Library: Policy

317:30-5-327.3. Coverage for residents of long-term care facilities

Issued 9-1-21

(a) An attendant must accompany members during SoonerRide NEMT. An attendant must be at least at the level of a nurse's aide, and must have the appropriate training necessary to provide any and all assistance to the member, including physical assistance needed to seat the member in the vehicle. The attendant must have the ability to interface with health care providers as appropriate. An attendant must be of an age of legal majority recognized under Oklahoma State law.

(1) The long-term care facility must provide an attendant to accompany members receiving NEMT services.

(2) The attendant will be responsible for any care needed by the member(s) during transport and any assistance needed by the member(s) to assure the safety of all passengers and the driver of the vehicle. An attendant leaves the vehicle at its destination and remains with the member(s).

(3) When multiple members residing in the same long-term care facility are being transported to the same provider for health care services, the long-term care facility may provide one (1) qualified attendant for three (3) members unless other circumstances indicate the need for additional attendants. Such circumstances might include, but are not limited to:

(A) The physical and/or mental status of the member(s);

(B) Difficulty in getting the member(s) in and out of the vehicle;

(C) The amount of time that a member(s) would have to wait unattended, etc.

(4) SoonerRide NEMT is not responsible for arranging for an attendant. The services of the attendant are not directly reimbursable by the SoonerRide program or SoonerCare. The cost for the attendant is included in the SoonerCare long-term care facility per diem rate.

(5) In certain instances, a family member or legal guardian may wish to accompany the member for health care services. In such instances, the family member or legal guardian may accompany the member in place of the attendant. Only one (1) medical escort may accompany a member and it must be declared, upon reservation, that the medical escort is accompanying the member. The medical escort must be able to provide any services and assistance necessary to assure the safety of the member in the vehicle.

(A) When a medical escort wishes to accompany the member in place of an attendant provided by the long-term care facility, the medical escort and the long-term care facility must sign a release form stating that a medical escort will be traveling with the member and performing the services which would normally be performed by the attendant. This release must be faxed to the SoonerRide broker's business office prior to the date of the transport.

(B) If a medical escort is used in place of an attendant provided by the long-term care facility, that medical escort cannot be counted as a medical escort for any other member who is traveling in the same vehicle.

(C) In the event that additional individuals request transportation, it is the responsibility of the member to contact the transportation provider directly to request allotment of additional passengers. The SoonerRide NEMT broker will not facilitate this request.

(D) A medical escort or attendant is not eligible for direct compensation by the SoonerRide NEMT broker or SoonerCare.

(b) For members who require SoonerRide NEMT for dialysis, one (1) attendant is required to accompany a group of up to three (3) dialysis patients when they are being transported for dialysis services. The attendant must remain with the patient(s) unless the provider of the dialysis treatment and the long-term care facility sign a release form stating that the presence of the attendant is not necessary during the dialysis treatment. The release must be faxed to the SoonerRide NEMT broker's business office prior to the date of the dialysis service.

(1) In instances when an attendant does not remain with the member(s) during dialysis treatment, SoonerRide NEMT is not responsible for transporting the attendant back to the long-term care facility.

(2) In instances when an attendant does not remain with the member(s) during dialysis treatment, the long-term care facility is responsible for providing an attendant to accompany the member(s) on the return trip from the dialysis center. The long-term care facility is also responsible for transporting that attendant to the dialysis center in order to accompany the member(s) on the return trip.

(c) In the event that a member is voluntarily moving from one (1) long-term care facility to another, SoonerRide will provide NEMT to the new facility. The long-term care facility that the member is moving from will be responsible for scheduling the transportation and providing an attendant for the member.

(d) In the event that a long-term care facility's license is terminated, SoonerRide will provide NEMT to a new long-term care facility. The long-term care facility that the member is moving from will be responsible for scheduling the NEMT through SoonerRide and providing an attendant to accompany the member. SoonerRide is only responsible for transporting the member. Personal belongings and/or durable medical equipment (with the exception of portable oxygen or a wheelchair that is medically necessary for transportation) will not be transported through SoonerRide NEMT.

(e) The long-term care facility is responsible for providing a wheelchair when needed. This item is not provided by the SoonerRide NEMT transport.