or employees.

(3)   The provider ensures all members wear safety belts during transport.

(4)   Regular vehicle maintenance and repairs are the responsibility of the transportation provider. Providers of adapted transportation services are also responsible for maintenance and repairs of modifications made to vehicles. Providers of non-adapted transportation with a vehicle modification funded through HCBS assistive technology services may have repairs authorized per OAC 317:40-5-100.

(5)   Providers must maintain documentation, fully disclosing the extent of services furnished that specifies the:

(A)   service date;

(B)   location and odometer mileage reading at the starting point and destination; or trip mileage calculation from Global Positioning System(GPS) software;

(C)   name of the member transported; and

(D)   purpose of the trip.

(6)   A family member, including a family member living in the same household of an adult member may establish a contract to provide transportation services to:

(A)   work or employment services;

(B)   medical appointments; and

(C)   other activities identified in the Plan as necessary to meet the needs of the member, per OAC 340:100-3-33.1.

(7)   Individual transportation providers must provide verification of vehicle licensure, insurance and capacity to the DDS area office before a contract may be established and updated verification of each upon expiration. Failure to provide updated verification of a current and valid Oklahoma driver license and/or vehicle licensure may result in cancellation of the contract.

(d)   Services not covered. Services that cannot be claimed as transportation services include:

(1)   services not approved by the Team;

(2)   services not authorized by the Plan of Care;

(3)   trips that have no specified purpose or destination;

(4)   trips for family, provider, or staff convenience;

(5)   transportation provided by the member;

(6)   transportation provided by the member's spouse;

(7)   transportation provided by the biological, step or adoptive parents of the member or legal guardian, when the member is a minor;

(8)   trips when the member is not in the vehicle;

(9)   transportation claimed for more than one member per vehicle at the same time or for the same miles, except public transportation;

(10)   transportation outside Oklahoma unless:

(A)   the transportation is provided to access the nearest available medical or therapeutic service; or

(B)   advance written approval is given by the DDS area manager or designee;

(11)   services that are mandated to be provided by the public schools pursuant to the Individuals with Disabilities Education Act;

(12)   transportation that occurs during the performance of the member's paid employment, even when the employer is a contract provider; or

(13)   transportation when a closer appropriate location was not selected.

(e)   Assessment and Team process. At least annually, the Team addresses the member's transportation needs. The Team determines the most appropriate means of transportation based on the:

(1)   present needs of the member. When addressing the possible need for adapted transportation, the Team only considers the member's needs. The needs of other individuals living in the same household are considered separately;

(2)   member's ability to access public transportation services; and

(3)   availability of other transportation resources including natural supports, and community agencies.

(f)   Adapted transportation. Adapted transportation may be transportation provided in modified vehicles with wheelchair or stretcher-safe travel systems or lifts that meet the member's medical needs that cannot be met with the use of a standard passenger vehicle, including a van when the modification to the vehicle was not funded through HCBS assistive technology service and is owned or leased by the DDS HCBS provider agency.

(1)   Adapted transportation is not authorized when a provider agency leases an adapted vehicle from a member or a member's family.

(2)   Exceptions to receive adapted transportation services for modified vehicles other than those with wheelchair/stretcher safe travel systems and lifts may be authorized by the DDS programs manager for transportation services when documentation supports the need, and there is evidence the modification costs exceeded $10,000. All other applicable requirements of OAC 317:40-5-103 must be met.

(3)   Adapted transportation services do not include vehicles with modifications including, but not limited to:

(A)   restraint systems;

(B)   plexi-glass windows;

(C)   barriers between the driver and the passengers;

(D)   turney seats; and

(E)   seat belt extenders.

(4)   The Team determines if the member needs adapted transportation according to:

(A)   the member's need for physical support when sitting;

(B)   the member's need for physical assistance during transfers from one surface to another;

(C)   the portability of the member's wheelchair;

(D)   associated health problems the member may have; and

(E)   less costly alternatives to meet the need.

(5)   The transportation provider and the equipment vendor ensure that the Americans with Disabilities Act requirements are met.

(6)   The transportation provider ensures all staff assisting with transportation is trained according to the requirements specified by the Team and the equipment manufacturer.

(g)   Authorization of transportation services. The limitations in this subsection include the total of all transportation units on the Plan of Care, not only the units authorized for the identified residential setting.

(1)   Up to 12,000 units of transportation services may be authorized in a member's Plan of Care per OAC 340:100-3-33 and OAC 340:100-3-33.1.

(2)   When there is a combination of non-adapted transportation and public transportation on a Plan of Care, the total cost for transportation cannot exceed the cost for non-adapted transportation services at the current non-adapted transportation reimbursement rate multiplied by 12,000 miles for the Plan of Care year.

(3)   The DDS area manager or designee may approve:

(A)   up to 14,400 miles per Plan of Care year for people who have extensive needs for transportation services; and

(B)   a combination of non-adapted transportation and public transportation on a Plan of Care, when the total cost for transportation does not exceed the cost for non-adapted transportation services at the current, non-adapted transportation reimbursement rate multiplied by 14,400 miles for the Plan of Care year.

(4)   The DDS division director or designee may approve:

(A)   transportation services in excess of 14,400 miles per Plan of Care year in extenuating situations when person-centered planning identified specific needs that require additional transportation for a limited period; or

(B)   any combination of public transportation services with adapted or non-adapted transportation; or

(C)   public transportation services in excess of $5,000, when it is the most cost effective service option for necessary transportation.

[Source: Reserved at 18 Ok Reg 1168, eff 5-11-01; Added at 20 Ok Reg 165, eff 10-8-02 (emergency); Added at 20 Ok Reg 1228, eff 5-27-03; Amended at 23 Ok Reg 3192, eff 6-7-06 (emergency); Amended at 24 Ok Reg 958, eff 5-11-07; Amended at 28 Ok Reg 1550, eff 6-25-11; Amended at 32 Ok Reg 1162, eff 8-27-15; Amended at 34 Ok Reg 746, eff 9-1-17]