№ files_lp_4_process_2_75365
File format: docx
Character count: 1066
File size: 67 KB
Form for requesting non-emergency transportation services for Medicaid-enrolled clients attending Health Home programs, detailing client information, transportation needs, and certification by a care coordinator.
Year:
2026
Region / City:
Washington State, USA
Topic:
Medical Transportation
Document Type:
Request Form
Organization / Agency:
Health Home Services
Author:
Care Coordination Organization
Target Audience:
Medicaid clients and care coordinators
Effective Period:
Until further notice
Approval Date:
2026
Relevant Links:
http://www.hca.wa.gov/medicaid/transportation/pages/phone.aspx
Price: 8 / 10 USD
The file will be delivered to the email address provided at checkout within 12 hours.
The file will be delivered to the email address provided at checkout within 12 hours.
Don’t have cryptocurrency yet?
You can still complete your purchase in a few minutes:- Buy Crypto in a trusted app (Coinbase, Kraken, Cash App or any similar service).
- In the app, tap Send.
- Select network, paste our wallet address.
- Send the exact amount shown above.
The final amount may vary slightly depending on the payment method.
The file will be sent to the email address provided at checkout within 24 hours.
The product description is provided for reference. Actual content and formatting may differ slightly.
Note:
Year
Type of Document:
Informed Consent Form
Target Audience:
Patient or legal representative
Treatment:
Unapproved drug, device, or biologic
Condition:
Serious medical condition without FDA-approved treatments
Duration of Treatment:
Specified per case
Risks:
Potential unknown harms including death or harm to fetus
Costs:
May be billed to patient or insurance
Oversight:
Institutional Review Board (IRB) and FDA
Year:
2024
Region / City:
Victoria, Australia
Topic:
Non-emergency patient transport, clinical protocols
Document type:
Clinical Practice Protocols
Author:
Victorian Government, Department of Health
Target audience:
Licensed non-emergency patient transport providers, healthcare services
Period of validity:
August 2024 - June 2025
Approval date:
August 2024
Revision date:
June 30, 2025
Year:
2022
Region / City:
Massachusetts
Topic:
Transportation Services
Document Type:
Contract Appendix
Organization / Institution:
Commonwealth of Massachusetts, EOHHS, HST Office
Author:
Not specified
Target Audience:
Transportation Providers under contract
Effective Period:
From 7/1/22
Approval Date:
Not specified
Revision Date:
Not specified
Jurisdiction:
Victoria, Australia
Legislation reference:
Non-Emergency Patient Transport Regulations 2016 Part 3, Regulations 19–21
Subject:
Clinical competency standards for Non-Emergency Patient Transport staff
Document type:
Official regulatory standard
Issuing authority:
Victorian Government, Department of Health
Place of publication:
Melbourne
Address:
1 Treasury Place, Melbourne
Publication date:
November 2021
Copyright holder:
State of Victoria, Australia
Applicable roles:
Clinical Instructor (CI), Ambulance Transport Attendant (ATA), Patient Transport Officer (PTO)
Training requirements:
Annual skills maintenance training aligned to patient acuity levels
Contact:
[email protected]
Note:
Year
Theme:
Non-Emergency Healthcare Transportation
Document Type:
Policy / Program Information
Organization / Institution:
Aetna Better Health of Ohio, Molina Healthcare
Target Audience:
Medicaid members, Medicare members, MyCare Ohio members, CareSource members
Year:
2015
Region / City:
Maine
Topic:
Non-Emergency Transportation
Document Type:
Policy and Procedure
Organization / Institution:
Maine Department of Health and Human Services
Author:
MaineCare Services
Target Audience:
MaineCare Members, Transportation Providers, Brokers
Effective Period:
From 4/5/2015
Approval Date:
4/5/2015
Date of Last Update:
4/5/2015
Year:
2024
Region / City:
Victoria, Australia
Topic:
Non-Emergency Patient Transport Licence Renewal
Document Type:
Checklist
Organization:
Department of Health, Victoria
Author:
Victorian Government, Department of Health
Target Audience:
NEPT service providers and applicants
Validity Period:
Ongoing
Approval Date:
February 2024
Last Modified:
February 2024
Year:
2023
Region / City:
Victoria, Australia
Subject:
Non-Emergency Patient Transport (NEPT) licensing
Document type:
Form
Organization:
Department of Health, Victoria
Author:
Victorian Government
Target audience:
Individuals or corporate bodies applying for a Non-Emergency Patient Transport license
Effective period:
Indefinite, subject to updates
Approval date:
September 2023
Date of amendments:
N/A
Year:
2023
Region / City:
Victoria, Melbourne
Country:
Australia
Sector:
Non-Emergency Patient Transport (NEPT)
Subject:
Clinical staff qualifications and crew-mix requirements
Document Type:
Official guidance sheet
Issuing Authority:
Victorian Government, Department of Health
Legislative Reference:
Non-Emergency Patient Transport Regulations 2016
Related Document:
Non-Emergency Patient Transport Clinical Practice Protocols 2023
