138.4 Transportation Allowances

The CAO may provide an allowance for costs related to transportation as a special items allowance or, in some cases, as a payment from the CAO petty cash fund. If all requirements are met, an allowance is given to a person who needs transportation for:    55 Pa. Code § 175.23

• Necessary medical care;

• Employment and training. See Section 135.6;

• Other special needs; or

• Relocation of a non-exempt minor parent to the home of a parent or legal guardian. See Section 138.42, Other Special Transportation Allowances.     55 Pa. Code § 141.21(q) & (r)

138.41 Transportation for Necessary Medical Care

Medical transportation services are available to TANF, MAGI, NMP, MNO and SSI recipients who have no other means of transportation to necessary medical care or to obtain prescription drugs.    55 Pa. Code § 175.23

Exception: Transportation services are not available to recipients of Healthy Horizons cost-sharing benefits, SelectPlan for Women, or individuals in the Private Coverage Option (PCO).

Transportation grants for necessary medical care are available to recipients from one of two sources:

1. The Medical Assistance Transportation Program (MATP), if the county has this program.

2. The CAO for medical transportation needs not covered by MATP or for medical transportation needs in counties that do not have an MATP.

138.411 Medical Assistance Transportation Program (MATP)

The MATP is available in all but a few Pennsylvania counties. See Appendix C for a list of the MATP agencies in each county. Title XIX funds the program. It is not a CAO program. The service can be provided in a variety of ways:

• Actual transportation of eligible recipients to and from the medical services.

• Tokens or tickets for public transportation.

• Reimbursement to the person for the cost of the trip.

• Other methods as approved by DHS.

Follow these steps when an eligible recipient requests medical transportation services from the CAO:

• Confirm that the recipient's category of medical assistance (MA is eligible to receive MTA

• Contact the county MATP agency to determine if it will provide the necessary assistance.

• If the MATP will provide the service, advise the recipient how to contact the MATP to apply for the service. It is the person’s responsibility to contact the service to make arrangements and verify Medical Assistance eligibility.

• Give a special allowance only if the MATP agency is unable to provide the service. This special allowance should never be a vendor payment.

The MATP will establish a service area. The MATP agency will cover all transportation to necessary medical care within the designated service area.

The CAO will need to contact the local MATP agency to determine the service area.

MATP services may be denied for these reasons:

• The MATP determines that the care is within the service area but is not necessary or is for a service the MA program does not cover.

• There are sanctions from the MATP program.

• The MATP did not receive adequate notice of the medical appointment.

Written notice of denial is not required unless the person requests written notice. The person may appeal the decision to the MATP agency.

If the MATP determines that the service is outside the service area or is unable to provide transportation for any reason, it must refer the person to the CAO to request a medical transportation allowance. The CAO will approve a medical transportation allowance only if the requirements of Section 138.412 are met.

138.412 Medical Transportation Allowances (MTAs)

The CAO will approve a medical transportation allowance, paid by EBT to the client or by  check to the provider of the service, if all of the following requirements are met:     55 Pa. Code § 175.23

• The county does not have an MATP or it has an MATP, but the recipient has been denied services or needs medical care that can only be provided outside the MATP service area. The CAO must receive a copy of the MATP denial notice and scan it into the case record.

      NOTE: This denial must be updated at renewal.

• The medical service is necessary.

• No other means of transportation is available.

• The person has provided written verification from the physician or medical facility that an appointment has been scheduled or the service has been provided.

• Travel is to the closest source for providing the required care.

NOTE:  If the person chooses to travel a distance longer than the CAO determines necessary, approval and the amount of the allowance is based on the closest available care.

• The transportation is to a medical service covered by the MA Program. It is not a requirement that the provider actually accept DHS payment. MA reimbursable providers include:

• Ambulatory surgical centers

• Birth centers

• Chiropractors

• Dentists

• Dialysis clinics

• Drug and alcohol clinics (including methadone maintenance services)

• Family planning clinics

• General hospitals and all out-patient services provided by the hospitals

• Health Maintenance Organizations

• Home health agencies

• Independent laboratories

• Independent medical/surgical clinics

• Medical suppliers (including low vision centers and opticians)

• Midwives

• Nursing facilities (including those for the mentally retarded: ICF/MR)

• Optometrists

• Pharmacies

• Physicians

• Podiatrists

• Primary health care clinics

• Private psychiatric hospitals

• Psychiatric clinics (including mental health partial hospitalization)

• Rehabilitation hospitals and all out-patient services provided by the hospital

• Rural health clinics

• Short procedure units

NOTE:  If in doubt about the eligibility of the medical service, the CAO may check the MA Fee Schedule to determine if the service is covered. This may require contacting the provider to determine the procedure code for the service.

