Non-Emergency Medical Transportation Brokerage Services

Transcription

1 Date of Release: July 18, 2017 For Non-Emergency Medical Transportation Brokerage Services REQUEST FOR PROPOSALS Willamette Valley Community Health

2 Table of Contents Introduction... 1 WVCH Goals for NEMT... 1 Goal 1 Mission Driven... 1 Goal 2 Quality... 1 Goal 3 Accessible... 1 Goal 4 Compliant... 1 Goal 5 Collaborative... 1 Solicitation Timeline... 2 Instructions for Preparing and Submitting a Proposal... 3 Requirements... 3 Questions about the RFP... 3 Reasonable Accommodations... 3 Pre-bid Conference Call... 3 Withdrawal of Proposal... 3 Technical Proposal Content... 4 Section 1: Organization Description & Key Personnel... 4 Section 2: Qualifications... 4 Section 3: Approach... 4 Section 4: Cost Proposal... 5 Example Pricing Methods... 6 Performance Incentives and Prohibition on Trip Dumping... 6 Selection Criteria... 7 Acknowledgements by Proposer... 7 Exhibit A: Scope of Services... 8 Term... 8 Service Area & Population... 8 Services... 8 Exhibit B: Service Standards... 9 Exhibit C: Operating Statistics for January December Exhibit D: Required Policies and Procedures Tables: Table 1. Targeted utilization rates for contract term... 6 Table 2. Monthly average WVCH member enorllment & NEMT utilization Table 3. Historic ridership (aveage numbber of unlinked trip legs per month) by mode Table 4. Average cost per trip by mode Table 5. Average cost per mile by mode Table 6. Average trip distance by mode Table 7. Historic reimbursement utilization... 16

3 Introduction Willamette Valley Community Health (WVCH) operates as a Coordinated Care Organization (CCO) under a contract with the Oregon Health Authority (OHA) to provide physical, dental and behavioral health services to Oregon Health Plan (OHP) recipients in Marion (85% of enrolled members) and Polk (15% of enrolled members) counties with a small number of individuals (less than 1% of enrolled members) living in surrounding counties. WVCH is accepting bids to provide Non-Emergency Medical Transportation (NEMT) Brokerage Services for approximately 95,500 Oregon Health Plan members. CCOs were organized in Oregon in 2012 to improve the quality of healthcare OHP members receive while also improving health outcomes and reducing healthcare expenditures. CCOs have flexibility in delivering care in a more patient-centered way allowing for better coordination of services, improved prevention, and more effective chronic illness management. To accomplish this, CCOs are paid a single global budget to provide all of the health services needed by OHP members. Services are coordinated within the global budget to achieve the triple aim of improved quality, improved health outcomes, and lower overall cost. WVCH integrated NEMT into its global budget in July, 1, 2014 and contracted with Salem Area Mass Transit as its NEMT broker. With over three years of experience managing the NEMT benefit, WVCH is now seeking bids from qualified vendors to provide NEMT services pursuant to the goals and the scope of services described in this RFP. WVCH Goals for NEMT Goal 1 Mission Driven WVCH seeks a NEMT partner who is passionate about providing quality NEMT services and takes pride in getting people the right ride at the right time. Goal 2 Quality WVCH seeks a NEMT partner who can consistently achieve high levels of performance in call center speed to answer and cumulative call hold times, on-time performance, scheduling accuracy, customer satisfaction and healthcare provider satisfaction. Goal 3 Accessible WVCH seeks a NEMT partner who makes the NEMT benefit easy for members to use and has sufficient capacity to meet the needs of our membership. Goal 4 Compliant WVCH seeks a NEMT partner who uses documented policies and procedures, scripts and protocols that comply with state and federal regulation for NEMT within a managed care environment. Goal 5 Collaborative WVCH seeks a NEMT partner who is collaborative, team-oriented and effective in communicating with WVCH in both formal and informal contexts. 1 P age

4 Solicitation Timeline This solicitation will be carried out according to the following schedule, subject to change. Milestone Date RFP Released Tuesday, July 18, 2017 Pre-bid Conference Call Tuesday, July 25, 2017, 1:00 PM PDT Questions Due Tuesday, August 1, 2017, 5:00 PM PDT Proposals Due Friday, August 18, 2017, 5:00 PM PDT Interviews August 30 September 1, 2017 Board Approval September 20, 2017 Notice of Intent to Award September 22, 2017 Contract Execution October 20, 2017 Software Testing November 6, 2017 Call Center Soft Opening November 30, 2017 Launch January 1, P age

