TRANSPORTATION SERVICES: AN EXAMINATION OF REGULATORY PROBLEMS IN MEDICAID AND SOCIAL SERVICE PROGRAMS

This report presents an analysis of the federal statutory, regulatory, and administrative barriers to the participation of all types of transportation providers in the programs authorized by Titles XIX and XX of the Social Security Act. The analysis includes examples of the variety of problems and barriers encountered by the five HEW/HDS demonstration projects in terms of involving the state programs supported by Titles XIX and XX in their coordinated human service transportation systems. The conclusion of this analysis is that at the federal level there are two broad problems that inhibit--but do not prohibit--the involvement of various transportation providers in these programs. The first problem is the lack of federal regulations directly relating to the provision of transportation as a discrete service. In the absence of such regulations, transportation is treated as a component of the health care or social service delivery system, not as a distinct service with unique service delivery requirements. The second problem is the multiplicity of services and service delivery patterns developed by the states in response to the broad mandates in the legislation for Titles XIX and XX. There are three key decision area in the development of Title XIX and XX program plans which define the parameters of a state's program: (1) selection of services, clients, and program accountability measures; (2) approach to the provision of services; and (3) state fiscal and program accountability. The decisions a state makes in these areas are influenced by such factors as the size of the programs, the extent of urban areas in the state, the policies toward the provision of welfare. (Author)

• Corporate Authors:

  Department of Health, Education and Welfare

  Human Development Services, 330 C Street, SW
  Washington, DC  United States  20201
• Publication Date: 1980-1

Media Info

• Features: Appendices; Figures; Tables;
• Pagination: 68 p.

Subject/Index Terms

• TRT Terms: Aged; Conflict (Psychology); Constraints; Demonstration projects; Federal assistance programs; Federal government; Low income groups; Paratransit services; Persons with disabilities; Regulations; Service agencies; Social service
• Uncontrolled Terms: Disadvantaged persons; Federal programs
• Subject Areas: Highways; Law; Public Transportation; Society; I10: Economics and Administration;

Filing Info

• Accession Number: 00322680
• Record Type: Publication
• Contract Numbers: HEW-105-76-7402
• Files: TRIS
• Created Date: Apr 15 1981 12:00AM