DEPARTMENT OF AUDITS AND ACCOUNTS Medicaid and Local Government Audits
MONITORING REPORT OF NON-EMERGENCY TRANSPORTATION VEHICLE 'INSPECTIONS AND PROVIDER INTERVIEWS
TECHNO SYSTEMS, INC.

TABLE OF CONTENTS

LETTER OF TRANSMITTAL

.I

INTRODUCTION

1

General Infonnation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Broker Infonnation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1

Objectives

2

~col'e ancl l\I[et1loclolo~ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2

FINDINGS AND RECOMMENDATIONS

.3

APPENDIX I

~ummary of Vehicle Insl'ections

5_

APPENDIX II

Vehicle Insl'ections by ~ervice Provicler . . . . . . . . . . . . . ..

7

Report Prepared By:
State ofGeorgia Department ofAudits and Accounts Medicaid and Local Government Audits Division
254 Washington Street, S. w., Suite 322
Atlanta, Georgia 30334-8400 (404) 656-2006
Michael A. Plant, Director

CLAUDE L. VICKERS
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
DIRECI'OR

May 18,1999

Dr. William R. Taylor, Commissioner Georgia Department ofMedical Assistance 2 Peachtree Street, N.W. Atlanta, Georgia 30303-3159
Dear Dr. Taylor:
This report provides the results of our inspections of Non-Emergency Transportation (NET) vehicles and interviews with service providers in the NET region operated by Techno Systems, 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 ofMedical Assistance Non-Emergency Transportation Program and is not to be used or relied upon for any other purpose.

CLV/bw

Respectfully Submitted,
?L~
Claude L. Vickers State Auditor

1998 Report:Techno Systems, Inc.

1

INTRODUCTION

General Information

The Medicaid program in Georgia is administered by the Georgia Department ofMedical 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 of NET

.

.

services in each region, and.awarded contracts 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. The DMA contracted with three Brokers to service

the five geographical regions.

Broker Information

Techno Systems, Inc., was awarded a contract for the region that includes Fulton and DeKalb counties. As the NET broker, Techno Systems, Inc., is responsible for arranging transportation in properly equipped. vehicles for Medicaid recipients in its region. It is the responsibility of Techno Systems, Inc., to ensure that service providers in its region 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 this review was to determine whether the service providers in Techno Systems, Inc.'s, NET region have properly equipped vehicles for the transportation of Medicaid recipients, and to determine whether Techno Systems is paying all service providers according to the agreed upon contract between the service providers and Techno Systems, Inc. The specific objectives of this review were to determine:



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.



IfTechno Systems Inc., is making payments to service providers

in a timely manner as defined by terms of their service contracts.

Scope and Methodology

To accomplish these objectives, we obtained a listing of service providers from Techno Systems, Inc. We visited each service provider, and inspected its NET vehicles to determine if the vehicles complied with certain vehicle standards set by the DMA. We interviewed personnel at each service provider to determine whether Techno Systems, Inc., has been making payments in a timely manner as defined by their contract. We also examined, on a sample basis, documentation of p~yments made to service providers to determine if payments were made within the time frame specified by the contract terms. We also interviewed personnel at Techno Systems, Inc., to obtain an understanding oftheir billing and payment procedures.

1998 Report:Techno Systems, Inc.

3

FINDINGS AND RECOMMENDATIONS

Vehicle Inspections

We visited 41 transportation service providers and inspected 96 nonemergency vehicles used to transport Medicaid recipients in Techno Systems' region. We did not check for compliance with every
I
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 vehicle's compliance with the safety requirements, listed in Appendix I ofthis report.
Overall, the condition of the vans operated by the service providers was better than at the time of our previous inspections. However, of the 96 vehicles that we 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 II of this 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 Techno Systems, Inc., examines and removes from service those vehicles that do not comply with all vehicle standards contained in the RFP.

4 Payments
Appendix Information

Non-Emergency Transportation Program
We interviewed personnel at all 42 active service providers in Techno System's region. We asked if they were being paid in a timely manner according to the terms of their contracts with the Broker. We also interviewed personnel at Techno Systems and obtained an understanding of their billing and payment procedures. Six ofthe 42 service providers interviewed stated that they had not been receiving payments in accordance with the terms of their contract. However, these six service providers failed to submit any proof of these late payments. We also selected a sample of payments made during the month of March, 1999 and determined that all payments were made to the service providers within the time period stated in the contracts.
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.