5 Instructions for Preparing and Submitting a Proposal Requirements Proposals must be submitted by to contracting@mvipa.org by Friday, August 18, 2017, 5:00 PM Pacific Daylight Time. Proposals that are late or submitted by fax or other means will be rejected. Proposal must meet the following format requirements: 1) Cover letter: Include a one-page cover letter signed by an official of the proposer s organization on company letterhead indicating acknowledgement of the terms listed on Page 5. 2) Single PDF file: The cover letter, technical proposal, resumes and any attachments should be combined into a single PDF file. 3) Minimum font size: 11 pt. 4) Margins: 1 5) Page limit: The technical proposal shall not exceed 20 pages. This page limit does not include the cover letter, resumes, or dividers used to separate sections of the proposal. Questions about the RFP Any questions related to this RFP must be submitted to contracting@mvipa.org no later than Tuesday, August 1, 2017, 5:00 PM Pacific Daylight Time. Questions and responses will be posted on the WVCH website within 5 days of question deadline. Reasonable Accommodations WVCH will provide reasonable accommodations such as informational materials in alternative formats for qualified individuals with disabilities upon request. Contact contracting@mvipa.org with accommodation requests. Pre-bid Conference Call An optional pre-bid meeting will be held via teleconference Tuesday, July 25, 2017 at 1:00 PM Pacific Daylight Time. The purpose of the meeting is to provide a high-level overview of WVCH s goals for this NEMT contract and to answer questions from prospective Proposers. Contact contracting@mvipa.org to RSVP. Dial-in information will only be sent to those who RSVP. Withdrawal of Proposal Proposer may withdraw proposals in writing at any time up to the Proposal closing date and time. The written request must be signed by an authorized representative of the Proposer, and delivered to contracting@mvipa.org. If a previously submitted Proposal is withdrawn before the Proposal due date and time, the Proposer may submit another Proposal at any time up to the Proposal closing date and time. 3 P age

6 Technical Proposal Content Proposals must address in detail how Proposer intends to meet the goals described on Page 1 of this RFP and how the Proposer will carry out the scope of work described in Exhibit A. Proposals must include the following content. Section 1: Organization Description & Key Personnel Provide a description of Proposer organization, including a brief history of Proposer organization, entity type, and staff proposed for this engagement. Identify key personnel by name and function. Resumes for key personnel must be included. At a minimum, the Proposer shall: 1) Describe the mission of your organization and explain how your mission aligns with the goals WVCH has articulated for its NEMT program; 2) Name a Brokerage Director, Call Center Supervisor and Transportation Supervisor (or equivalent positions) as key personnel and describe their professional qualifications; and 3) Include an organizational chart showing the structure of the proposed brokerage staffing plan, operational units and their geographic locations. Section 2: Qualifications Submit a description of prior engagements of similar scope, completed or initiated in the past three years. Provide the following details for each engagement: 1) The client name; 2) Dates of engagement; 3) A current contact person and a working phone number and address; 4) The location of services rendered, population served, average number of trips provided per month and average number of unduplicated individuals served per month; and 5) A narrative description of the engagement including a description of the functions performed, NEMT services managed, and notable achievements. Additional detail is permitted, provided that supplemental content stays within the page limit. Section 3: Approach Provide a detailed narrative for how the Proposer will: 1) Meet the goals described on Page 1 of this RFP; 2) Ensure compliance with the Service Standards presented in Exhibit B of this RFP; 3) Ensure adequate capacity to meet the NEMT needs of WVCH members at each of the utilization levels described in Exhibit C; 4) Provide necessary facilities to carry out NEMT brokerage services, including: a. Telephone and online systems. b. Scheduling and Dispatch software. c. HIPAA compliant data exchange with WVCH, including acceptance of eligibility data from WVCH processing and submission of encounter data. 5) Achieve the following key performance targets: 4 P age

