Transportation software for tribal ride programs

What each funder wants to see for a tribal ride

A tribal ride program often answers to more than one funder, and each one relies on a different record of the same trip. These are the three that come up most.

• FTA Tribal Transit Program. Yearly totals of vehicle revenue miles and ridership, plus revenue, operating costs and fleet size.
• Medicaid, for a ride an Indian Health Service (IHS) or tribal clinic requested. Proof the clinic asked for the ride, that it fell under the written agreement, and that it was billed once.
• IHS Purchased/Referred Care. A purchase order from the program’s ordering official, issued before payment, matched to the ride.

How each payer works, and what rates apply, is in the tribal NEMT guide. This page covers what a program’s software has to keep so each of those records can be produced later.

Why your trip miles shape next year’s transit funding

Half of the tribal transit formula money is divided by each tribe’s share of the vehicle revenue miles tribes report, so the mileage you record feeds the next apportionment. Under 49 U.S.C. 5311(j), formula grants are split three ways:

• 50 percent by miles. Each tribe’s share of all the vehicle revenue miles tribes report.
• 25 percent equally. Divided among tribes that provide at least 200,000 vehicle revenue miles of service a year.
• 25 percent by low-income residents. Shared among tribes serving lands where more than 1,000 low-income people live, in proportion to their numbers, with no tribe receiving more than $300,000 of this portion in a year.

The formula covers 80 percent of the tribal share. The other 20 percent is awarded competitively, and the tribal share is 5 percent of the Section 5311 money. FTA apportioned $37,555,590 in tribal formula grants and $9,358,487 in competitive grants for fiscal year 2025, and tribes can use the money for capital, operating and planning costs.

The reporting is not optional. FTA’s 2025 apportionment notice says any recipient or subrecipient of Section 5311 funds must report to the National Transit Database, and 136 tribes did for report year 2023. Section 5311(b)(4) lists what the annual report contains: total revenue, sources of revenue, operating costs, capital costs, fleet size and type, vehicle revenue miles, and ridership.

The database defines vehicle revenue miles as the miles vehicles travel while in revenue service. It leaves out deadhead, which includes leaving or returning to the garage and any driving with no expectation of carrying passengers, and it counts a passenger each time they board. Which drives count is settled by FTA’s reporting instructions, so keep each trip’s miles, times and riders rather than a monthly total that cannot be re-cut.

Where the cell signal ends

Expect stretches of the road between homes and clinics to have no usable signal, and choose software that does not depend on one. The FCC’s 2026 Section 706 Report, using data from June 2025, measures fast 5G service at 35/3 Mbps. On Tribal lands, 55.9 percent of road miles had it from at least one provider, against 69.2 percent of road miles nationwide. For people in a moving vehicle, 71.5 percent of people on Tribal lands were covered, against 85.5 percent nationally. That speed is far above what a driver app needs, so read these numbers as the direction of the gap, not a count of dead zones.

CMS describes the other half of the problem in its Medicaid transportation guide. The barriers it lists for Tribal communities include homes that lack formal street addresses, homes cut off from roadways, and rugged unpaved roads that only specially equipped vehicles can travel. For a home with no address, CMS says a driver can navigate by odometer reading or GPS coordinates and calculate mileage from them. It adds that the time and distance to care can make overnight stays, with meals and lodging, necessary.

Planning around long drives, and the rest of what rural routes demand, is in the rural NEMT software guide. Three things follow for software. The driver app has to carry a whole trip, with its arrival times and signatures, through a dead stretch. The office has to see which vans are out of contact rather than a stale position that looks current. And the pickup spot for a home with no address should be agreed once with the rider, saved, and reused on every later trip.

Medicaid rides requested by an IHS or tribal clinic

When a clinic practitioner requests a ride under a written care coordination agreement, the state can claim it at the 100 percent federal rate, and CMS tells states to document four things before claiming. SHO 16-002, dated February 26, 2016, lists them under “Compliance and Documentation”:

1. The ride was furnished to an American Indian or Alaska Native patient of a clinic practitioner because that practitioner requested it.
2. The request fell within a written care coordination agreement under which the practitioner stays responsible for the patient’s care.
3. The payment rate is authorized under the state plan.
4. The clinic and the provider did not both bill for the same service for the same person.

The letter asks the state to build the documentation process, but the provider holds the raw material. A ride record that shows who at the clinic requested the trip, when, and what happened on it supports the first two points. Billing each ride to one payer supports the fourth. The agreement’s conditions are in the tribal NEMT guide.

Purchased/Referred Care works differently. Under 42 CFR 136.24, no payment is made unless the ordering official has issued a purchase order to the provider. For a non-emergency service, notice goes to that official before the service. A ride paid this way needs its purchase order kept with the trip.

Dialysis and clinic trips that repeat

Kidney failure is more common among American Indians and Alaska Natives, so a tribal program should expect standing dialysis series. The HHS Office of Minority Health, using U.S. Renal Data System figures, reports an adjusted rate of new end-stage renal disease cases in 2022 of 508 per million American Indians and Alaska Natives, against 381 per million in the whole population, which is 33 percent higher. End-stage renal disease is the stage treated with dialysis or a transplant.

On a long reservation route, a dialysis series puts the same van on the same road week after week, so the schedule has to survive real life. A rider is admitted to the hospital, moves to another clinic, or misses a week. The series should pause, shift one day, and end without anyone rebuilding it, and the return should wait for the rider as a will-call trip when the end time is unknown. Chair-time planning and standing-order rules are covered in the dialysis software guide.

Billing each funder from the same trips

One day’s trips can belong to three different funders, so billing has to start from the trip, not from the month. As an example, a tribal health department’s van might carry a rider the clinic requested under Medicaid, a rider with a Purchased/Referred Care purchase order, and an elder riding to the senior center on the tribe’s own transit program. Each trip needs its payer on it from booking. Each payer then gets an invoice built from the trips it covers, priced at that payer’s rates, and each payment is recorded against those trips. That keeps what every funder still owes visible and keeps the same ride from being billed twice.

What to test before you choose software

Run each of these on one of your own routes during the trial.

1. A full trip with no signal. The driver runs pickup, drop-off and signature in a dead zone, and the office shows what happened once the phone reconnects.
2. GPS-recorded miles on every trip. Miles come from the vehicle, can be exported by trip, and do not depend on a driver typing an odometer reading.
3. Recurring trips that bend. One day moves, a series pauses for a hospital stay, and it ends when care changes.
4. Clinic access. Staff at a clinic or health department can request rides and follow them, so dispatch is not the only way in.
5. Billing by funder. Each ride belongs to a single payer, and every payer gets its own invoice and payment record.

Tribal ride programs in HealthRide

HealthRide’s driver app keeps working without cell service, saving every status and signature on the phone and sending it automatically once coverage returns. Each trip keeps its GPS-recorded miles and timestamps. Recurring trips keep clinic and dialysis rides going once you book them. Clinics can use the facility portal to request rides and watch vans on the map, and invoicing gives each payer its own invoice.