Sheryl S. WoolseyNovember 29, 2007

Texas Department of Transportation (TxDOT)

Medical Medical Transportation Transportation

Program (MTP)Program (MTP)

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MTP’s Goal and PurposeMTP’s Goal and Purpose

• To provide cost-effective non-emergency transportation to clients who do not have any other

means of transportation to access necessary health program allowable services.

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• MTP can arrange a free ride, via– Contracted demand response

providers

– Mass Transit

– Mileage reimbursement

– Meals & lodging for overnight stays

Available ServicesAvailable Services

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• For Medicaid under 21 only

– Advance funds for mileage

– Advance funds for meals & lodging

Additional ServicesAdditional Services

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• Three call centers Dallas San Antonio McAllen

• Central Office Program Management

Contract Monitoring Claims

MTP StructureMTP Structure

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• Medicaid

• Children with Special Health Care Needs (CSHCN)

• Transportation for Indigent Cancer Patients (TICP)

Clients ServedClients Served

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• Medicaid– 4,197,997 Trips

• CSHCN– 18,905 Trips

• TICP– 2,824 Trips

Services ProvidedServices Provided

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0

500,000

1,000,000

1,500,000

2,000,000

2,500,000

# of Calls Received

FY 2005

FY 2006

FY 2007

Call VolumesCall Volumes

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• In 2003, legislation mandated that HHSC contract with TxDOT for the provision of transportation services.

• Shortage in General Revenue may have driven the change with State Highway Funds paying for transportation services of Health and Human Services programs.

How Did We Get Here?How Did We Get Here?

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• September 2003 – HHSC signed agreement with TxDOT

• March 2004 - Staff and MTP operations transitioned from Texas Department of Health to TxDOT

When Did We Arrive?When Did We Arrive?

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• March 2004 - Successful transition to TxDOT

– No interruption of client services

• Feb 2005 – New Advance Funds contract

Accomplishments Accomplishments

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• June 2005 - Started reporting for Frew v. Hawkins lawsuit

– Settled in 1996, access to care– April 2005, Attorney General

recommended changes– Within 6 weeks, TxDOT was ready

Accomplishments Accomplishments 22

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• June 2006 – New contracts– Difference in perspective

• Transportation Services/Social Services

– Focus on coordination– Demand Response contractors

• 52 to 15

– Streamlined rate structure

Accomplishments Accomplishments 33

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• June 2006 – Consolidation– From 9 call centers to 3

– Automated Claims Processing

– Created 9 positions for contract monitoring

– Centralized non-call center functions

Accomplishments Accomplishments 44

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• For 5 months in FY 2007, met Frew requirements

– Average wait in queue 60 seconds

(or less)

– Abandon rate of 10% (or less)

Accomplishments Accomplishments 55

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• Rules, Medicaid authority, and reporting reside at different agency

• Separating transportation services from social service functions

• Frew lawsuit • Varying monthly call volumes• Constant change since March 2004

Challenges Challenges

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• Review & revise program rules prior to transition

• Consider moving authority of rules to receiving agency if possible

• Review operations• Look at existing locations and

structure prior to transition

SuggestionsSuggestions

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• Consult call center experts about design and technology

• Be ready for increased visibility

• Recognize differences between transportation models

SuggestionsSuggestions 22

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• Understand cost of delivering services

• Pilot ride-sharing programs

• Notify Centers for Medicaid & Medicare Services (CMS)

SuggestionsSuggestions 33

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• Legislation in 2007 transferred MTP to HHSC.

• Why? Speculatively:– Greater focus on Frew compliance

– CMS deferral

What is Next for MTP? What is Next for MTP?

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• Transition to HHSC by August 31, 2008

• MTP will be part of a new Associateship at HHSC

What is Next for MTP? What is Next for MTP? 22