Eligible transportation does not include ambulance service available from enrolled providers. It also does not include transportation to a sheltered workshop, medically-related day care, or mental health social rehabilitation programs such as adult day care and MH/MR Respite Care.

If the medical transportation need meets the above requirements, the CAO will authorize an OTI for the sum of the allowable costs.

The CAO will authorize an allowance for transportation based on the most economical and practical means of travel meeting the needs of the recipient.  Approval will not be based on convenience for the individual involved.

The Executive Director, or the designee, must review and approve all MTA payments prior to issuance.

138.413 Medical Transportation Allowance Payments

Medical Transportation Allowance payments will be paid via EBT or by check mailed directly to the transportation vendor.

Payments made directly to the medical transportation vendor for the client will be issued by a batch process initiated in CIS.  These may include payment for non-emergency ambulance transport, paratransit, and stretcher vans.

Payments made to a transportation vendor will be issued using reason code 265 for new issuances and reason code 266 for replacement issuances.  (For more information, see Chapter 180, Issuing Benefits, Section 180.5.)

Direct vendor payments will only be processed when:

•  The recipient has been determined eligible to receive an MTA per Cash Assistance Handbook 138.412;   and

•  The transportation service was provided and the vendor has not yet been paid; and

•  The CAO received an invoice from the transportation vendor showing the recipient’s name, destination,  and itemized amount of all charges;  and

•  The transportation vendor has been approved by Bureau of Policy as eligible to receive payment via direct vendor payment.  Approved vendors will have a prefix of ‘M’.  

Note: not all MTAs will be issued via this direct payment.  The following MTAs will continue to be issued via EBT and reason code 200:

•  Personal Auto: transportation provided by the person, volunteer driver, car or van pool, parking fees,  highway and bridge tolls.

•  Public transit: bus, subway, trolley, commuter rail service and passenger air service.

•  Taxi.

•  Lodging.  (For more information, see Section 138.315.)

•  Meals. (For more information, see Section 138.315.)

•  Requests where the client has actually paid for the transportation and is requesting reimbursement.

•  Mileage reimbursements.

•  Any other situation where an immediate need for payment is determined AND pre-approved by the Area  Manager.

Reminder: A PA1908 must be signed when the MTA is issued via EBT.  This form must be scanned into the record and a narrative must state the form was received.  Thereafter, a new form must be signed at renewal.

NOTE:  For transportation to obtain prescription drugs, the CAO may include medical transportation allowances in the regular payment if the need is continuing. The check is written for the actual amount of the costs even if that amount is less than $1.00. The CAO will issue all checks for less than $1.00 from county issuance.     55 Pa. Code § 175.23

138.414 Medical Assistance Transportation Program CAO Liaisons

Each CAO will appoint a liaison to serve as the point of contact between the CAO and the MATP agency.  The liaison is responsible for communication between the CAO and the MATP agency.  The CAO liaison should direct any questions regarding MATP service areas, reasons for denials, available modes of transportation, etc., to the MATP liaison to ensure that the CAO is responsible for payment of the least expensive mode of transportation being provided.                                        

The MATP agency is required to send a written referral to the CAO when MATP services are denied.  The CAO liaison will contact the MATP agency when the referral is needed or is incomplete.  With consent of the MATP liaison, the CAO liaison may correct the referral.  The CAO liaison should initial any changes or additions and narrate thoroughly.                                                                                                                     

The MATP referral must include the following information:

• Name, address and recipient number of the person being referred.

• Specific reason why MATP denied the service.  “Exceptional Transportation” is not a sufficient reason.  An explanation why the transportation is exceptional is required.

• The recipient's requested destination.

• Dates the denial is intended to cover.

138.415 Medical Transportation Allowance Narrative

Each step of the eligibility process must be narrated.  Narratives for ALL MTAs must include:

• The date the allowance was requested.  Confirm that the recipient was informed of all program requirements and no other means of transportation was available.

• The date the MATP referral was received and any action taken to correct incomplete information.  Include the reason MATP denied services.

• The date(s), starting location and destination of the transportation being requested, the written verification from the physician or medical facility, and verification that transportation is to the closest facility.

• If the individual chose to travel further than the CAO determines necessary, and an explanation of which facility the approval and amount of the allowance is based on.

• Written or verbal verification that the service is covered by MA.  It is not a requirement that the provider actually accept DHS payment, only that the service would be paid under the recipient’s benefit package.

• Whether the payment was issued via EBT or paid directly to the transportation vendor.

• If a bill from a transportation vendor is received, include the name of the company, dates of service, amount billed, and the invoice number.

• If EBT payment, state if the recipient signed the PA1908.

• Amount authorized.  Narrate if EBT payment or direct vendor payment.

