A private firm handling non-emergency medical transports (NEMT) for Waupaca County announced it will end its contract with the state.
LogistiCare Solutions, based in Atlanta, Ga., began managing NEMT for Medicaid recipients in Waupaca County in July 2011.
Previously, the Waupaca County Aging and Disability Resource Center managed a network of about 35 volunteer drivers who took area Medicare patients to medical appointments, such as checkups and treatments.
After LogistiCare began managing Waupaca County’s NEMT, few of the county’s volunteer drivers were used. Instead, riders waited until taxis from other counties would arrive to provide their rides.
The county began hearing chronic complaints about drivers failing to arrive in time to make a scheduled appointment or missed rides.
Jim Barry was among those who reported ongoing problems with service from LogistiCare.
The 67-year-old Weyauwega man needed dialysis three times a week. He was struggling with cancer and could no longer drive himself to his health care providers.
In August 2011, Barry told the County Post his problems with LogistiCare began the day the company took over the service.
“It took me an hour and a half just to get my first three appointments,” Barry said.
To schedule a ride, callers had to obtain a confirmation number from LogistiCare.
Callers were questioned about whether they have a car, whether they are able to drive and whether they have relatives or friends willing to drive them to their medical appointment without reimbursement.
They could be denied rides if they answered yes to any of the questions.
LogistiCare failed to provide Barry four rides in less than two weeks.
“These people don’t understand that I get really sick when they’re late picking me up,” Barry said, noting that being late for an appointment can result in his being at the clinic for eight hours as he waits for the dialysis equipment to become available again. And missing his dialysis treatment means toxic wastes are not being removed from his body.
A LogistiCare driver also failed to pick Barry up for a scheduled ride to the clinic for a CAT scan.
“I feel like they’re trying to kill me,” Barry said. “Yesterday, I made my funeral arrangements.”
Barry died Sept. 14, 2011.
“I think he would have lived a better quality of life for a longer period of time,” said Pat Enright, the county’s aging and disability resource manager, when asked about how the missed rides affected Barry’s health. “Prior to LogistiCare taking over in July, we were giving him rides, and there weren’t any complaints.”
Although county social workers offered to provide Barry rides through funding from another program, Enright believes Barry became increasingly discouraged as LogistiCare continued missing scheduled rides.
In November 2011, LogistiCare began using the county’s volunteer drivers again.
Medicare recipients would call LogistiCare, which would then arrange the rides with county volunteer drivers.
Enright said county volunteers did not originally agree to drive for LogistiCare because the company had slashed their mileage reimbursements.
“We pay our drivers the IRS rate per mile, and we were asking for an additional 3 cents per mile to cover administrative costs. They wanted to pay us 26 cents per mile,” Enright said, indicating that LogistiCare was unwilling to negotiate on the price.
Currently, LogistiCare is paying the county 59 cents per mile.
In September 2012, LogistiCare took responsibility for brokering rides in the Milwaukee area and complaints spiked, resulting in a spike in complaints.
In November, LogistiCare announced it would end its contract to manage all Medicare and BadgerCare Plus NEMTs on Feb. 17, 2013.
In a letter to the state Department of Health Services, LogistiCare CEO Herman Schwarz cited the lack of information in the state’s original request for proposal (RFP).
“The state provided only the number of eligible members but did not supply any utilization data,” Schwarz said. “The failure to provide any utilization data whatsoever made it a challenge to bid this contract appropriately.”
Schwarz said more than twice as many rides are being provided than the company anticipated when it made a bid.
“We cannot sustain the program on the amount we bid,” he said.
According to a report in the Milwaukee Journal Sentinel, Wisconsin spent about $31.6 million on NEMT for the entire state the fiscal year 2007-08 and paid LogistiCare $33 million from Aug. 1, 2011, through Aug. 31, 2012, for all areas outside the Milwaukee area.
Schwarz also noted, “The negative press has caused irreparable damage to our reputation both in Wisconsin and nationally.”
State Health Services Secretary Dennis Smith announced in a Nov. 21 press release that the state would issue a new request for proposal for the service.
“This announcement is not an indicator that we will go back to the old county-based system for providing members transportation to medical appointments or that we will be changing our approach to providing transportation,” Smith said in the press release.
Enright said the county will continue to be under contract with LogistiCare until the state finds a new company to broker the rides.
“When the state puts out bids and awards a contract, the county will aggressively seek to work with whoever is awarded the contract so there isn’t a lag in service like there was last time,” Enright said.
Enright said a privately owned brokerage system may work better if there is more transparency and an independent review of complaints.
He also recommended a company with Wisconsin ties, rather than one from out of state.
In an email to Waupaca County, LogistiCare said it would continue to provide transportation services for the duration of its contract.
The email also noted, “The Department of Health Services (DHS) will be releasing a new RFP and LogistiCare, along with others, will be competing for the work.”