Please Note: On March 21, 2021, this article was updated with the Indiana Department of Health’s revised COVID-19 Protocol for non-emergency medical transportation (NEMT) drivers to:
- Require testing of NEMT drivers and residents who utilize NEMT based on the positivity rate of the county where the facility is located, rather than to require testing weekly (as was required under the previous version of the guidance). NEMT drivers who are fully vaccinated or are COVID-recovered (i.e., are within 90 days of the end of their transmission-based precautions) are not required to be tested. The guidance remains unchanged with regard to the facility being required to provide the rapid testing, if the NEMT driver has not secured testing elsewhere.
- Reflect that NEMT drivers are not required to quarantine following exposure to COVID-19 if they are fully vaccinated.
Further highlights of the guidance are as follows:
- PPE/Environmental Cleaning: NEMT drivers must wear a mask that meets CDC requirements at all times, in addition to any other appropriate PPE, and must disinfect the vehicle after reach resident transport per CDC instructions. Importantly, it is the responsibility of Southeastrans to ensure that drivers have appropriate PPE.
- COVID Exposure: NEMT drivers who are fully vaccinated or COVID-recovered do not need to quarantine following exposure. Those NEMT drivers who are not fully vaccinated or COVID-recovered must quarantine for 14 days upon exposure.
- COVID-Positive Driver: NEMT drivers who test positive or exhibit symptoms should quarantine for a minimum of 10 days. If a NEMT driver tests positive, Southeastrans must notify every facility that the driver transported residents from within two (2) days of the positive test or within two (2) days of the symptom onset. This notification by Southeastrans must take place within four (4) hours of learning of the positive test or symptom onset of the NEMT driver.
- COVID-Positive Resident: Nursing facilities are required to report a resident’s COVID-19 status to the NEMT driver prior to the run.
- Testing of NEMT Drivers: NEMT drivers are required to undergo COVID-19 testing based on the positivity rate of the county where the facility is located (i.e., once a month for counties below 5%, once a week for counties between 5-10%, and twice a week for counties above 10%), unless a driver had and recovered from COVID-19 within the past 90 days or has received a complete series of an FDA-approved COVID-19 vaccine. The guidance states NEMT drivers must be tested by the nursing facility using a POC test, if available. Alternatively, the driver can choose to be tested at a local health department or another state testing site. If the nursing facility cannot provide the test at the time of pickup, the trip should still occur. If a driver tests positive using the POC test, the driver should inform Southeastrans immediately, and Southeastrans will work to satisfy the trip with another eligible driver that has already been tested that week.
- Reporting Test Results: The guidance states that it is the responsibility of Southeastrans to report the test results of the NEMT drivers to IDH using a RedCap Survey. However, if a nursing facility conducts a POC test for a NEMT driver using its CLIA Waiver, the nursing facility should report the results of the test to NHSN (if the nursing facility has SAMS Level 3 Access) or the RedCap Survey for POC Test Results (if the nursing facility does not yet have SAMS Level 3 Access), based on the utilization of the facility’s CLIA Waiver for the test. IHCA/INCAL has expressed concerns regarding this duplication to IDH.
- Testing of Residents: Nursing facility residents to be transported by NEMT must also be tested based on the positivity rate of the county where the facility is located, unless the resident had and recovered from COVID-19 within the past 90 days or has received a complete series of an FDA-approved COVID-19 vaccine. If the resident’s test is positive, transportation should occur by BLS ambulance and not the NEMT driver.
IDH also previously answered the following questions via email:
Q: SET drivers are known to be on tight schedules and only wait short periods for residents to be delivered to the vehicle. How will a facility hold the driver onsite while a POC test, if available, is run?
A: Point of care tests take 15 minutes to perform. Facilities can do the test and the drive can wait until the results.
Q: Assuming the SET driver stays at the facility until test results are available, if the driver is positive will SET send another driver to make the appointment or will all need to be rescheduled, including the medical appointment?
A: SET would work to satisfy the trip with another driver that has already been tested.
Q: SET drivers serve multiple facilities in an area. How will a driver show proof of testing if they do not get that at an Optum site? Are they to be tested at each facility they serve?
A: Drivers will provide a weekly attestation form. Nursing homes that perform the test will sign the form if the driver is negative. Drivers who are positive will report to SET for appropriate guidance on isolation. Drivers will not be tested at each facility.
Q: Who will the state provide Binax Cards to for testing – the facility or driver?
A: Facilities already receive Binax cards to help facilitate testing of their staff and those who care for their residents.
Q: If a facility is in outbreak testing, how recent does the test prior to transport have to be such that a test administered during outbreak testing counts under this policy? Under outbreak testing all residents, and staff, are tested every 3-7 days until no new positives are found.
A: If the resident was tested as part of an outbreak that would count towards this requirement.
If a driver is wearing a mask inappropriately, or there are infection control, safety, or professional issues to report, please contact Southeastrans Inc. at 1-888-833-4154. Please contact Elizabeth Eichhorn with any questions at Eeichhorn@ihca.org.