Another Privatization "Success" Story

For two years, all the non-emergency medical transports had to be channeled through one company - LogistiCare.  Previous to the contract with LogistiCare, each county was responsible for coordinating their own transports.

It soon became apparent that LogistiCare wasn't up to snuff and the complaints started pouring in, not just from customers but from vendors as well.   Eventually, LogistiCare had to give up their contract and this service was again put out for bids.  Another company has taken over the contract, at a cost higher than if the coordination had been left as it had been originally.

LogistiCare again made the news and again it is for failing to do their job properly:

But the state can get out of this arrangement at any time. And it should, clearing the way for the return of a system that doesn't leave patients on the curb when they should be getting the services they need to become and stay healthy.

Previously, local nonprofits both arranged and provided non-emergency rides to MaineCare patients. It was a setup that patients liked but that prompted questions from federal regulators, who said the same agency shouldn't be both setting up and giving rides.

The DHHS was given options to comply with federal regulations. According to a national Medicaid expert, the federal government would not have forced Maine to have regional coordinators arrange the rides. In fact, a local contractor won the ride contract for the Bangor area -- and riders there have had fewer problems.
MaineCare recipients in the rest of the state haven't been as lucky:

• A mother in Old Orchard Beach said her 3-year-old son was dropped off at the wrong house after his day at a preschool for developmentally challenged children. (He eventually was brought home safely.)
• A Winslow woman has found it difficult to secure transportation to the eye doctor, where she undergoes treatment to help preserve what's left of her vision.
• Because of logistical issues, a woman from Kennebunkport has missed out on therapy intended to improve her brain's functioning.
• A Skowhegan man with a degenerative disc disease has missed two medical appointments and been put on hold for hours trying to arrange rides.

Despite the fact that privatizing these services have made them much poorer and much more costly, the acolytes of austerity like Scott Walker and Chris Abele continue to promote privatization of these vital services.  That shouldn't surprise anyone since they are neither too bright or too honest.

What amazes me is that we keep electing these dopes.

LogistiCon - Privatization Still Bad For Our Health And Our Checkbooks

In his last budget, Governor Jim Doyle added a provision to make it possible to centralize all of the non-emergency medical transports which are covered by Medicaid.  In 2011 he enacted that provision by giving a contract to a company called LogistiCare, which was to cover all but the major Milwaukee area.

From the onset, there were major problems.

LogistiCare was failing to get rides for about 10% of the calls they were taking in. And when people would call to schedule a ride or complain about not getting a ride that had been scheduled, they were treated rather rudely.

And it wasn't only the patients complaining.  Vendors had many issues with the system.  So many that some of them were quitting the system within weeks of starting with them.

Things were getting so bad that Waupaca County had to file an elder abuse complaint with the state so that they had the grounds to override using LogistiCare.  Eventually, after missing at least seven kidney dialysis appointments, the man passed away.

Despite all of these problems, Scott Walker saw fit to expand LogistiCare's contract to cover the whole state.

Because LogistiCare had lowballed their bid so much, they started losing money on the contract.  Eventually, they chose to bail on their contract.

The state has now rebid the contract and awarded it to MTM, Inc.  The hitch is that the contract with MTM, Inc. is now worth more than $2 million per year than it would have cost to have kept the services in the public domain.

Naturally, this raises a lot of questions and a lot of red flags:

Gary Goyke, a legislative consultant for several transportation coalitions, accused state officials of making up savings to convince legislators to privatize.

"It was manufactured, in my opinion. Certainly, it hasn't shown up to date," he said. "The Assembly bill does not show a savings from brokers in it. That goes into effect July 1. It also does not show in how much has been spent."

Goyke, Disability Rights Wisconsin and state legislators are renewing their previous demands for an audit after officials from the state Department of Health revealed Thursday that they intend to pursue a three-year contract worth $53.8 million per year with Missouri-based MTM Inc.

Unsurprisingly, Walker's administration is standing by their privatization plan, saying that it's the most economical. Only in Fitzwalkerstan would something that costs more and delivers less would be considered economical. He was probably referring to the campaign donations he received from the lobbyists.

This doesn't surprise me a bit.

In the mid to late 1990s, there was a battle going on in Milwaukee County regarding its child welfare system.  A class action lawsuit was filed against Milwaukee County and the State of Wisconsin in which it was claimed that the civil rights of foster children were being violated by not reaching permanency in federally mandated time frames, children being moved from home to home to home and being abused while in the system.

An independent audit was done to determine the cause of these unacceptable conditions.  The results supported the claims that the county was being grossly underfunded by the state.  Despite this proof, the state claimed it was due to mismanagement by the county.  In 1998, the state took over the system.  By September 2001 they had privatized every aspect of the system that they legally could.  In fact, the audit showed that the public sector gave taxpayers twice the value of services than private agencies could.

To this date, taxpayers are paying more than $40 million a year for the privatized system and it's still not even up to the unacceptable standards that the county was performing at, much less up to federal requirements.

The fact that privatization doesn't work has been repeatedly pointed out, but the sheeples that make up groups like Americans for Prosperity won't let go of their fantasies that it is somehow a good thing.

But until people start waking up and realizing who the real takers are, expect to keep getting to pay more taxes for less services.

And people will still wonder why it's not working.

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.