2024 -- S 3127

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LC006205

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2024

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A N   A C T

RELATING TO PUBLIC UTILITIES AND CARRIERS -- MOTOR PASSENGER CARRIERS

-- NON-EMERGENCY MEDICAL TRANSPORTATION

     Introduced By: Senators Britto, Ciccone, DiMario, Sosnowski, F. Lombardi, and Lawson

     Date Introduced: June 03, 2024

     Referred To: Senate Health & Human Services

     (Governor)

It is enacted by the General Assembly as follows:

     SECTION 1. Section 39-13-1 of the General Laws in Chapter 39-13 entitled "Motor

Passenger Carriers" is hereby amended to read as follows:

     39-13-1. Definitions.

     (a) “Coordinated paratransit services” means paratransit services coordinated by the

department of transportation, to be provided under a brokerage or other contractual model to

provide, promote, and coordinate new or existing paratransit operations to enable all state,

municipal, and private agencies access to appropriate paratransit services. For the purpose of this

chapter, non-emergency medical transportation as defined in § 39-14.3-1 shall not be considered to

be coordinated paratransit services.

     (b) “Jitney” means and includes any motor bus or other public-service motor vehicle

operated in whole or in part upon any street or highway in such manner as to afford a means of

transportation similar to that afforded by a street railway company, by indiscriminately receiving

or discharging passengers; or running on a regular route or over any portion thereof; or between

fixed termini.

     (c) “Paratransit services” means flexible transportation services provided on a demand-

responsive and advance-reservation basis, for any destination within the scope of a service program

provided by a state or municipal agency, the fee for which is determined pursuant to a contract

between the service provider and the state or municipal agency. Paratransit includes single or group

trips or trips made on a recurring basis such as for work, school, medical, nutrition, and sheltered

workshops.

     (d) “Public-service motor vehicle” shall include all motor vehicles as defined in § 31-1-3,

used for the transportation of passengers for hire.

     (e) “Transportation operator(s)” means an entity(ies) providing flexible transportation

services that are operated publicly or privately, and are distinct from conventional fixed-route,

fixed-schedule transit, and are generally operated with low-capacity vehicles that provide curb-to-

curb or door-to-door service that typically involves transportation of elderly, disabled, low-income,

or the otherwise transportation-dependent population.

     SECTION 2. Title 39 of the General Laws entitled "PUBLIC UTILITIES AND

CARRIERS" is hereby amended by adding thereto the following chapter:

CHAPTER 14.3

NON-EMERGENCY MEDICAL TRANSPORTATION

     39-14.3-1. Definitions.

     Terms used in this chapter shall be construed as follows, unless another meaning is

expressed or is clearly apparent from the language or context:

     (1) "Certificate" means a certificate of operating authority issued to a non-emergency

medical transportation service provider.

     (2) "Common carrier" means any person engaging in the business of providing for-hire

non-emergency medical transportation services as defined in this chapter.

     (3) "Division" means the division of public utilities and carriers.

     (4) "Driver" means any person operating a motor vehicle used to provide non-emergency

medical transportation services that the person owns or is operating with the expressed or implied

consent of the vehicle owner.

     (5) "EOHHS" means the Rhode Island executive office of health and human services.

     (6) "Non-emergency medical transportation" or "NEMT" means the transportation

program established to provide cost effective NEMT services for individuals eligible for medical

assistance under the Medicaid State Plan who need access to health care services and have no other

means of transportation. The program is inclusive of the Elderly Transportation Program (ETP)

and monthly bus pass distribution for the TANF ("RI Works") program. It is a key benefit of

Medicaid defined under 42 C.F.R. 457.1206 and is frequently coordinated by state agencies,

departments, and authorities, including the executive office of health and human services and the

RIde program administered by the Rhode Island public transit authority, and may be coordinated

by a third-party scheduler contracted by such state agency, department or authority. For the

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purposes of this chapter, the coordination of transportation by medical facilities when discharging

patients/clients shall not be deemed NEMT.

     (7) "Non-emergency medical vehicle" ("NEMT vehicle") means a vehicle operated under

the authority of a NEMT certificate holder in vehicles bearing "Public Service" registration plates

issued by the department of motor vehicles.