Date of Publication:
May 2023
Minimum Crew Requirement:
Two crew members per vehicle
Source Availability:
NEPT legislation and clinical protocols
Year:
Not specified
Region / City:
Not specified
Document Type:
Operational medical report form
Responsible Unit:
Medical Unit / Incident Management Team
Intended Audience:
EMS personnel, on-scene incident commanders
Operational Period:
Click or tap here to enter text
Patient Assessment Sections:
Initial patient assessment, treatment, evacuation plan
Transport Options:
Air ambulance, ground ambulance
Communication Channels:
State Air/Ground EMS Frequencies, hospital contacts
Prepared By:
Medical Unit Leader
Reviewed By:
Safety Officer
Year:
2016
Region / City:
Washington State, USA
Subject:
Domestic Violence, Survivor Support
Document Type:
Guidance / Protocol
Organization:
Washington State Department of Social and Health Services
Author:
Deadria Boyland
Acknowledgements:
Multiple domestic violence organizations and advocacy groups in Washington State
Target Audience:
Shelter staff, advocates, volunteers
Period Covered:
Non-emergency intake procedures as of December 2016
Date Published:
December 2016
Training Requirements:
Staff, volunteer, and relief worker training on screening and intake
Intended Use:
Screening and intake of domestic violence survivors seeking non-emergency services
Year:
2021
Region / City:
Victoria, Australia
Topic:
First Aid Service Licensing
Document Type:
Application Form
Authority / Institution:
Victorian Government, Department of Health
Author:
Victorian Government
Target Audience:
First aid service providers
Regulation Reference:
Regulation 23(1), OFFICIAL Non-Emergency Patient Transport and First Aid Services Regulations 2021
Submission Method:
Email to [email protected]
Required Attachments:
Prescribed fee, supporting evidence for licence variation
Year:
2025
Region / city:
New Zealand
Topic:
Non-emergency ambulance transport for aged residential care facilities
Document type:
Fund application guidelines
Institution:
Health NZ - Te Whatu Ora
Author:
Health NZ
Target audience:
Aged residential care providers
Validity period:
From February 2025
Approval date:
February 2025
Date of amendments:
February 2025
Note:
Year
Topic:
Hazardous Materials Transportation
Document Type:
Regulatory Guideline
Issuing Organization:
US Department of Transportation (DOT)
Target Audience:
Shipping and transportation professionals, regulatory compliance officers
Year:
2025
Region / city:
Wisconsin
Subject:
Transportation, Environmental Coordination
Document Type:
Request Form
Organization / institution:
Wisconsin Department of Transportation (WisDOT)
Author:
Wisconsin Department of Transportation (WisDOT)
Target Audience:
WisDOT staff, Environmental Coordinators
Period of validity:
Not specified
Approval Date:
Not specified
Date of changes:
Not specified
Year:
2023
Region / City:
Miami, FL
Subject:
Emergency Management, Transportation
Document Type:
Instructional Agreement
Agency:
Miami-Dade County Department of Emergency Management
Author:
Not specified
Target Audience:
Facilities requiring emergency transportation agreements
Effective Period:
Annual
Approval Date:
Not specified
Amendment Date:
Not specified
Context:
A set of instructions detailing the requirements for submitting emergency transportation agreements by facilities in Miami-Dade County.
Year:
2016
Region / City:
New York City
Topic:
Education, Pupil Transportation
Document Type:
Data Dictionary
Institution:
NYC Department of Education
Author:
NYC Department of Education
Target Audience:
Public, Schools, Data Analysts
Period of Validity:
Ongoing
Approval Date:
2016
Modification Date:
N/A
Year:
2025
Region / City:
United States
Topic:
Transportation Research
Document Type:
Progress Report
Agency / Organization:
Federal Highway Administration (FHWA)
Author:
Jim Austrich
Target Audience:
Transportation Agencies, Research Organizations
Period of Validity:
4/13/2022 – 4/12/2027
Approval Date:
4/13/2022
Date of Changes:
N/A
Year:
2004
Region / State:
Georgia, USA
Topic:
Transportation, Road Safety, Work Zone Management
Document Type:
Policy Document
Organization:
Georgia Department of Transportation
Authority:
Federal Highway Administration
Audience:
GDOT staff, local agencies implementing Federal-aid highway projects
Legal Basis:
23 CFR 630 Subpart J
Components:
Policy Statement, Goals and Objectives, Policy Provisions, Project Evaluation Criteria, Transportation Management Plans (TMPs), Roles and Responsibilities
Appendices:
TMP Components Checklist, Work Zone Management Strategies Matrix, Significant Project Flowchart, Roles & Responsibilities Chart, Links to Documents, Final Rule on Temporary Traffic Control Devices
Year:
2025
Region / City:
Columbia, SC
Topic:
Transportation Services
Document Type:
Statement of Award
Agency:
Department of Social Services
Author:
Jon Baysden
Target Audience:
Contractors, Procurement Officers
Contract Period:
August 20, 2025 – July 06, 2030
Date of Approval:
August 08, 2025
Date of Changes:
N/A