1.1 	A bill for an act
1.2 	relating to human services; specifying criteria for
1.3 	coverage of medical assistance special transportation
1.4 	services; increasing special transportation
1.5 	reimbursement rates; extending the prohibition on the
1.6 	use of brokers or coordinators to manage special
1.7 	transportation services; requiring a review of special
1.8 	transportation services; amending Minnesota Statutes
1.9 	2004, section 256B.0625, subdivision 17; Laws 2003,
1.10 	First Special Session chapter 14, article 12, section
1.11 	93.
1.12 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.13 	Section 1. Minnesota Statutes 2004, section 256B.0625,
1.14 	subdivision 17, is amended to read:
1.15 		Subd. 17.Transportation costs.  (a) Medical assistance
1.16 	covers transportation costs incurred solely for obtaining
1.17 	emergency medical care or transportation costs incurred by
1.18 	eligible persons in obtaining emergency or nonemergency medical
1.19 	care when paid directly to an ambulance company, common carrier,
1.20 	or other recognized providers of transportation services.
1.21 	(b) Medical assistance covers special transportation, as
1.22 	defined in Minnesota Rules, part 9505.0315, subpart 1, item F,
1.23 	if the recipient has a physical or mental impairment that would
1.24 	prohibit the recipient from safely accessing and using a bus,
1.25 	taxi, other commercial transportation, or private automobile.
1.26 	For purposes of this requirement, a recipient has a physical or
1.27 	mental impairment that would prohibit the recipient from safely
1.28 	accessing and using a bus, a taxi, other commercial
2.1 	transportation, or a private automobile if the recipient:
2.2 	(1) lacks the upper body strength, lower body strength, or
2.3 	coordination to safely transfer from a wheelchair and position
2.4 	and secure the recipient's body in a prone or seated position in
2.5 	a vehicle;
2.6 	(2) is unable to safely walk or self-propel a wheelchair
2.7 	from the recipient's residence to a vehicle and from the vehicle
2.8 	through the outside door of the medical facility to the medical
2.9 	appointment; or 
2.10 	(3) is a vulnerable adult as defined in section 626.5572,
2.11 	subdivision 21.
2.12 	The commissioner may use an order by the recipient's attending
2.13 	physician to certify that the recipient requires special
2.14 	transportation services.  Special transportation includes
2.15 	driver-assisted service to eligible individuals.
2.16 	Driver-assisted service includes passenger pickup at and return
2.17 	to the individual's residence or place of business, assistance
2.18 	with admittance of the individual to the medical facility, and
2.19 	assistance in passenger securement or in securing of wheelchairs
2.20 	or stretchers in the vehicle.  Special transportation providers
2.21 	must obtain written documentation from the health care service
2.22 	provider who is serving the recipient being transported,
2.23 	identifying the time that the recipient arrived.  Special
2.24 	transportation providers may not bill for separate base rates
2.25 	for the continuation of a trip beyond the original destination.
2.26 	Special transportation providers must take recipients to the
2.27 	nearest appropriate health care provider, using the most direct
2.28 	route available.  The maximum medical assistance reimbursement
2.29 	rates for special transportation services are:
2.30 	(1) $18 $18.75 for the base rate and $1.40 $1.60 per mile
2.31 	for services to eligible persons who need a
2.32 	wheelchair-accessible van;
2.33 	(2) $12 for the base rate and $1.35 per mile for services
2.34 	to eligible persons who do not need a wheelchair-accessible van;
2.35 	and
2.36 	(3) $36 $60 for the base rate and $1.40 $2.40 per mile, and
3.1 	an attendant rate of $9 per trip, for services to eligible
3.2 	persons who need a stretcher-accessible vehicle.

3.3 	Sec. 2. Laws 2003, First Special Session chapter 14,
3.4 	article 12, section 93, is amended to read:
3.5 	Sec. 93REVIEW OF SPECIAL TRANSPORTATION ELIGIBILITY
3.6 	CRITERIA AND POTENTIAL COST SAVINGS.
 3.7 	The commissioner of human services, in consultation with
3.8 	the commissioner of transportation and special transportation
3.9 	service providers, shall review eligibility criteria for medical
3.10 	assistance special transportation services and shall evaluate
3.11 	whether the level of special transportation services provided
3.12 	should be based on the degree of impairment of the client, as
3.13 	well as the medical diagnosis.  The commissioner shall also
3.14 	evaluate methods for reducing the cost of special transportation
3.15 	services, including, but not limited to:
3.16 	(1) requiring providers to maintain a daily log book
3.17 	confirming delivery of clients to medical facilities;
3.18 	(2) requiring providers to implement commercially available
3.19 	computer mapping programs to calculate mileage for purposes of
3.20 	reimbursement;
3.21 	(3) restricting special transportation service from being
3.22 	provided solely for trips to pharmacies;
3.23 	(4) modifying eligibility for special transportation;
3.24 	(5) expanding alternatives to the use of special
3.25 	transportation services;
3.26 	(6) improving the process of certifying persons as eligible
3.27 	for special transportation services; and
3.28 	(7) examining the feasibility and benefits of licensing
3.29 	special transportation providers.
3.30 	The commissioner shall present recommendations for changes
3.31 	in the eligibility criteria and potential cost-savings for
3.32 	special transportation services to the chairs and ranking
3.33 	minority members of the house and senate committees having
3.34 	jurisdiction over health and human services spending by January
3.35 	15, 2004.  The commissioner is prohibited from using a broker or
3.36 	coordinator to manage special transportation services until July
4.1 	1, 2005 2006, except for the purposes of checking for recipient
4.2 	eligibility, authorizing recipients for appropriate level of
4.3 	transportation, and monitoring provider compliance with
4.4 	Minnesota Statutes, section 256B.0625, subdivision 17.  This
4.5 	prohibition does not apply to the purchase or management of
4.6 	common carrier transportation.

4.7 	Sec. 3. EVALUATION OF SPECIAL TRANSPORTATION SERVICE
4.8 	PROVIDERS.
 4.9 	The commissioner of human services, in consultation with
4.10 	the commissioner of transportation, special transportation
4.11 	service providers, and the broker or coordinator for access
4.12 	transportation service, shall evaluate methods for assuring
4.13 	quality and safety and reducing the cost of special
4.14 	transportation services, including, but not limited to:
4.15 	(1) restricting special transportation service from being
4.16 	provided for trips to day treatment and habilitation services;
4.17 	(2) establishing an independent complaint and dispute
4.18 	resolution process for clients and providers;
4.19 	(3) establishing additional levels of service with
4.20 	corresponding levels of reimbursement; and 
4.21 	(4) establishing appropriate safety standards for vehicles
4.22 	and drivers, including standards for vehicle inspections and
4.23 	driver background checks.
4.24 	The commissioner of human services shall present
4.25 	recommendations for changes in eligibility criteria and quality
4.26 	and safety standards, and provide estimates of potential
4.27 	cost-savings, to the chairs and ranking minority members of the
4.28 	house and senate committees having jurisdiction over health and
4.29 	human services spending by February 1, 2006.