     (8) "Passenger" means an individual being transported by a certificated carrier in

conformance with the provisions of this chapter.

     (9) "Person" means and includes any individual, partnership, corporation, or other

association of individuals.

     (10) "Public motor vehicle" and "PMV" and "public motor vehicle certificate of operating

authority" means the type of vehicle and operating certification process as defined in § 39-14.1-1.

     (11) "RIPTA" means the Rhode Island public transit authority.

     (12) "Special license" means a license, commonly referred to as a "hackney operator's

license," issued by the division of public utilities and carriers authorizing drivers to transport

passengers for compensation.

     (13) "Taxicab" means every motor vehicle identified as such in § 39-14-1.

     (14) "Third-party scheduler" means a vendor engaged by a state agency, department or

authority to schedule and coordinate transportation services for clients of the agency, department

or authority.

     (15) "Vehicle" means a motor vehicle used to provide non-emergency medical

transportation services as defined in this chapter.

     (16) "Vehicle markings" means markings required to be affixed to the outside of vehicles

identifying the vehicle as providing NEMT service.

     (17) "Wheelchair-accessible vehicle" means a vehicle designed and equipped to allow the

transportation of a passenger who uses a wheelchair without requiring that passenger to be removed

from the wheelchair.

     39-14.3-2. Powers of division.

     Every person owning or operating a motor vehicle engaged in providing non-emergency

medical transportation is declared a common carrier and subject to the jurisdiction of the division.

The division may prescribe any rules and regulations that it deems proper to ensure adequate,

economical, safe, and efficient service regulated under this chapter. Moreover, the executive office

of health and human services shall determine reasonable vehicle standards to ensure NEMT

vehicles are of satisfactory condition, age, and mileage to be used to transport NEMT passengers

in a safe, sanitary, and acceptable manner.

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     39-14.3-3. Certificate required for NEMT operations.

     (a) No person shall operate a vehicle in the provision of non-emergency medical

transportation in this state until the person shall have obtained an NEMT certificate of operating

authority from the division certifying that the applicant is fit, willing, and able to provide such

service to passengers. The certificate shall be issued only after submission to the division of a

written application for it, accompanied by a fee of one hundred twenty-five dollars ($125), and

after a public hearing has been conducted on the application. Certificates issued under this chapter

shall be renewed before the close of business on December 31 of each calendar year. The renewal

fee shall be one hundred dollars ($100) and shall be submitted with the renewal form. All revenues

received under this section shall be deposited as general revenues.

     (b) Notwithstanding the provisions of subsection (a) of this section, the division shall have

the authority to automatically grant such a certificate to any applicant who has previously held a

public motor vehicle certificate, issued under § 39-14.1-3 ("PMV certificate"), and has utilized that

certificate solely to provide non-emergency medical transportation prior to the establishment of

this chapter. In such instances, the division may administratively convert such a PMV certificate to

an NEMT certificate without the need for an additional application fee to be paid or an application

hearing to be held. The division shall establish a mechanism for all such certificate conversion

requests to be made no later than August 1, 2024. Nothing in this subsection shall be construed to

mean that such converted certificates are exempt from the annual renewal process listed in

subsection (a) of this section.

     (c) Non-emergency medical transportation services provided by RIPTA and by licensed

ambulance companies shall be exempt from this chapter.

     (d) Taxicab companies certificated and authorized by the division under chapter 14 of title

39 shall be permitted to provide non-emergency medical transportation services without the need

to apply for an NEMT certificate as required in subsection (a) of this section; provided, however,

that taxicabs shall not provide services beyond the authority conferred through its division-issued

certificate of public convenience and the requirements set forth in chapter 14 of title 39.

     (e) Transportation network companies authorized by the division under chapter 14.2 of title

39 shall be exempt from this chapter, provided, that non-emergency medical transportation

conducted by such companies shall be provided in accordance with policies established by EOHHS.

     (f) No for-hire transportation services authorized by the division under chapter 14 of title

39 under chapters 13 or 14.2 of title 39 shall be authorized to provide non-emergency medical

transportation services, without first having obtained an NEMT certificate as required in subsection

(a) of this section.

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     39-14.3-4. Hearing on application.

