Monday, August 15, 2011

Privatization Is Bad For Wisconsin's Fiscal And Physical Health

The State of Wisconsin had decided to take more local control away from county governments by centralizing and privatizing non-emergency medical transports which are covered by Medicaid.  A three-year contract was given to LogistiCare, a company based in Atlanta, Georgia.  The contract went into effect on July 1, 2011. Previous to that date, each county coordinated these rides on their own or through a contracted agency.

 The theory behind the move was that LogistiCare would streamline all of the non-emergency transports around the state in what they claim would save money. The people that would be served would include the poor, the elderly and the disabled who rely on BadgerCare Plus for their medical needs.  It would be used for routine medical appointments, including those receiving kidney dialysis.

The way it was supposed to work was that the patient would call in at least two days before the appointment to schedule a ride. After being thoroughly questioned on whether there was any other way for the patient to make their appointment, to the point of making sure there were no family members or friends that would do the transportation, the patient would receive a confirmation number and then the ride at the appointed time. LogistiCare would then make arrangements with a contracted transport agency to provide the ride.  LogistiCare did not own any vehicles and would not be providing the transportation.

In other words, Logisticare would put another level of bureaucracy for the patient to navigate through.

Months before the privatization even went into effect, many people had concerns about how this was going to work.  One of the biggest concerns was the fact that LogistiCare was getting paid per person eligible to receive these services instead of per service rendered.  That system made it inherent for LogistiCare to provide the least amount of services in order to increase their profit margin.  They could do this by not providing the rides needed or inappropriately downgrading the person's eligibility, thereby forcing the patient into potentially unsafe situations.

Sure enough, LogistiCare started screwing up by the numbers.  Their performance was so bad that one transport company severed their contract with them in order to protect their own reputation:
A spokesman for Badger Cab says the company is "severing its relationship" with Logisticare because of "numerous issues," including customer phone numbers and addresses provided by Logisticare that were "riddled with errors" and communications problems so serious that at one point on a chaotic Friday, according to accounts representative Kurt Schneider, "four or five" of his dispatchers could not take regular calls because they were trying to iron out problems with Logisticare customers. Schneider says the contract could have been worth up to millions of dollars, depending on the volume of business.

Schneider says Logisticare booked rides with Badger for patients in wheelchairs, even though the company has no vehicles that can transport wheelchairs. Logisticare also booked rides with Badger for patients in Milwaukee and spots as far away as Green and Rock counties, Schneider says. When his staff tried to work these problems out, they were unable to reach anybody at Logisticare's new call center in Madison who could help them, Schneider claims. "We had people calling their 800 number on hold for over an hour," he says. "We never knew who we were talking to. We got people in Atlanta and Arizona."

On Saturday, several patients waited up to two hours at home for rides to critical dialysis treatments, according to one nurse at the Wisconsin Dialysis Center on Fish Hatchery Road. As a result, says the nurse who did not want to be identified, a couple of the patients were not given their full treatments. The nurse claims that she was also put on hold for 18 minutes as she was trying to get them help.

And confusion over whether Logisticare would provide rides to patients needing to get from area hospitals to nursing homes after discharge left at least one patient over the weekend stranded until the hospital stepped in and arranged and paid for the ride itself, according to Sue Farkas with St. Mary's care management department.

LogistiCare came back with the usual "nothing to see here" and "it was just the first day jitters" and my personal favorite, "it's all the stupid consumer's fault" spiel that one might expect. They also stated that things were getting better.

Well, that's a load of poppycock. It's not better and it's just not in Dane County.

Waupaca County used to have a volunteer coordinator that took care of making sure patients were connected with volunteer drivers who only got paid for mileage reimbursement. But with the privatization, all those people, most of whom were out of work or retired, no longer have a way to help supplement their incomes or, in some cases, have any income at all. Instead, that money and a whole lot more is going to LogistiCare and it's contracted agencies, some as far as 80 miles away in Green Bay.

And not only is this a waste of money, LogistiCare is continuing to fail in its assigned duties. Their failure is so much so that an elder abuse complaint had to be filed against Logisticare:
Pat Enright is the aging and disability resource manager for Waupaca County DHHS. He has logged dozens of complaints from patients who have missed their medical appointments due to their rides arriving late or not showing up at all.

On Aug. 1, Enright sent a letter to Greg DiMiceli, the Medicaid transportation analyst who oversees the state program, detailing the problems since LogistiCare took control.

Enright also filed an elder abuse complaint against LogistiCare as a result of Barry’s experience.

"A vulnerable adult that has a care provider who has assumed responsibility for a portion of their care and then failed to provide that care could be charged with abuse of a vulnerable adult," Enright said in his letter to DiMiceli.

