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Committee weighs volunteer-driver grants and Medicaid nonemergency-transport contract review
Summary
Conference committee discussed Senate additions to the transportation bill that would fund volunteer-driver coordinators, require reporting and outreach, and ask the Department of Vermont Health Access to provide analysis before renewing the Medicaid nonemergency transportation contract.
The conference committee reviewed multiple Senate provisions meant to support demand-response transportation and coordination with Medicaid nonemergency transportation (NEMT) services.
Damian Leonard of the Office of Legislative Council summarized provisions that would authorize $600,000 to fund grants for public transit agencies to hire coordinators for volunteer drivers and would require the Department of Vermont Health Access (DVHA) to provide the Joint Fiscal Committee with a detailed analysis before executing a renewed Medicaid NEMT contract.
"Prior to executing a renewed contract for the Medicaid nonemergency transportation services program, the Department of Vermont Health Access would provide the joint fiscal committee a detailed analysis demonstrating that the contract would not result in a degradation of service to eligible individuals, and the financial stability of the state's public transportation systems will be maintained," Leonard said, reading the Senate language. He noted DVHA has raised concerns about portions of that requirement under federal rules.
Leonard explained DVHAs position: federal rules permit coordination that ensures cost-effective transport of Medicaid beneficiaries, but "Medicaid is not responsible for the general operation or deficit financing of public or private transportation providers," and DVHA cannot guarantee the financial stability of public transit systems through the contracting process.
The Senate also included a report requirement directing DVHA to meet with the Vermont Public Transit Association, the Agency of Transportation, and other stakeholders to identify federally permissible ways to expand the pool of volunteer drivers, including an analysis of background-check barriers and whether those bars are triggered by federal fraud, waste and abuse rules. Both DVHA and the Vermont Public Transit Association would be expected to provide updates to the House and Senate committees on transportation and corresponding health-care committees by January.
Other Senate provisions discussed included a publicity and outreach program led by the Commissioner of Motor Vehicles, and a working group run by the Secretary of Transportation in coordination with the Commissioner of Vermont Health Access to improve coordination of health care and transportation scheduling; that working group would return a report in January.
No formal vote or binding instruction was taken; the items were flagged for further discussion in conference and with stakeholders.
"I do understand that [public transit agencies and the Vermont Public Transit Association] have been continuing to talk about ways [to] clean up the language, but there's some... objections and concerns about their ability to comply with federal requirements," Leonard said.