• Statement that this was the least expensive mode of transportation available to the client.

• Any other action taken.

• Narrate when the invoice does not have a number or trip identifier

• When issuing multiple MTA’s on subsequent days, complete a case narrative for each MTA on the day it is issued.

• Narrate the date that the invoice/receipts, MATP Denial, and written verification of the medical appointment were scanned into imaging.

Note:  When issuing multiple trips on one MTA, the narrative must include all trip numbers or trip identifiers, the     dates of the transportation, and dollar amounts of all trips.

• Example: 8/1/14 Trip ID 123456789  $125.00

                                    8/2/14 Trip ID 987654321  $125.00

138.416 Verification

All verification must be scanned and attached to the record.  These documents will be attached together under Special Allowances.  Enter the payment date in the comments.  Each scanned package will contain:

• MATP referral.

• Physician or medical facility verification.

• Vendor invoice.

• PA1908, if required.

• Any other documentation received.

138.417 Issuing the Medical Transportation Allowance to the Transportation Vendor

The CAO will issue payment to the transportation vendor following the current One Time Issuance (OTI) process.  The system will always default to central issuance for reason codes 265 and 266.           

Access the OTI screen via the Financial Management module in eCIS. Enter case number and search.  The case result section appears.  The worker will select reason code 265 (initial issuances) or 266 (replacement issuances) and complete the following required fields:

Budget:  From the drop-down box, select the category/budget group for the individual who received the transportation.

Amount:  Enter the amount of the allowance.

Individual #:  From the drop-down box, select the name of the person who received the transportation.

Description:  Enter the invoice number from the vendor invoice.

Benefit Period:  Enter the exact dates on the vendor invoice.

Prefix – Vendor ID: Click “Look up” and select the name of the vendor from the table.

When you submit this information, the local issuance field at the bottom of the page will populate.  The worker will not be able to make any adjustments to this section.  The worker must verify that the vendor name and address shown matches the invoice.

If the information does not match OR the vendor is not listed in the vendor drop-down table, the CAO Liaison will contact Bureau of Policy.

The OTI will be sent for approval by the Executive Director, or their designee, before the allowance is issued.

Multiple checks to one provider for the same client on the same day will be pulled for inquiry.  If possible, combine trips for one MTA; and if additional MTA’s are necessary, issue on subsequent days.

If a benefit is returned, the CAO must take any corrective action as directed by their Area Manager.  Reissue the benefit when it shows returned in benefit history.  These benefits will be reissued via reason code 265.            

            Reminder:  Do not reissue until the benefit shows returned.

138.42 Other Special Transportation Allowances

Allowances for special transportation needs are available to TANF recipients only if the expenses cannot be met from other sources. Allowances for special transportation costs are limited to:     55 Pa. Code § 175.23

• Transportation to get to the place where the person is to have a medical or psychological examination the Department is requiring. 55 Pa. Code § 175.23    

• Transportation that is part of an agency or institution's plan for the treatment of the recipient, his spouse, parent, substitute parent or child.   55 Pa. Code § 175.23

Example: A person’s child is living in a mental retardation facility and the CAO verifies that a visit by the parent is part of the institution's plan for treating the child.

• Transportation required to comply with an operational requirement.     55 Pa. Code § 175.23

Examples:

• The CAO asks the person to report to a site for a new photo ID card.

• The CAO asks the person to travel to a Notary Public for a notarized affidavit when a Notary is not available in the CAO.

• The CAO asks the person to report to the office for a redetermination and the CAO does not have a petty cash fund.

• Transportation for children to participate in EPSDT outreach screening.    

• Transportation costs required as part of a plan for decreasing the need for assistance.

Examples:

• A TANF mother is required to appear in court in another state to establish paternity and petition for payment of a court order.

• Transportation of the person to apply for admission of a dependent child or for the dependent child to attend a secondary or vocational school.     55 Pa. Code § 175.23

  Reason Code	Special Requirements
  171 – Transportation for a child to apply for or attend school (Includes: Private Auto, Public Transit, Taxi, and Paratransit)	Note: Not related to RESET. Must be required as part of the application procedure. The school cannot be part of a public or parochial school system. Nonrecurring.
  Prior Approval:	No.
  Description Required:	Yes.

• Transportation of a TANF dependent, unemancipated child to attend a secondary school or an equivalent vocational or technical training school.      55 Pa. Code § 175.23

  Reason Code	Special Requirements
  171 – Transportation for a child to apply for or attend school (Includes: Private Auto, Public Transit, Taxi, and Paratransit)	Note: Not related to RESET. The child is required to provide and pay for the transportation. The child can reasonably be expected to complete the program before age 19. A secondary school or an equivalent vocational or technical school may not be part of a public or parochial school system. Nonrecurring.
  Prior Approval:	No.
  Description Required:	Yes.