7 a. Maintain better than 90 percent compliance with on-time windows of +/- 15 minutes of scheduled pick up and drop off times for scheduled rides. b. Measure and reduce missed appointments caused by lack of transportation. c. Achieve average speed to answer of less than 30 seconds for 80 percent of calls. d. Achieve cumulative call hold times of less than 2 minutes for 80 percent of calls. e. Measure and improve satisfaction levels among members, transportation providers, and healthcare providers. 6) Oversee Transportation Subcontractors. Please reference Exhibit B: Service Standards under Section 3 for the required driver training and screening information WVCH will expect the successful Proposer to document and retain. 7) Monitor and respond to factors impacting quality and utilization of NEMT services. 8) Coordinate with WVCH in developing innovative services that advance the goals on Page 1 of the RFP. 9) Provide at least five (5) example policies selected from the list provided in Exhibit D. Proposers shall include an implementation schedule that describes the steps the Proposer will take between Notice of Intent to Award and Launch. At a minimum, the following milestones must be included: 1) Readiness Review & Software Testing: November 6, ) Call Center Soft Opening: November 30, ) Launch: January 1, 2018 Section 4: Cost Proposal Proposers are invited to submit alternative payment methodologies and innovative approaches for structuring NEMT services to meet the goals described earlier in this RFP. Example pricing structures are provided below to illustrate potential pricing models. Proposers are not limited to these pricing models. Exhibit C provides historic experience data to aid Proposers in assessing historic utilization and ridership patterns. While WVCH has recently taken responsibility for arranging and paying public transit passes and mileage reimbursement, Proposers are encouraged to submit cost proposals for managing all modes of NEMT services to meet the needs of WVCH members including bus passes and/or tickets, travel reimbursement, volunteer drivers, sedan, wheelchair accessible, secure, stretcher, non-emergent ambulance, and common carrier). Should a Proposer decide not to include one or more of these modes, the Proposal should explain the rationale for each excluded mode and the Proposer's plan for coordinating with WVCH to arrange and pay for these modes. At a minimum, each Proposer must; 1) Describe in narrative form the pricing methodology proposed and the extent to which risk is borne by the Proposer. Proposers are strongly encouraged to bear risk. 2) Provide supporting tables or other data demonstrating how the proposed pricing methodology is calculated. Describe assumptions for direct transportation cost, 5 P age

8 administrative cost, call center operating cost, reserve and profit. Describe assumptions related to any incentives or pay-for-performance measures included in the price proposal. Example Pricing Methods Example 1: Floating Capitation: A floating capitation rate is one that adjusts based on utilization levels. In this payment model, risk is shared. The broker is at risk for changes in ridership and the cost of transportation, but not for changes in the number of unique utilizers who access the NEMT program. This methodology allows for growth in utilization while controlling for unit costs and ridership trends. PMPM prices under this model can be calculated using the following formula: UU RR CC 1 AA = PPPPPPPP Where U is the ratio of unduplicated utilizers of the NEMT benefit relative to total enrolled members, R is the average number of trips per member per month, C is the average cost per trip across all modes of transport, and A is the percent of total expenses available for call center operations, general administration, contribution to reserve requirements and profit. In a floating capitation pricing methodology the PMPM rate is calculated by fixing inputs for R, C and A while U is allowed to fluctuate within a range, such as the one described in Table 1. Table 1. Targeted utilization rates for contract term Utilization Capitation 3.00% X.XX% 3.25% X.XX% 3.50% X.XX% 3.75% X.XX% 4.00% X.XX% Example 2: Hybrid Fee for Service and Capitation: In a hybrid fee for service and capitation pricing model, direct costs are paid on a fee for service basis while administrative expenses, profit and overhead of the broker are paid on a capitated basis. Example 3: Full Risk Capitation In a full-risk capitated pricing model, Proposers are expected to bid a fixed PMPM rate for each year of the three-year contract term. Performance Incentives and Prohibition on Trip Dumping Regardless of the payment model proposed, WVCH intends to negotiate a compensation agreement that incorporates financial performance incentives and withholds tied to objective measures such as timely reporting, on-time performance, call hold times, customer satisfaction, and management of member and provider no-shows. 6 P age

