. -DEPARTMENT OF AUDITS AND ACCOUNTS Medicaid and LocalGovernment Audits
MONITORING REPORT OF
NON-EMERGENCV.TRANSPORTATION 'VEHICLE INSPECTION , . INTELITRAN, INC. .OCTOBERJ999

TABLE OF CONTENTS

LETTER OF TRANSMITTAL

I

INTRODUCTION. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1

Generallnfonnation

1

Broker Infonnation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1

Objectives

2

Scope and Methodology

2

FINDINGS AND RECOMMENDATIONS

.3

APPENDIX I

Summary ofVehicle Inspections

6

APPENDIX II

Vehicle Inspections by Service Provider . . . . . . . . . . . . . ..

8

RUSSELL W. HINTON
STATE AUDITOR

DEPARTMENT OF AUDITS AND ACCOUNTS
MEDICAID AND LOCAL GOVERNMENT AUDITS
254 Washington Street, S.w., Suite 322 Atlanta, Georgia 30334-8400
Telephone (404) 656-2006 Facsimile (404) 656-7535
October 27, 1999

MICHAEL A. PLANT
DIRECTOR

Members of the Board of Community Health, and The Honorable Russ Toal, Commissioner Georgia Community Health
2 Peachtree Street, N.W.
Atlanta, Georgia 30303-3159
Dear Mr. Toal:
This report provides the results of our inspections ofNon-Emergency Transportation (NET) vehicles with service providers in the NET region operated by Intelitran, Inc. These inspections were conducted at your request.

This report is intended to be used solely in connection with the administration of the State of Georgia Department of Community Health Non-Emergency Transportation Program and is not to be used or relied upon for any other purpose.
Respectfully Submitted,

RWHlbw

Russell W. Hinton State Auditor

1999 Report: InteliTran, Inc.

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INTRODUCTION

General Information

The Medicaid program in Georgia IS administered by Georgia Community Health (GCR) and is jointly funded by the State of Georgia and the federal government. Medicaid pays health care providers to furnish health care services to individuals or families with low income and limited resources. The GCR has established specific guidelines and limitations for each covered medical service.

The Non-Emergency Transportation (NET) program offers transportation services for Medicaid recipients who need to secure necessary health care and have no other means oftransportation.

Effective October 1, 1997, five geographical regions were established for the administration of the NET Program. Bids were solicited from potential brokers for the administration and provision ofNET services in each region, and contracts were awarded based on an evaluation ofthe bids received. All bids were in response to a Request for Proposal (RFP) which outlined all specifications required to become a Broker in the State of Georgia. Three brokers were contracted to service the five geographical regions.

Broker Information

Intelitran, Inc., was awarded a contract for the North Georgia region. As the NET broker, Intelitran, Inc., is responsible for arranging transportation in properly equipped vehicles for Medicaid recipients in its region. It is the responsibility ofIntelitran, Inc., to ensure that service providers in its region are operating vehicles that meet the vehicle requirements established by the GCR (RFP sections 3.011,3.240, and 3.241).

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Non-Emergency Transportation Program

Objectives

The purpose of this review was to determine whether the service providers in Intelitran, Inc.'s, NET region have properly equipped vehicles for the transportation of Medicaid recipients. Specifically our objectives were to determine if;



the vehicles operated by the service providers in Intelitran's NET

region are in compliance with the safety requirements and

regulations listed in Appendix I of this report; and



Intelitran, Inc., has adequate procedures in place to ensure that

vehicles operated by service providers meet all ofthe established

vehicle requirements.

Scope and Methodology

To accomplish this objective, we obtained from Intelitran, Inc., a listing of service providers. We visited each service provider and inspected its NET vehicle(s) to determine if the vehicle(s) complied with certain
vehicle standards set by GCH. As noted in Appendix n, we did not
inspect ambulances operated by service providers because they are inspected by the Department of Human Resources. In addition, we reviewed documentation from the Broker to determine the adequacy of procedures in place to ensure that all vehicles operated by service providers meet the requirements established by GCH.