1998 Report:Techno Systems, Inc.

5

ADpendix]
SUMMARY OF VEHICLE INSPECTIONS
96 vehicles were ins.pected. 32 vehicles met all standards. 46 vehicles did not contain two (2) seat belt extensions.
vehicles did not contain a functional frre extin~isher of at least 5 pounds mounted within reach of the
4
~.
o vehicles did not contain a retractable ste,p or a ste,p stool for passenger use.
1 vehicles contained no spill kit. 12 vehicles contained no seat belt cutter mounted above the driver's door.
o vehicles contained no Bp,proved child seatin&.
1 vehicles contained no functionin& interior li&ht.
o vehicles did not have an exterior rear view mirror on each side of the vehicle.
3 vehicles did not have adeQuate side wall paddin& and ceilin~ coverin~ in the vehicle. 4 vehicles did not contain an interior rear view mirror. 2 vehicles contained hazardous debris or unsecured items.
o vehicles contained no rubber mat or carpet on the floor of pBssen~ercompartment.
9 vehicles did not contain the provider's name. the vehicle number. and the Broker's telca>hone number
prominently displayed inside the vehicle

6

Non-Emergency Transportation Program

5 vehicles contained inadeq.uate heatini and air conditionin.i.

o vehicles did not contain functionini seat belts for all passeniers.
21 vehicles did not contain three (3) portable trianplar reflectors mounted on stands.

vehicles did not contain a vehicle infonnation packet with vehicle registration, valid proof of 33 insurance,
and accident procedures and forms.

12 vehicles contained no valid PSC cab card
3 vehicles contained no fully equjp,ped first aid kit
o vehicles did not contain an operable two-way communications system.

15 vehicles contained no map of the NET reiion.
o vehicles contained no reasonable means to secure wheelchairs or stretchers.
o wheelchair vehicles had no hydraulic or electro-mechanical wheelchair lift installed.

1998 Report:Techno Systems, Inc.

7

Al1Pendix II
VEHICLE INSPECTIONS BY SERVICE PROVIDER

Provider Name
A Loving Touch A-I Transportation AJCC Weinstein Center Allen N.E.T. Service, Inc. B&L Transportation Blackburn Transportation Cameron Transportation Common Health Transportation Divine Order Dudley Transportation Exceptional Services Five Star N.E.T. Gatlin Transportation Global Transportation Grady Transportation Howard & Smith
It's About Time N.E.T., Inc. J.D. Transportation J.S. N.E.T.,Inc. J's. Transportation L&J Transportation Lord & Myers, Inc. Loving Hart's Transportation Medstat E.M.S., Inc. On-Time Transportation P&B Transport P.A.L.S. Transportation

Date Inspected
01119/99 01120/99 01129/99 01113/99 01120/99 01126/99 02/03/99 01114/99 01125/99 01115/99 01121199 01116/99 01121199 01115/99 01128/99 01127/99 & 02/19/99 61122/99 02/04/99 01120/99 01124/99 01/19/99 01/19/99 01122/99 Ambulances 01122/99 01/27/99 01130/99

#of Vehicles Inspected

# of Vehicles Meeting all Requirements
We Checked

2

0

1

0

5

2

3

3

1

0

2

2

1

0

1

0

2

0

2

0

2

0

3

0

2

0

2

0

6

6

3

0

1

0

2

1

1

1

4

0

2

0

1

0

1

0

0

N/A

2

2

4

4

2

0

8
Provider Name

Non-Emergency Transportation Program

Date InSDected

#of Vehicles
Inspected

# of Vehicles Meeting all Requirements WeCheckeci

Patrona's Transportation Puckett Transportation Rogers Transportation Ross Transportation S&B Transport Senior Connection of Dekalb Special Touch, Inc.
Star Plus Transportation Styles Transportation T&TN.E.T. Tyler Transportation United Transportation Universal Travel Vinson Transportation

01127/99

1

0

01128/99

1

0

01127/99

2

0

02/19/99

1

0

02/10/99

1

0

01126/99

5

5

02105/99 &

3

2

02110/99

01128/99

2

0

02/04/99

4

4

01130/99

6

0

01129/99

3

0

02/07/99

4

0

01122/99

2

0

01120/99

3

0

Totals

96

32

33% Met

Requirements

We Checked.

Note: There were 42 active service providers we spoke with, however, one service provider, Shay's Transportation, is not currently transporting any Medicaid recipients and their lone vehicle is currently not operable. They are not included in either Appendix I or ll.