Executive Office of Health and Human Services Human Service Transportation (hst) Office

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Executive Office of Health and Human Services

Human Service Transportation (HST) Office

Department of Public Health Transportation for Early Intervention Services

Program Description: Early Intervention (EI) in Massachusetts is a statewide, integrated, developmental service available to families of children between birth and three years of age. Children may be eligible for EI if they have developmental delays due to identified disabilities, or if typical development is at risk due to certain birth or environmental circumstances. EI provides family-centered services that facilitate the developmental progress of eligible children. EI helps children acquire the skills they will need to continue to grow into happy and healthy members of the community. The HST Office manages non-emergency transportation for DPH’s Early Intervention (EI) program through the HST brokerage system via both demand-response and program-based service models. Demand response (“dial-a-ride”) transportation is provided on an as-needed basis for consumers to and from varying locations. Program-based transportation operates on a daily or regularly scheduled basis in which consumers are picked up from their homes and transported to the same program facility, on a grouped or shared-ride basis (similar to a school-bus route). 
Program Statutory Obligations: From Early Intervention Operational Standards: (http://www.mass.gov/Eeohhs2/docs/dph/com_health/early_childhood/operational_standards.pdf) The Massachusetts Department of Public Health (MDPH) is the designated lead agency for Part C of the Individuals with Disabilities Education Act of 2004. Operational Standards are developed based on Part C of Public Health Law (108-446 43 CFR Part 303 Early Intervention Program for Infants and Toddlers with Disabilities), and on Massachusetts General Law, Chapter 111G.
Additionally for MassHealth-eligible EI consumers, the program operates under the auspices of 130 CMR 440.000, Commonwealth of Massachusetts Medical Assistance Program Provider Manual Series, EARLY INTERVENTION PROGRAM MANUAL.
Program Administration: The HST Office is a unit within the EOHHS Secretariat and reports directly to the Chief Administrative Officer. The Office serves the transportation needs of multiple EOHHS agencies via a brokerage system for which it provides service standards development, contract management, oversight and reporting. The HST Office is supported by an Advisory Board made up of senior managers from the participating EOHHS purchasing agencies (MassHealth, DDS, DPH, MRC, and MCB) and other stakeholder agencies (Executive Office of Elder Affairs, MassDOT and Department of Veterans’ Services). Currently six Regional Transit Authorities are contracted with to provide broker services statewide. These brokers implement transportation requests through contracts with over 350 local transportation providers.
Program Eligibility: Eligibility for Early Intervention is determined through an evaluation by a multidisciplinary team exercising sound clinical judgment and using a developmental inventory tool approved by the Massachusetts Department of Public Health. Instruments approved by the Department of Public Health for establishing eligibility are: the Early Intervention Developmental Profile and the Battelle Developmental Inventory-2 (“BDI-2”). Consumer eligibility for DPH transportation within the HST system is determined by DPH. All HST participating agencies including DPH maintain internal control and responsibility for determining:

Program Geographical Service Area: The HST system serves all cities and towns throughout the Commonwealth for DPH transportation.
Program Benefits: Transportation for DPH consumers through the HST system allows such members to have access to necessary care as required by program statutory obligations.

Program Cost and Funding Sources:
Management costs (Broker and HST office) Total HST FY10 management costs were just over $7 million and are funded through an agency chargeback account assessed to the participating agencies and are based on volume/cost of the agency’s services. Costs for DPH were $.2 million (7% of direct service costs). Broker management costs are established through a contract and are reimbursed to the broker via a monthly recurring payment process that does not require invoicing.
Direct service costs (consumer trips) Funding for direct consumer transportation costs is maintained at the agency that authorized the services and broker service claims are billed directly to that agency.
FY10 DPH Transportation

Financial Summary

Operational Summary

Total Expenditures


Consumers served


Average cost per consumer trip


Consumer one-way trips


NOTE: The average cost per consumer trip is a blended rate including mileage and both ambulatory and non-ambulatory (chair-car) trips. This transportation is highly specialized serving infants and toddlers (with developmental delays or at risk for delays) and their families.
For additional details, please see the FY10 HST Annual Report.

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