Did a wheelchair rider need medical help during the trip for the vehicle to count as an invalid coach?

Plain-English summary

In November 1995, Connecticut’s AG clarified his September opinion distinguishing licensed invalid-coach service from wheelchair livery. The earlier opinion had made the rider’s status as a statutory “patient” important but left the kind of assistance unclear. Looking at legislative history, the AG said “assistance” meant medical assistance during the ride. A person had to be injured, ill, crippled or physically handicapped and need both transportation and in-transit medical help to be a patient under the emergency medical services statute.

Invalid-coach transport of such patients fell under the Office of Emergency Medical Services. Transportation for elderly or disabled people who did not need medical assistance during the trip remained livery service under the Department of Transportation, even if the ride went to a doctor’s appointment. The AG said those livery services were reimbursable under Medicaid. He suggested that the service boundary could be clarified further by regulation or legislation, without deciding particular riders’ medical needs.

Riders and transport providers at the time

The opinion made in-transit medical assistance the key distinction. A disability or wheelchair use alone did not make a person an invalid-coach patient under the AG’s interpretation.

Medicaid and transport regulators at the time

The AG assigned patient transport needing medical assistance to emergency medical services oversight and other qualifying livery to DOT. He said the latter could receive Medicaid reimbursement.

Currency note

This opinion was issued in 1995. Subsequent statutory amendments, court decisions, or later AG opinions may have changed the analysis. Treat this page as historical context, not current legal advice. Verify current law before relying on any specific rule, deadline, or remedy mentioned here.

Common questions

Q: Did a trip to a medical appointment automatically count as invalid-coach service?
A: No. The AG focused on whether the rider needed medical assistance during transportation.

Q: Who regulated livery rides for disabled people without that in-transit need?
A: The opinion placed those services under the Department of Transportation rather than emergency medical services.

Q: Could Medicaid reimburse such wheelchair livery?
A: Yes. The AG expressly said those livery services were reimbursable.

Background and statutory framework

The AG read “patient” in §19a-175(b) through legislative history, then applied the invalid-coach definition in §19a-175(k). He distinguished DOT’s livery authority under §13b-105.

Citations and references

Statutes: §19a-175(b); Conn. Gen. Stat. §19a-175(k); Conn. Gen. Stat. §13b-105.

Source

• Landing page: https://portal.ct.gov/AG/Opinions
• Opinion page: https://portal.ct.gov/ag/opinions/1995-formal-opinions/honorable-joyce-thomas-department-of-social-services-1995031-formal-opinion-attorney-general-of-conn

Original opinion text

Honorable Joyce Thomas, Department of Social Services, 1995-031 Formal Opinion, Attorney General of Connecticut

Attorney General's Opinion

Attorney General, Richard Blumenthal

November 1, 1995

Honorable Joyce Thomas

Department of Social Services

25 Sigourney Street

Hartford, CT 06106

Dear Commissioner Thomas:

On September 25, 1995, the Attorney General issued a formal opinion concerning the regulation of invalid coach and wheelchair livery services within the State of Connecticut. The Office of Emergency Medical Services ("OEMS") regulates invalid coach service as an ambulance service pursuant to Conn. Gen. Stat. §19a-180. The Department of Transportation ("DOT") regulates the transportation of livery service for the elderly and the handicapped pursuant to Conn. Gen. Stat. §13b-105. Subsequent to the issuance of the opinion, a question has arisen regarding the distinction between invalid coach and wheelchair livery service, and therefore, whether the regulation of a particular transportation service falls under the jurisdiction of OEMS or DOT. The distinction between the two types of service, and the resulting regulatory authority of OEMS or DOT, depends upon whether or not the person being transported is a "patient" as defined in Conn. Gen. Stat. §19a-175.

Section §19a-175(b) defines a patient as "an injured, ill, crippled or physically handicapped person requiring assistance and transportation." The term is used in the definitions of "ambulance" and "invalid coach" contained in Conn. Gen. Stat. §19a-175. Specifically, an ambulance is defined as "a motor vehicle specifically designed to carry patients," Conn. Gen. Stat. §19a-175(c). An invalid coach is defined as "a vehicle used exclusively for the transportation of nonambulatory patients, who are not confined to stretchers, to or from either a medical facility or the patient's home in nonemergency situations or utilized in emergency situations as a backup vehicle when insufficient emergency vehicles exist." Conn. Gen. Stat. §19a-175(k).

It is within this statutory setting that the term "patient" must be analyzed. The person must be injured, ill, crippled or physically handicapped. Such person must also require assistance and transportation. The statute, however, does not clarify the type of "assistance" such a person requires. Therefore, the analysis requires further inquiry into the legislative intent. "When the language of a statute is unclear, we may ascertain the intent of the legislature by looking beyond the language to the statute's legislative history and the purpose that the statute was intended to serve." Weinberg v. ARA Vending Co., 223 Conn., 341.

The provisions of Chapter 368d, which include §19a-175 and the statutory provisions governing the regulation of ambulances and invalid coaches, were enacted as part of the Emergency Medical Services Act, Public Act 74-305. In reviewing the legislative history of Public Act 74-305, it becomes apparent that the referenced "assistance" required by an injured, ill, crippled or physically handicapped person must be "medical assistance."

REP. KABLIK:

Mr. Speaker, obviously I, too, support the bill. I have just a few specific questions to Representative Wilber for the benefit of the legis---- My questions relate to what many towns have which is a dial a ride type of set up for elderly senior citizens. And my concern, particularly for those senior citizens who may be physically handicapped, who are utilizing the dial a ride system to, for instance, go to a regularly scheduled doctor's appointment or what have you. First, through you, Mr. Speaker, to Representative Wilber, would the assistance indicated on line 13 obviously be a medical assistance.

REP. WILBER:

Yes, I would say absolutely a medical assistance.

Connecticut General Assembly, House Proceedings 1974, pp. 4337.

The legislature amended the definition of "invalid coach" in 1987 by Public Act 87-79. The legislative history confirms that the term "assistance" in the definition of "patient" means "medical assistance."

REP. GIONFRIDDO:

Yes Mr. Speaker. This is a simple bill. What it would do is prohibit invalid coaches from carrying persons who are on stretchers. Invalid coaches don't carry attendants along with them for persons on stretchers so that for the most part, they're no longer being used for this purpose. This would make the statute conform to what is generally accepted practice, an acceptable practice in the field of transporting persons who have medical needs....

H-455 Connecticut General Assembly, House Proceedings 1997, Vol. 30, Part 6, pp. 1829-2176, p.2007.

Thus, in order to be a "patient" within the purview of Chapter 368d, a person must be injured, ill, crippled or physically handicapped and must need both transportation and "medical" assistance during such transportation. Such transportation services fall under the jurisdiction of OEMS. Otherwise, the transportation services provided to persons who are elderly or handicapped, but who do not require medical assistance during transit, fall under the jurisdiction of DOT. Such livery services are reimbursable under Medicaid.

Because this issue has a significant effect on State Medicaid expenses and on the individuals receiving these transportation services, you may wish to further clarify the services to be provided by invalid coaches and wheelchair livery services through additional regulation or legislation. Please feel free to contact me if I can be of any further assistance.

Very truly yours,

Richard Blumenthal

Attorney General