Monitoring report of Non-Emergency Transportation vehicle inspections and provider interviews, Logisticare, Inc. [1999]

DEPARTMENT OF AUDITS AND ACCOUNTS l\fedicaidandLocal Government Audits
GA~
't\'bC~: tJ\~
R\ '
L5:l5
i9'\'\

MONITOIUNGREPORTOF ' '

~

,',

'- -

'

" . ' ,~

.

- ' --' ~

, -'

. - , ~.

,

, .NON-EMERGENCYT~8POltTATION.,

VEIDCLE lNSPECTIONSANDPROVIDERINTERVIEWS

LOGISTICARE, INC~

TABLE OF CONTENTS

LETTER OF TRANSMITTAL

I

INTRODUCTION

1

General Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Broker Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1

Objectives

2

~coI>e ancl l\I.[etl1oclolo~)T . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2

FINDINGS AND RECOMMENDATIONS

3

APPENDIX I

~ummary ofVel1ic1e Inspections

.4

APPENDIX II

Vehicle Inspections b)T Service Provider. . . . . . . . . . . . . .. .

6

Report Prepared By:
State ofGeorgia Department ofAudits and Accounts Medicaid and Local Government Audits Division 254 Washington Street, S. W:, Suite 322
Atlanta, Georgia 3.0334-8400 (404) 656-2006
Michael A. Plant, Director

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

MICHAEL A. PLANT
DIRECTOR

June 8,1999

Dr. William R. Taylor, Commissioner Georgia Department of Medical Assistance 2 Peachtree Street, N.W. Atlanta, Georgia 30303-3159
Dear Dr. Taylor:
This report provides the results of our inspections ofNon-Emergenqy Transportation (NET) vehicles with service providers in the three NET regions operated by LogistiCare, Inc. These inspections and interviews were conducted at your request.
This report is intended to be used solely in connection with the administration of the Georgia Department of Medical ~ssistance Non-Emergency Transportation Program and is not to be used.or relied upon for any other purpose.

RWHlbw

Respectfully Submitted,
~ilJ.<1l~
Russell W. Hinton State Auditor

1999 Report: LogistiCare, Inc.

1

INTRODUCTION

General Information

The Medicaid program in Georgia is administered by the Georgia Department of Medical Assistance (DMA) 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 DMA 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 of transportation.

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

Broker Information

LogistiCare, Inc., was awarded the contract for three regions; Central, East, and Southwest. As the NET broker, LogistiCare, Inc., is responsible for arranging transportation in properly equipped vehicles for Medicaid recipients in its regions. It i~'the responsibility of LogistiCare, Inc., to ensure that service providers in its regions are operating vehicles that meet the vehicle requirements established by the DMA (RFP sections 3.011, 3.240, and 3.241).

2

Non-Emergency Transportation Program

Objectives

The purpose of tbis review was to detennine whether the service providers in LogistiCare, Inc. 's, three NET regions have properly equipped vehicles for the transportation of Medicaid recipients. Specifically our objective was to detennine if vehicle deficiencies cited in our monitoring report of November 25, 1998 still existed and to evaluate each vehicle's compliance with the safety requirements listed in Appendix I of this report.

Scope and Methodology

To accomplish this objective, we obtained from LogistiCare, Inc., a listing of service providers and all vebicles operated by each service provider as of February 25, 1999. We visited each service provider and inspected its NET vebicle(s)to detennine ifthe vebicle(s) complied with certain vehicle standards set by the DMA.

1999 Report: LogistiCare, Inc.

3

FINDING AND RECOMMENDATIONS

Vehicle Inspections

We visited 61 transportation service providers and inspected 329 non-emergency vehicles used to transport Medicaid recipients in LogistiCares'regions. We did not check for compliance with every -If. vehicle requirement listed or referenced in the RFP. Our goals were to determine if the deficiencies cited in our monitoring report of November 25, 1998 still existed and to evaluate each vehicles compliance with the safety requirements, listed in Appendix I ofthis report.
Overall, the condition of the vehicles operated by the service providers had not significantly improved since our previous inspections. Of the 329 vehicles we inspected, 242 (74%) met all the requirements we checked. A suinmiuy of the deficiencies noted in each service provider's vehicles is included in Appendix I and Appendix II ofthis report.
We recommend that the DMA assess liquidated damages as set forth in the RFP. We also recommend that periodic reviews be conducted to ensure that LogistiCare, Inc., examiries and removes 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 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.

