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On June 10, 2009, the Legislative Audit Commission approved the following recommendation from the Legislative Auditor:

Recommendation

Because of changes enacted by the 2009 Legislature, we recommend that OLA postpone starting work on an evaluation of medical nonemergency transportation until early 2010. This would allow the “dust to settle” and give all parties involved time to address transition problems that might occur.

In the meantime, we recommend that OLA immediately begin an evaluation of public libraries, with a report due in early 2010.1 Once completed, staff from this evaluation would return to the medical nonemergency transportation evaluation, with a report due in mid-2010.

Additional Information

On April 17, 2009, the Legislative Audit Commission directed the Office of the Legislative Auditor (OLA) to evaluate medical nonemergency transportation services for public assistance recipients. Legislators were concerned about the Department of Human Services’ (DHS) use of a private broker, Medical Transportation Management (MTM), to arrange access transportation services in the 11-county metropolitan area.2 They also questioned whether DHS’s use of the broker to assess, on a statewide basis, whether recipients qualified for special transportation services is a conflict of interest, leading to inappropriate levels of service for some recipients.

The 2009 Legislature adopted major changes to the medical nonemergency transportation program. The Omnibus Health and Human Services bill signed by the Governor on May 14, 2009, prohibits DHS from using a broker to arrange for and monitor access transportation services after June 30, 2009.3 The department can continue to use a broker to assess recipients’ need for special transportation services.

The 11 counties in the Twin Cities metropolitan area, DHS, and MTM have been meeting to help ensure an orderly transition. However, it is still not entirely clear how ATS will be organized in the metropolitan area as of July 1. The counties themselves could individually arrange access transportation services for their public assistance clients, which would cost them about $3.7 million for fiscal year 2010.4 It is more likely that the counties will jointly contract with MTM to arrange access transportation services for their public assistance recipients. The 11 counties involved are currently meeting with MTM to work out the details and costs of such an arrangement. According to DHS, if the counties are not able to work out an agreement with MTM, MTM would likely not want to continue assessing recipients’ need for special transportation services, since this component is a small portion of its current responsibilities. If this happens, DHS would assume responsibility for making such determinations.


1The Legislative Audit Commission added public libraries to OLA’s 2009 list of approved topics on April 17, 2009, with the understanding that such a study would begin after the current round of studies was completed.
2 Access transportation services are provided to ambulatory and wheelchair recipients who do not require driver assistance from inside their residences to inside their health care providers’ offices. It includes buses, taxis, and personal or volunteer mileage for curb-to-curb or door-to-door services. In contrast, special transportation services are provided to recipients who have a severe physical or mental condition that prevents them from accessing medical treatment without driver-assisted services from inside their residences to inside their health care providers’ offices.
3Laws of Minnesota 2009, chapter 79, art. 5, sec. 34.
4 Minnesota Management and Budget, Local Fiscal Impact Note: Non-Emergency Medical Transportation Modifications, St. Paul, Minnesota, May 14, 2009.