     Upon receipt of an application for new authority, the division shall, within a reasonable

time, set the time and place for the required hearing. Notice of the hearing shall be given by first-

class mail to the applicant and shall be published on the division's agency website. Following the

hearing, the administrator of the division shall issue a decision granting or denying the application

as soon as practicable.

     39-14.3-5. Safety and sanitary condition of vehicles - Inspection and suitability.

     The division of motor vehicles shall have jurisdiction over the lighting, equipment, safety

and sanitary condition of all vehicles utilized to provide non-emergency medical transportation and

shall cause an inspection of it to be made before registering it, and from time to time thereafter, as

it shall deem necessary for the convenience, protection, and safety of passengers and of the public.

The division of motor vehicles shall establish a reasonable fee to be paid for each annual inspection.

Moreover, the executive office of health and human services shall ensure that the vehicles are of

satisfactory condition, age, and mileage to be used to transport NEMT passengers in a safe, sanitary,

and acceptable manner.

     39-14.3-6. Registration and vehicle markings.

     (a) Every vehicle engaged in non-emergency medical transportation shall be appropriately

registered with the division of motor vehicles to be operated on the roadways of the state. Moreover,

before being used to transport passengers, certificate holders shall register each vehicle with the

division on a form that lists vehicle year, make, model, and license plate number.

     (b) Every vehicle used to provide non-emergency medical transportation services shall bear

markings on the outside of the vehicle identifying it as authorized to provide such services. Such

markings shall make it clearly identifiable as an NEMT vehicle and shall list the NEMT certificate

number issued by the division. The division shall, in conjunction with EOHHS and all other state

agencies that contract for NEMT services on behalf of passengers, establish reasonable guidelines

for such vehicle markings.

     39-14.3-7. Drivers - General requirements.

     No person shall operate an NEMT vehicle for compensation upon the public highways

until the person shall have first obtained an operator's license as provided for in chapter 10 of title

31. Provided, further, no person shall operate an NEMT vehicle upon the highways until the person

shall have first obtained a special license from the division under any rules and regulations that the

division shall have established in accordance with § 3-14-20 and § 39-14.1-8. Nothing in this

section shall prohibit the executive office of health and human services from requiring additional

vetting and/or training of NEMT drivers.

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     39-14.3-8. Proof of financial responsibility.

     The owner of any NEMT vehicle operating under this chapter shall file with the division a

certificate of insurance issued by an insurance company authorized to transact business in this state,

showing that the owner has a policy insuring the NEMT certificate holder against liability for injury

to person and damage to property that may be caused by the operation of the NEMT vehicle, which

policy shall provide for the indemnity in the sum of not less than one million five hundred thousand

dollars ($1,500,000) for personal injury and indemnity of not less than one hundred thousand

dollars ($100,000) for damage to property. Such proof of financial responsibility shall be

resubmitted annually when the NEMT certificate is renewed in accordance with § 39-14.3-3 (a).

     39-14.3-9. Penalty for violations - General.

     (a) Any person, firm, or corporation, subject to the provisions of this chapter and/or any

rules and regulations promulgated under it, who shall knowingly or willfully cause to be done any

act prohibited by this chapter, or who shall be guilty of any violation of this chapter or the rules

and regulations shall be deemed guilty of a misdemeanor and shall, upon conviction, be subject to

a fine not to exceed one thousand dollars ($1,000) or imprisonment for a term not exceeding one

year, or both for each offense.

     (b) The administrator of the division may, in their discretion, in lieu of seeking criminal

sanctions, and/or in lieu of revoking or suspending the carrier's operating authority as conferred

under this chapter, impose upon its regulated common carriers an administrative civil penalty

("fine"). This fine shall not exceed one thousand dollars ($1,000) per violation under this chapter

or the division's rules and regulations promulgated under this chapter.

     SECTION 4. This act shall take effect on August 1, 2024.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO PUBLIC UTILITIES AND CARRIERS -- MOTOR PASSENGER CARRIERS

-- NON-EMERGENCY MEDICAL TRANSPORTATION

***

     This act would establish a safe and reasonable regulatory framework for companies and

drivers providing non-emergency medical transportation services to a population of vulnerable

passengers through coordination with the state's health and human service agencies.

     This act would take effect on August 1, 2024.

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