1999 Report: InteliTran, Inc.

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FINDING AND RECOMMENDATIONS

Finding No.1 Finding No.2

Vehicle Inspections
We visited 19 transportation service providers and inspected 178 non-emergency vehicles used to transport Medicaid recipients in Intelitran's region. We did not check for compliance with every vehicle requirement listed or referenced in the RFP. Our goal was to evaluate each vehicle's compliance with the safety requirements, listed in Appendix I of this report.
Of the 178 vehicles inspected only 32 met all the requirements we checked. A summary of the deficiencies noted in each service providers' vehicles is included in Appendix I and Appendix IT ofthis report.
We recommend that OCH assess liquidated damages as set forth in theRFP.
Broker Inspection Procedures
We interviewed Intelitran personnel and reviewed documentation to determine the procedures Intelitran uses to monitor service provider vehicles. We found that Intelitran personnel conduct inspections of each service provider's vehicles at least once per year. However, these inspections do not address all of the safety requirements contained in the RFP. In addition to the other less critical requirements included in the RFP, the broker's inspections did not
..

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Non-Emergency Transportation Program

address the following safety requirements that we believe to be critical and have addressed during our inspections:
retractable step or step stool available for passenger use (minibus);
adequate side wall padding and ceiling covering in vehicle; interior rear view mirror; transportation provider's name, vehicle number, and the
Broker's phone number prominently displayed inside the vehicle; valid Public Service Commission (PSC) cab card (Form G) maintained in the vehicle - must be original - copies are not allowed; and map of the NET region in the vehicle.
We also inquired as to the actions taken by the broker when a vehicle does not pass an inspection. Any vehicle in violation of a requirement the broker believes to pose a safety risk is immediately taken out of service. If they are in violation of any other requirement, the service provider is given two weeks to correct the violation(s). However, we were given no documentation to show that any vehicle has ever been taken out of service by the broker.
We recommend Intelitran, Inc., conduct periodic reviews more often than once per year and remove from service those vehicles that do not comply with all vehicle standards contained in the RFP.

Appendix Information
Attached to this report are summaries of our vehicle inspections. Appendix I lists the standards we reviewed for compliance and the

1999 Report: InteliTran, Inc.

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number ofvehicles not in compliance with each standard. Appendix II lists the number of vehicles we inspected and the number we found in compliance for each service provider.

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Non-Emergency Transportation Program

Appendix I
SUMMARY OF VEmCLE INSPECTIONS
178 vehicles were inspected 32 vehicles met all standards we checked.
..!Lvehicles contained no spill kit.
~vehicles did not contain a functional fIre extinguisher of at least 5 pounds mounted within reach ofthe driver.
~vehicles did not contain (2) seat belt extsnsions _O_vehicles contained no approved child seating. _O_vehicles contained no reasonable means to secure wheelchairs or stretchers
..!!-vehicles contained no seat belt cutter mounted above the driver's door. 2 -vehicles did not contain a retractable step or a step stool for passenger use. -!.-vehicles contained no functioning interior light.
...!!-.vehicles did not have an exterior rear view mirror on each side of the vehicle.
-!.-vehicles did not have adequate side wall padding and ceiling covering in the vehicle ..1-vehicles did not contain an interior rear view mirror.
_O_vehicles contained hazardous debris or unsecured items. _O_vehicles contained no rubber mat or carPet on the floor of passenger compartment.
.!!!..vehicles did not contain the provider's name. the vehicle number. and the Broker's
telephone number prominently.

1999 Report: InteliTran, Inc.

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_8_vehicles contained inadequate heating and air conditioning. _O_vehicles did not contain functioning seat belts for all passengers.
-!Lvehicles did not contain three (3) portable triangular reflectors mounted on stands.
.1Lvehicles did not contain a vehicle information packet with vehicle registration, valid
proof of insurance, and accident procedures and forms.
.11-vehicles contained no valid PSC cab card.
_2_vehicles contained no fully equipped first aid kit . _2_vehicles did not contain an operable two-way communications system.
.!Lvehicles contained no map ofthe NET region.
_2_wheelchair vehicles had no hydraulic or electro-mechanical wheelchair lift installed.

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Non-Emergency Transportation Program

AllPendix II
VEmCLE INSPECTIONS BY SERVICE PROVIDER

Note: We did not inspect all vehicles operated in InteliTran's region. Ambulances that are operated by service providers are inspected by the Department ofHuman Resources (DHR). Therefore we did not inspect them. They are not included in either Appendix I or II.