"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 said his problems with LogistiCare began the day the company took over the program.

"It took me an hour and a half just to get my first three appointments," Barry said.
The story goes on to cite numerous examples of LogistiCare's failure, including a vendor who cancelled the ride themselves, but no one bothered to confirm or even notify the patient.

What is just as, if not more, disturbing than these examples of privatization's failure is this:
Stephanie Smiley, the communications director with the state Department of Health, said that while she has received complaints, LogistiCare is "managing to deliver 6,000 rides a day."

Smiley said that in the six weeks since LogistiCare took over the statewide transportation program, the complaint rate has dropped from 1 percent to 0.5 percent of the rides being provided.

"We are in daily contact with LogistiCare," Smiley said. She said the company has increased staff at the Madison call center and reduced the amount of time callers spend on hold. In addition, she said LogistiCare is introducing an incentive plan that rewards drivers who make their appointments on time.
This should raise several questions for the reader.

First, exactly why is a government official playing the role of public relations person for a private agency? I would expect the government to demand corrections from LogistiCare, not making excuses for them.

Secondly, even Smiley's defense of the company is lame. Putting 30 people in harm's way every single day is not a bragging point! It is a point of shame and shows exactly how warped the mind set is in Scott Walker's administration, where the Almighty Dollar holds more sway than a person's life.

And shouldn't the incentive for these drivers be to collect a paycheck for doing their jobs, and that's if it's even their fault to begin with? Given the widespread and ongoing problems that are being reported, it's much more conceivable that the problem lies with LogistiCare than with the drivers or individual transport companies.

In summary, we again have solid, documented and undeniable proof that privatization, the stalwart of the current regime, costs a lot more money and provides a lot less service. Only Walker or one of his apologists could even begin to say this a good thing. The simple hard fact is that privatization, once again, has proven to be an expensive and untenable approach to providing services, or in this case, not providing services to the most vulnerable of our citizens.

The sad part is that this is only the beginning. We are sure to see this repeated time and time again as Walker and cronies continue to privatize schools, state parks and anything else they can get their hands on.


  1. Thanks.

    Perhaps Gov. Walker thinks he lives in Georgia.

    Gee, the Koch brothers own Georgia Pacific, which is headquartered in Atlanta. What a coincidence.

  2. Do your job and you get a paycheck. Do your job right and you get a bonus?

  3. Your such an idiot. You and your communist faggots only have one answer for everything. That's for the government to run everything. Communism was a failure and so are you and your leftist commy pres.

  4. Leftist commy president? Wow, you are so brainwashed from the right you can't even see whats going on. Did you ever think that if one of these people were you, how would that feel?
    You sure wouldn't be special because you voted for the gop. They would toss you to the side with no hesitation. I think you better do some serious research and see what's really going on.

  5. "Your such an idiot"
    That's "'you're' such an idiot".
    "leftist commy pres"
    That's "leftist 'commie' pres".
    I thought he was a socialist, like those scary people in Norway. Or a nazi, like Glenn Beck says.
    I wish you people would make up your minds.

  6. This was introduced by Democratic Governor Doyle. Walker had nothing to do with it. If you do some homework, you will find that there were no checks and balances when counties ran this. Therefore, millions of dollars worth of fraudulent claims that were paid to crooked transportation providers. Who paid for that? You guessed it, TAXPAYERS! Also, Logisticare uses "Volunteer Drivers" who are paid by the mile. Anyone interested should contact Logisticare to sign up. The bottom line is checks and balances are now in place to eliminate fraud that will save the state of Wisconsin millions of dollars.

  7. LOL!

    Yes, Doyle started it, Walker loved it and pushed it forward.

    And where is your proof of the millions of dollars in fraudulent claims? We already know from these few stories that LogistiCare is not having any checks or balances and are ripping off tax payers by not providing at least 30 rides each and every single day.

    All that is being accomplished is a concentration of the fraud and on a much larger scale.

  8. Badger Cap broke its contract the first day. Sounds like they bit off more than they could chew, got scared and bailed. What reputable compant quits before giving a new system at least a few weeks to work the bugs out? Have other transportation companies given up so easily as well?

  9. Here's the proof of fraud you asked for. Keep in mind this is only 1 of the 100's of transportation providers.

  10. Yeah, just what was Badger Cab wanting? To actually be given correct address and times? Sheesh, those whiners!

    And given that LogistiCare brags about how many states they contract with, you'd think that they'd have it down by now. But you did give me an idea. I wonder how many other states are also having issues with them.

