Sept. 13--After waiting three months, Jesse Galarza was finally scheduled for oral surgery at 8:30 a.m. Monday. But instead of getting his gums fixed, he spent the morning waiting at home for a cab ride that never arrived.
"They called me around 7:30 and said they were on their way," the South Milwaukee resident said. "Eight o'clock came around and I called them. They said they were rerouted. I said, 'I have surgery at 8:30!' They said, 'Well, I'm sorry' and hung up. When I called LogistiCare, they got on the phone. I said, 'Can I speak to your supervisor?' They acted like they didn't hear me and hung up on me."
Galarza is just one of several LogistiCare customers who have called the Journal Sentinel since Sept. 1 to complain because their cabs never showed up or arrived so late that people missed their medical appointments. Many say when they called the "Where's my ride" complaint line, they encountered hold times in excess of 35 to 40 minutes and then just got an apology, but no explanations or solutions.
Complaints to LogistiCare of no-show transportation have quadrupled since July. A company official attributed the problems to the volume of calls, which he said was twice as large as expected.
LogistiCare experienced widespread problems right after it began arranging rides for 600,000 Medicaid and BadgerCare recipients outside the greater Milwaukee area on July 1 last year.
But problems have spiked since Sept. 1. That's when LogistiCare became responsible for nonemergency medical transportation of an additional 265,000 people in Milwaukee, Waukesha, Racine, Kenosha, Ozaukee and Washington counties whose Medicaid and BadgerCare Plus coverage is overseen by private health insurers under contract with the state. The insurers previously made their own transportation arrangements with providers such as American United, but Atlanta-based LogistiCare now books the rides with other local companies.
"We're seeing an increase in the number of rides we're providing and the number of calls we're getting per day about this," said Stephanie Smiley, a spokeswoman for the Department of Health Services. "With any sort of large-scale implementation like this, you're going to have those bumps in the road, and this is no different."
Albert Cortina, chief administrative officer with LogistiCare, said the company had previously serviced one of the insurers in the six-county area it took over on Sept. 1. The company believed this was one-fifth of the population and calculated needs for transportation based on that, he said.
"We . . . were ready to provide services to the additional 80% of the members served by other managed care entities," he said in an email Wednesday. "In actuality the volume handled by the remaining managed care companies was 200% more than the volume that could have been projected from the data that was available via our one existing managed care company. Unfortunately the state agency provided no projections or figures whatsoever in their procurement and so we used our one contract as a basis to extrapolate expected volume. This was the only known piece of data to us."
In January, LogistiCare received 237 valid complaints (0.18% of all reservations). That more than tripled to 768 (0.56% of all reservations) in June, according to data released by the state Department of Health in response to a request from the Journal Sentinel. A couple of weeks ago, the Journal Sentinel requested data for the year to date, but the state was unable to produce all of it by Wednesday.
For residents in the six counties added Sept. 1, the transition has been a bumpy ride.
"My first experience, the gentleman picked me up. His brakes were so bad. These were broken brakes. He'd have to stop a block and a half before he got to the stop light. On the way back, I had to wait two hours before they came to get me," Galarza recalled. "Then I had two other appointments where they didn't show up at all."
The number of times a cab failed to show up for a scheduled pickup increased from 31 in January to 91 in July, according to the state. So far, that number has exploded to 91 in the first week of September, state data shows.
Smiley said the number of riders who didn't show up increased from 42 in January to 268 in July.
Bessie Gordon, a northwest side Milwaukee resident who gets rides to doctor's appointments and attends weekly family counseling sessions, said she has had similar problems with late cabs since last year. She said she has missed two appointments and was half an hour late for another.
"The cab is always late. They're never on time," she said. "They're not there when we're done."
The family session now involves her infant grandchild.
"We have to sit there and wait till the ride gets there. Before LogistiCare took over, it was never a problem," she said.
According to the state data, the number of times a provider showed up more than 15 minutes after a scheduled pickup rose from 85 in January this year to 256 in July. In the first week of September, 77 people complained about the same thing.
Expected cost saving
Smiley said the three-year contract for consolidated transportation services would save the state at total of $5 million from 2011 to 2013 ($2 million for the outlying areas served starting in 2011 and $3 million for the greater Milwaukee area included Sept. 1) and improve ride access and reliability. Previously, individual counties arranged rides for Medicaid patients who had no other way to get to nonemergency medical appointments.
Transportation to doctor appointments and other nonemergency medical care is federally mandated under Medicaid. The consolidation of transportation took place under Gov. Jim Doyle and has continued under Gov. Scott Walker.
Cudahy resident Alyse Hendrickson said LogistiCare had assured her a cab would pick her up within 45 minutes after her appointment with her therapist on Thursday. She waited 3 1/2 hours. Calling the hotline just led to more waiting.
"When you call to try to find something out, you're at least an hour on hold and they have no idea how to answer your question. I almost lost my therapist because I didn't show up for my appointment. The drivers hit on you. They're smoking when you're in the cab," Hendrickson said. "How can you run a company when you don't even pick up your clients or you treat them like crap?"
Smiley encouraged people who have issues to let LogistiCare know, and to notify the state if they don't feel their complaint is being handled appropriately by LogistiCare.
"If they're having issues with any particular provider, company or personnel, those are the things we're expecting LogistiCare to follow up on," she said. "If they are not receiving an adequate response, those are the things we're supposed to know about."
Cortina from LogistiCare said the company is working to ramp up its capacity.
"We have vigorously worked to provide additional telephone back up support from other existing call centers around the country, continue to educate members about the new process and reservation line and continue to add vehicle capacity and additional transportation company to service this volume," he wrote in an email. "We are focused on providing as much additional resources as needed to get over these first two transitional weeks of this program."
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If you have a complaint
If you have waited for your ride more than 15 minutes, call the Where's-my-ride line: (866) 907-1494 or (866) 288-3133 (TTY). Call your doctor to let them know you are running late. Rides after your appointment should arrive within 15 minutes. If you don't know when your appointment will be over, you can call LogistiCare after the appointment is over and a ride will pick you up within one hour.
LogistiCare takes complaints from people having a hard time getting a ride or experience long waiting times or rude drivers at (866) 907-1494 or (866) 288-3133 (TTY).
You can also write to LogistiCare at LogistiCare Solutions, LLC, 2335 City View Dr., Ste. 200, Madison, WI 53718.
LogistiCare, on its website, promises to get back to you with an initial response in 10 days and send you a final response in writing within 30 days of receiving a complaint.
Customers who are unhappy with LogistiCare's response to their complaints or feel they were denied transportation can contact the state Division of Hearing and Appeals for a fair hearing by writing to the Department of Administration, Division of Hearings and Appeals, PO Box 7875, Madison, WI 53707-7875.
Or request it using an online form available at http://dhs.wi.gov/em/customerhelp.
To learn more about the complaint process and your rights, visit the state's ForwardHealth website at http://bit.ly/ForwardHealth.
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