• Transportation of a member of a CAO or state citizen's advisory committee to attend committee meetings. Child care or incapacitated adult care may also be covered in certain situations.      55 Pa. Code § 175.23

  Reason Code	Special Requirements
  850 – Transportation (Includes: Private Auto, Public Transit, Taxi, and Paratransit)	Child care for children under age14 only. The incapacitated adult must live in the home.
  296 - Child Care	Nonrecurring only.
  Prior Approval:	Yes.
  Description Required:	Yes, except Codes 296 & 297

• Transportation for a minor parent and the dependent child when the minor parent is not exempt from the requirement to reside in the home of the minor parent's parent or legal guardian.         55 Pa. Code § 175.23(e)

  Reason Code	Special Requirements
  254 – Transportation (Includes: Private Auto, Public Transit, Taxi and Paratransit)	Does not meet an exemption under Section 110.6.
  	The parent or legal guardian live within the state or in another state.
  	The minor parent and dependent child will not be forced to return to unsafe living conditions.
  	The allowance will be based on the most economical and practical means of travel required to meet the minor parent's needs.
  	Payment will not be authorized until it is confirmed that the minor parent has permission to reside in the parent's or legal guardian's home.
  	The allowance will be limited to once in a 12-month period.
  Prior Approval:	Yes.
  Description Required:	Yes.

138.43 Petty Cash Fund Disbursements

Payments to cover the cost of certain special transportation needs are available to applicants and recipients of TANF or GA from the CAO’s Petty Cash Fund when the CAO determines that there are transportation barriers. The CAO issues a payment from petty cash for transportation based on the most economical and practical means of travel required to meet the person’s needs, including child care needs, the person’s health and the public transportation schedule.    55 Pa. Code § 175.23   55 Pa. Code § 229.24(a)   55 Pa. Code § 229.24(e)(10)

Approval is not based on convenience. For example, a person may not choose to take a taxi to and from an appointment at the CAO if there is available bus service that meets the person’s needs. The CAO may issue a payment only:

• To explore job referrals at the request of the CAO or Job Service.

• To obtain a medical examination at the request of the CAO.

• To report for an office interview at the request of the CAO.

• To report for an office interview at the request of the Domestic Relations Section (DRS) under the child support program.

• To attend a citizen’s advisory meeting at the request of the Department.

Payment from petty cash may be made either in cash or transportation tokens. Payment is limited to:

• Actual minimum cost for employment-related activity required by the CAO or Job Service. See Section 138.31.

• Actual minimum cost to attend a citizen's advisory committee meeting.

• Actual minimum cost per trip per recipient for any other purpose.

NOTE:  This does not affect the mileage rate of $0.12 per mile when a private automobile is used. The CAO may pay the actual cost for use of a private automobile using actual miles traveled multiplied by the mileage rate ($0.12 per mile).

Examples for recipients:

• Ms. D receives cash assistance and is scheduled for a redetermination interview. She does not own a car and calls the caseworker with transportation concerns. She lives 8 miles from the CAO and takes the bus to and from her appointment. The round trip bus fare is $4.50. The CAO authorizes $4.50 from the petty cash fund to reimburse Ms. D’s expenses for the actual cost of the trip.

• Mr. H receives cash assistance and is asked to report to the CAO for an interview. He lives 22 miles from the CAO and uses his own vehicle to make the trip. During the interview, Mr. H advises the caseworker he may not have enough gas to get home. The CAO authorizes $5.28 (22 miles x $0.12 x 2) from the petty cash account.

Examples for Applicants:

• Mr. Q submitted his GA application.  He receives a notice advising when his interview appointment is.  Mr. Q calls the caseworker to explain that his car broke down.  He has no means to fix it and lives 26 miles from the CAO.  The caseworker offers mileage reimbursement at $0.12 per mile to be disbursed at the interview.  Mr. Q’s neighbor drives him to the interview and he gives the mileage reimbursement to his neighbor to pay for gas.

• Mrs. X and her child come into the CAO near closing time wanting to apply for assistance.  It is not safe for them to return home and they have no place to go.  The CAO offers petty cash to Mrs. X, so she and her child can get to the local women and children’s shelter.

Use the Petty Cash Voucher, Form PA 122-PC, to authorize payments from the fund. The IMCW checks the box next to "Immediate Need" after verifying that the applicant or recipient meets the criteria for Petty Cash disbursement. Prepare the form in original form only. Retain and use the form for accounting necessary to replenish the fund.

NOTE:  See Section 135.6, Special Allowances for Supportive Services, for special allowances for supportive services.

Reissued June 7, 2019, Replacing February 6, 2015