4

Non-Emergency Transportation Program

Appendix I
SUMMARY OF VEHICLE INSPECTIONS
329 vehicles were inspected. 242 vehicles met all standards.
o vehicles contained no fully equipped first aid kit
46 vehicles did not contain a functional fire extinguisher of at least 5 pounds mounted" within reach of the driver.
22 vehicles did not contain two (2) seat belt extensions.
o vehicles contained no approved child seating.
1 vehicles contained no reasonable means to secure wheelchairs or stretchers.
o vehicles contained no seat belt cutter mounted above the driver's door.
4 vehicles did not contain a retractable stl(p or a ste.p stool for passenger use. 1 vehicles contained no functioning interior light.
o vehicles did not have an exterior rear view mirror on each side of the vehicle.
3 vehicles did not have adequate side wall padding and ceiling covering in the vehicle.
o vehicles did not contain an interior rear view mirror. o vehicles contained hazardous debris or unsecured items.
o vehicles contained no rubber mat or camet on the floor of passenger compartment.
1 vehicles did not contain the provider's name. the vehicle number. and the Broker's telephone number prominently displayed inside the vehicle

1999 Report: LogistiCare, Inc.

5

8 vehicles contained inadequate heatin~ and air conditionin~.
o vehicles did not contain functioning seat belts for all passengers. o vehicles did not contain three (3) portable triangular reflectors mounted on stands.
11 vehicles did not contain a vehicle information packet with vehicle registration, valid 11 vehicles contained no valid PSC cab card 1 vehicles contained no spill kit.
o vehicles did not contain an operable two-way communications system.
4 vehicles contained no map of the NET region.
o wheelchair vehicles had no hydraulic or electro-mechanical wheelchair lift installed.

6

Non-Emergency Transportation Program

Appendix II
VEmCLE INSPECTIONS BY SERVICE PROVIDER

Provider Name
A Wright Transportation A-I Medical Transportation AAA Transport Adams Transport All Atlanta American Liberty EMS AmeriTrans USA, Inc. Archtrans Augusta Cab Autumn Care B.R. Rider Burke County Transit Clark's Transportation Coachline Colquitt Concerted Services Cook County Transit Gateway Georgia Transit Gold Cross Ambulance Golden Isles Transport Golden Personal Care Golden Year's Hancock County Transit Health Allied Health Stars Henry Transit Hope NET Hulin Transportation

Date Inspected

#of Vehicles Inspected

# of Vehicles Meeting all Requirements
We Checked

04/14/99 & 04/15/99

3

3

03/18/99

2

0

03/19/99

3

3

03/02/99

2

1

03/16/99

1

0

03/02/99

8

3

Various

72

62

03/22/99 & 03/23/99

6

4

04/16/99

1

0

03/30/99

1

1

03/05/99

3

1

03/09/99

1

1

--,. 03/06/99

3

0

03/04/99

2

1

03/19/99

1

1

03/02/99

2

2

03/16/99

5

0

03/03/99 & 03/04/99

8

8

03/09/99

2

2

03/30/99

1

1

03/03/99

3

1

03/16/99

1

0

03/11/99

1

1

04/08/99

1

0

03/0499

4

0

03/03/99

6

6

03/03/99

4

0

03/02/99

6

6

03/31/99

6

5

1999 Report: LogistiCare, Inc.

7

Provider Name
Jefferson County Transit Kay's Transport Liberty Convalescence Life Star Ambulance Manor Transportation Med Tech EMS Med TranNew Medecon Medical Riders MedlifeEMS Med-Travel, Inc. Mitchell County Transit Mid Ga Ambulance Middle Flint MillS, Inc. Need-a-Ride OAC Pierce Transit Pineland Renex Shedway Transit Son-Shine Transport Sureway Medi Port Talbot County Taylor Transportation Tidelands Toby's Transportation Waco-Med Travel Ward's Delivery We Care We Care Too Transportation Winters Transport
Totals

Date Inspected

#of Vehicles
Inspected

# of Vehicles Meeting aU Requirements We Checked

03/31/99

1

1

03/04/99 & 03/05/99

13

13

03/18/99

4

0

04/06/99

3

3

03/24/99

4

4

04/09/99

2

0

03/30/99 & 03/31/99

4

0

03/24/99

8

7

03/03/99

3

0

03/24/99

5

4

03/11/99

1

1

03/19/99

8

6

03/04/99

2

0

03/24/99

4

4

03/17/99

28

28

03/05/99

1

1

04/07/99

2

I

03/02/99

4

3

03/10/99

9

7

Various

6

0

03/04/99

2

0

03/23/99

1

1

03/11/99

2

0

03/25/99

4

3

03/30/99

4

4

03/11/99

6

4

03/23/99

1

0

04/08/99

7

6

03/05/99

6

6

03/17/99

5

4

Various

19

18

03/02/99

1

0

74% Met

Requirements

329

242

We Checked.

8

Non-Emergency Transportation Program

Note: We did not inspect all service providers in the three LogistiCare operated regions. Some service providers only operated ambulances which are inspected by the Department of Human Resources (DHR). Therefore we did not inspect them. We did, however, obtain copies of and review their most recent DHR inspections. In addition, some service providers vehicles passed our last inspection and had no new vehicles which required inspection. They are not included in either Appendix I or II.