9 Furthermore, in order to prevent brokerage services from negatively impacting local public transportation services, the selected broker will be prohibited from using local public transportation services unless said public transit service providers are paid a negotiated rate that is not less than half of the fully allocated cost of those services. For the purposes of this paragraph, public transportation is defined as any transportation service that receives public funding and is available to the general public. Selection Criteria Proposals will be evaluated as follows: Section 1: Organization Description & Key Personnel 10% Section 2: Qualifications 30% Section 3: Approach 30% Section 4: Cost 30% TOTAL 100% Acknowledgements by Proposer By submitting a proposal, the Proposer acknowledges and accepts the following: Debarment: Proposer affirms that neither they nor any owners or employees have been debarred, suspended, or otherwise excluded from participation in Federal assistance programs. Furthermore, the Proposer will need to certify the same for its subcontractors. Conflict of Interest: The Coordinator affirms that they do not have, nor will they acquire any interest, direct or indirect, that will conflict in any manner with its performance of the services described in this RFP. If so, Proposer must disclose any conflicts in their proposal. Right to Reject Proposal: WVCH reserves the right to reject any and all proposals. Right to Negotiate Terms: Contract terms and conditions will be negotiated upon selection of the winning proposal. All contractual terms and conditions will be subject to review by WVCH and will include scope, budget, schedule, and other necessary items pertaining to the project. Intent to Award: All organizations who respond to this RFP will be notified via of WVCH s intent to award a contract to the winning bidder. Incurred Costs: WVCH is not responsible for any costs incurred by Proposer while responding to this RFP. 7 P age

10 Exhibit A: Scope of Services Term The initial term of this engagement shall commence January 1, 2018 and end on December 31, 2021 unless extended in accordance with the negotiated contract. In any case, one party must give the other party at least 90 days prior notice of non-renewal before the end of the term. Service Area & Population All persons who are enrolled in the WVCH CCO are entitled to receive NEMT Services. Currently, WVCH provides services for approximately 95,500 members. While the majority of WVCH members reside in Marion and Polk counties, some members temporarily reside in residential treatment or foster care outside of these two counties. Additionally, a number of NEMT rides are provided to covered services outside of Marion and Polk Counties. Exhibit C provides recent data from the Salem-Keizer Transit (SKT) brokerage for WVCH members. Additional data is available upon request. Services The following outline is an excerpt from WVCH s proposed contract for NEMT. It outlines the Service Standards that WVCH will expect the Broker to provide and comply with. While WVCH reserves the right to make alterations to the wording of these items, they have all been identified as important in achieving WVCH s vision for NEMT. In Exhibit B Contractor refers to WVCH and Subcontractor refers to the NEMT Brokerage. 8 P age

11 Exhibit B: Service Standards 1. GENERAL Subcontracted work will be provided according to Oregon Administrative Rules currently in force including and through including any amendments thereto, and these service standards. a. Subcontractor shall have written and approved policies and procedures to facilitate the provision of the NEMT benefit, including at a minimum those described in Exhibit D. b. NEMT services shall be provided 24 hours per day, 365 days per year. c. Contractor and Subcontractor shall form an advisory committee to discuss the needs and concerns of the community related to NEMT. This group shall meet when needs arise, but no less than once per quarter. 2. CALL CENTER Subcontractor shall: a. Provide customer intake, needs assessment and scheduling and dispatch services, including but not limited to: i. Verify member eligibility. ii. Verify that travel is necessary and is for a covered service. iii. Assess member transportation needs and available resources. b. Schedule and dispatch the most appropriate NEMT mode including but not limited to: taxi, sedan, non-emergent ambulance, wheelchair van, stretcher van, common carrier, volunteer driver, reimbursement and public transportation. c. Provide a toll free phone number and operate a call center at a minimum Monday through Friday 6:00 AM to 7:00 PM. Provision needs to be made for weekend and after hours call center capacity. Call Center may be closed on New Year s Day, Memorial Day, Independence Day, Labor Day, Thanksgiving, and Christmas Day. d. Require no longer than forty-eight (48) hours notice for routine ride requests. e. Develop and maintain a documented policy allowing approval of next-day and sameday ride requests. This policy shall be developed with the input of Contractor. f. Train call center staff as required under OHA rules and WVCH s NEMT Service Standards for providing NEMT Services and in accordance with applicable required policies and procedures described in Exhibit D, specifically including annual grievances and appeals training. 9 P age

