Counties seek clarity as state moves to take over non‑emergency medical transportation

Human‑services staff told the joint Dakota‑Scott workshop that a 2024 legislative change would transfer non‑emergency medical transportation (NEMT) responsibilities toward the state, raising continuity and fiscal questions for counties.

A presenter described NEMT as a federally required Medicaid service and said counties are watching a state procurement and vendor selection process that has lagged. "This is required by federal Medicaid law," the presenter said when describing the program's scope. Staff explained the state initially set an implementation date for July 1 and counties are seeking updates and contingency options because contracts and county staffing are already affected: Scott County removed the service from its budget and said staff are retiring, creating a continuity concern.

Counties asked whether the state will provide ongoing funding for the service and whether the timing will be extended. County administrators reported that Dakota, Scott and Carver signed and sent a letter to the Department of Health and Human Services to highlight legal authority and fiscal impacts, and staff said they are tracking legislative proposals to move the planned transition back to allow more time for a smooth changeover.

Commissioners directed staff to continue monitoring the state's vendor process, estimate county fiscal exposure under several timelines, and propose contingency options including temporary consortium arrangements with other counties or with Hennepin County’s consortium model to preserve service for residents reliant on dialysis, chemotherapy and other medical appointments.