    Then again, I don't know how many companies like Logisticare can miss seven appointments with just one person. They probably should be referred for adult protection services and child protection services.

    I know that they also need a 500 day turn around when counties only needed 30. Go figure.

  11. Two things about that story.

    One, it was under Walker's control, since he was county exec then, and you want people to think he's gotten better now and will keep LogistiCare in check? Not an auspicious start in these several weeks.

    Two, that's one county, with an inept county exec, and even the story says that the system was overhauled and that had stopped.

    So why should we sell off local control so that an Atlanta company can rip us off and put our vulnerable citizens in harm's way?

  12. You asked for proof, I gave it to you. Why are you so against saving the state millions of dollars? Logisticare has a set contract with Wisconsin and they employ locals workers. How many other local companies are owned by someone out of state? How many Wisconsin citizens own a business in another state? Are you so gullable to believe that there were no problems with the old system? People were comfortable with it and don't like change. Unfortunately, change was needed. Give it some time before you pass judgement. Did you make any mistakes when you first started a job or business? Probably not as it sounds like you know everything. Sorry I disagreed with you.

  13. Saving money? That's a joke. They're taking money meant for rides and skimming it off for their own profit. Then there is the cost of the extra medical care when they fail to take people to life-sustaining appointments like dialysis, the higher cost of the emergency care, the pulling of county officials to take care of what wasn't a problem until LogistiCare took over, the costs of the investigation into the neglect by LogistiCare, the lawsuits that will come from all of this...oh, the list does go on.

    These aren't mistakes. These are examples of putting people's lives in jeopardy. How cavalier of you to dismiss that as being inconsequential.

  14. heres the thing. you got a bunch a lazy bumbs screaming in your ear cause they think theyre entitled to the tax paid ride. they expect you to have the address, phone number which they are told to have ready atleast 3 times by recording, and a cab all lined up and waiting "just for them" the worst part is theyre supposed to give atleast 2 days notice. this keeps errors from happening and allows all the strenuous back end paperwork that you dont hear about on the phone to get done. do they give 2 days notice? hell no they expect this to be a damn limo service. they can call weeks in advance but they wait the night before after all the cabs are closed to make a ride to dialysis at 5am and bitch cause all the cab companies are closed. its not a perfect system, but for it to be is an unrealistic thought. not when you got atleast 3000 people wanting a ride the night before cause they cant follow the rules. its there to help people and some abuse it going to the finest doctors some 200 miles away on your tax payer dime. think of that before you bitch. and btw, the people on the phones sound like the most miserable, lazy fattest slobs who dont even bother to wipe their ass cause they think someone should do it for them.

  15. Yeah, right. I've had clients wait for 8 hours waiting for a ride to pick them up from the doctor's office. They knew they were there, it was set up with plenty of time and they were the ones that drove them there in the first place. The system as it is now sucks and people will die for it. Live with that, if you can.

  16. Don't be fooled. Most of the ride recipients are whiners and bitchers. They are very quick to set up their transportation but then forget all about it when the time comes to go. Many times these losers (yes, that's right!)do not have the courtesy to call and cancel because, oh crap! It's Friday and I ain't going no wheres. Better are those who decide that medicaid transportation is a free taxi/ limo service to any where they want to go, like shopping but don't have any friends or family to pick them up. Take into consideration that drivers take the time to drive to a home that has no phone contact only to find "they ain't goin'" The legitimate people GET their ride. The users are put at the bottom of the list and are the first to complain. They are the one's that jeopardize Dialysis and urgent trips. This I know.
    I drove for a company for nearly 4 years and I will tell you that those companies are out to run you into the ground for less than minimum wage. They will say you are salaried until you need an hour off and then all of a sudden they will deduct an hour's pay from you. Or,you are salaried for a 40 hr work week and run you 60-70 hours with no breaks.Most companies that contract with Logisticare are crooks lining their pockets and screwing their workers. They take on an incredible amount of work load because all they see are the $$$ for their own pockets. I sued my former employer and made sure they went bankrupt. They deserved it. They were making 1-2 mil but paid drivers $300/ wk.yet working them 60+ hrs. They took advantage of the scarcity of job opportunities in the area.

  17. Logisticare just started in arizona. I set up my mother in laws appointment 6 days in advance. I gave logisticare all of the details ie phone numbers, addresses, date, time, etc.. No one showed up to give her a ride. I found out because the doctor called me to make sure she was okay. I spent 30 minutes on hold just to talk to someone, then 15 more on hold to tell me the driver would be there in 10 to 15 minutes. Too late. The appointment was for an hour before this "10 to 15 minute" arrival. I am not impressed.