Rider and Trip Type Eligibility Determination | MAN1425
This section applies to Human Service Providers (HSP), whose staff are responsible for determining eligibility and ordering transportation services. Transportation Providers (TP) are encouraged to be familiar with the criteria used for eligibility determination.
Individuals may qualify for transportation services under a variety of programs administered by DHS and other participating agencies. Eligibility criteria varies based on DHS and other partnering agencies' policies and eligibility criteria. It is the responsibility of HSPs to verify whether an individual has exhausted or is not eligible for Medicaid/Medicare transportation benefits.
Rider eligibility and trip type criteria are provided below for each Division, Department, and Agency that is served in the Coordinated Transportation Program.
As transportation funding increases or decreases, DHS will coordinate with the respective divisions to determine which essential trips will be performed.
Rider Eligibility by Divisions
Division of Aging Services (DAS)
DAS HSP staff (e.g., Senior Centers) use standard assessment instruments to determine eligibility. Individuals age 60+ are eligible. Priority is given to those with the greatest social and economic need, with emphasis on persons who fall into the categories of low-income, minority, limited English speaking, rural, and/or functionally impaired.
For the most up-to-date information regarding eligibility, refer to the DAS manual (MAN5300) on the state’s Policy and Manual Management System (PAMMS) at pamms.dhs.ga.gov/das/.
Division of Child Support Services (DCSS)
The Parental Accountability Court (PAC) program is a joint effort of the Division and Superior Court Judges to offer an alternative to incarceration and to help chronic nonpayers of child support make regular payments. The goal of PAC is to reduce recidivism, reduce the burdens and cost of jail, and reduce the public debt for public assistance and public medical care. Through judicial oversight and partnership with public agencies and community-based organizations, PAC will assist and transition noncustodial parents in overcoming barriers to gain self-sufficiency with the integration of screening, assessment, treatment, and the use of rehabilitative services.
For information regarding eligibility and funding, contact the Regional Transportation Office (RTO).
Division of Family and Children Services (DFCS)
Eligible DFCS individuals for Temporary Assistance to Needy Families (TANF) and Supplemental Nutrition Assistance Program (SNAP) are eligible for transportation assistance to support their participation in job search activities, work activities, or to meet personal responsibilities. DFCS case management staff may authorize transportation for additional child welfare trips and other trips for non-TANF trip purposes. If you are uncertain about the availability of funding for non-TANF transportation needs, contact the RTO to inquire.
Transportation assistance for DFCS individuals requires prior-approval by a DFCS case manager.
Department of Behavioral Health and Disabilities (DBHDD)
Eligible individuals within DBHDD meet the requirements for disability services and have no other reasonable and affordable means of accessing DBHDD services. Services are outlined in Individual Service Plans (ISP) or on as needed basis- as approved by a physician for ADA and/or Intellectual and Developmental Disabilities (IDD) diagnosis.
Trip Type Eligibility by Divisions
Division of Aging Services (DAS)
Essential Trips for DAS are listed below, in order of priority:
-
Trips to and from Senior Centers
-
Trips to and from medical appointments, including dialysis, chemotherapy, etc.
-
Trips to and from preventative health screenings and appointments, including dental, vision, hearing, etc.
-
Trips for shopping including, groceries, medications, etc.
-
Trips to and from work/employment
-
Field trips
-
Trips that support application and management of public benefits
-
Trips to pay bills, conduct banking, etc.
-
Trips that support civic engagement and continued involvement in the community, including cultural activities
-
Trips that support evidence-based programs offered through DAS and health/wellness activities offered in the community
-
Trips that facilitate attendance at support group meetings for both caregiver services and kinship care services
Division of Child Support Services (DCSS)
Essential Trips within DCSS include trips that support the Parental Accountability Courts.
Division of Family and Children Services (DFCS)
Essential Trips for the DFCS are listed below, in order of priority:
-
Trips in support of recipients who receive TANF and SNAP Works Program including, employment, job training, job search, etc.
-
Trips to and from technical schools and adult education
-
Trips to and from work experience sites for food stamp recipients
-
Trips to and from medical appointments
-
Trips to and from mental health centers
-
Transitional support service trips
-
Other non-TANF trips
-
Trips to and from substance abuse treatment
-
Trips for Social Service individuals
-
Trips for children in foster care and under child protective services
Department of Behavioral Health and Disabilities (DBHDD)
Essential Trips for DBHDD are listed below:
-
Trips to and from employment locations
-
Trips to and from mental health appointments
-
Trips to and from community training and integration activities
-
Trips to and from medical appointments
-
Trips for social services
HSP Verification of Eligibility
Prior to DHS Coordinated Transportation enrollment, HSPs should verify the individual’s eligibility for DCH or Medicare transportation for all individuals seeking transportation services.
DCH Benefits Eligibility Line - 1-800-334-5432.
The HSP should follow the steps below to determine eligibility:
Step 1
HSPs must validate whether an individual is eligible or receiving transportation benefits through Medicaid or Medicare. The HSP should contact DCH’s Benefits Eligibility Line at 1-800-334-5432.
Step 2
If an HSP is unable to obtain Medicaid/Medicare verification, the HSP should contact the RTO for assistance with DCH verification. The HSPs may also conduct random case list verification and determine continued eligibility for Coordinated Transportation Services.
Step 3
Individuals should receive eligibility verification for Medicaid/Medicare transportation services and should provide verification to the HSPs, if applicable. It is the responsibility of the HSPs to request and obtain the verification prior to enrolling an individual into Coordinated Transportation Services. If an individual is not eligible for Medicaid/Medicare transportation services, the individual should be considered for Coordinated Transportation Services, in accordance with the respective division’s eligibility criteria.
Step 4
If an individual is eligible for Medicaid/Medicare transportation, the individual should not be enrolled in Coordinated Transportation Services until entitlement benefits are exhausted.
Step 5
The HSP must send verification of eligibility to the RTO prior to enrolling an individual into the eTRIPS system.
Step 6
The RTO reserves the right to request additional verification of eligibility, if needed. The RTO and HSP should coordinate to ensure the validity of all verifications.
Step 7
The RTO will work with the HSP to determine trip types and the number of trips that will be required to fulfill the individual’s needs.
Step 8
At any point, the RTO can randomly request validation or verification for existing individuals who participate in Coordinated Transportation Services and are enrolled in the eTRIPS system. The RTO, in coordination with the HSP, can determine if an individual is no longer eligible for Coordinate Transportation Services.
Step 9
The RTO will provide support and/or onsite training to the HSPs and TPs, as needed.
Step 10
TPs can also verify Medicaid/Medicare service eligibility. TPs should also notify HSPs and RTOs, if a determination can be made whether an individual is eligible for Coordinated Transportation Services.