12 g. Employ bilingual Customer Service Representatives in proportion to the percentage of Members with limited English proficiency or have a Telephone Interpreting Service available during all hours the Call Center is open. h. Subcontractor s phones shall have the capability of performing an attended call transfer. i. Develop and maintain a procedure for scheduling rides when the Call Center is closed. 3. DRIVERS Subcontractor shall ensure that all drivers that provide NEMT Services: a. Comply with the driver standards set forth in OAR and policies and procedures described in Exhibit D. b. Have at least a three-year (3) driving history without accidents where the driver was at fault. c. Participate in a Contractor approved random drug and alcohol testing program. d. Meet state and federal criminal background check requirements. e. Meet all of the following driver training requirements before providing transportation: i. Understand NEMT Services in general, including OHA Rules and WVCH s Service Standards for providing NEMT Services ii. Passenger Assistance, Service and Safety (PASS) course, University of Wisconsin curriculum iii. National Safety Council Defensive Driving course iv. Red Cross-approved First Aid and CPR, including blood-borne pathogen spill clean-up procedures v. Vehicle orientation (familiarity with each vehicle driven, including wheelchair securement and lift operation) vi. On-the-road supervised test vii. English proficiency viii. Complete a certified HIPAA Training Program ix. Complete an approved cultural sensitivity training program f. Subcontractor shall employ bilingual drivers in proportion to the percentage of Members with limited English proficiency. 4. VEHICLES Subcontractor shall ensure that all vehicles used for providing NEMT services: a. Comply with vehicle standards set forth in OAR P age

13 b. Comply with all local, state, and federal safety standards. c. Are properly insured at limits no less than is required under OAR d. Are clean. 5. PROVIDERS All Providers shall be considered Participating Providers for the purpose of OAR Subcontractor shall ensure that all these Providers: a. Comply with OHA rules and these Service Standards for providing NEMT Services, including: i. Verifying participation in drug and alcohol testing program. ii. Conducting and/or verifying criminal background checks. iii. Conducting annual vehicle inspections. iv. Providing driver training if no other training is available when needed to comply with capacity requirements and service standards. v. Auditing Provider records on a regular basis to ensure compliance. b. Are licensed and insured at limits no less than is required under OAR c. Are not barred, suspended, or excluded from federal or state contracting. 6. CUSTOMER SERVICE In order to establish a conduit for customer feedback, Subcontractor agrees to: a. Attend and/or participate in local Community Advisory Council meetings when requested by Contractor. b. Document and follow-up on all Member complaints and grievances in accordance with Contractor s grievance procedures. c. Document all actions in accordance with WVCH s appeals process using WVCH supplied forms for notices of action. d. Participate in OHA and WVCH initiated customer satisfaction surveys. 7. AWARENESS Subcontractor shall coordinate with Contractor to actively increase awareness of NEMT services to OHP members living in the Service Area. This shall, at a minimum, include: a. Developing and maintaining a website with information about NEMT services, contact information, and electronic versions of forms and guides; 11 P age

14 b. Developing and maintaining a Riders Guide in English and Spanish that is specific to Service Area; c. Outreach to Members with limited English language proficiency; and d. Partnership with Contractor on other NEMT awareness outreach campaigns. 8. PERFORMANCE STANDARDS a. Will call: Pickup shall occur no more than sixty (60) minutes after request. b. Travel times: Travel times shall be no more than two (2) times drive time, as measured using Google driving direction, or similar. c. Maximum on-time performance window: The on-time window shall not exceed fifteen (15) minutes before or fifteen (15) minutes after scheduled pickup time. d. Call center: Average speed to answer shall be less than 30 seconds for no less than eighty (80) percent of calls. Cumulative call hold time shall be no more than two (2) minutes and not less than eighty (80) percent of the calls. e. Subcontractor and Transportation Subcontractor s facilities shall meet the special needs of Members who require accommodations because of a disability or limited English proficiency f. Cultural sensitivity: All staff who come into contact with members shall receive instruction in trauma informed care and cultural sensitivity training appropriate to the population served by WVCH. 9. REPORTING Subcontractor shall maintain data in a manner that allows for subsequent cross-reference of individual trip requests and actual trips performed. This data must be available for bulk export in spreadsheet (.csv,.txt or similar) format with trip records disaggregated by trip leg. Subcontractor shall, at a minimum, provide data to Contractor according to the following schedule: a. Weekly The following data shall be submitted within one hundred and twenty (120) days of the encounter date: i. Encounter data can be submitted daily, but at a minimum weekly, in a 837P file via secure FTP or clearinghouse. b. Monthly The following data shall be reported by the tenth (10th) day of the month following the month for which data is being reported. i. Unduplicated members served ii. Total NEMT trips by mode 12 P age

15 iii. On-time performance by mode iv. Total calls v. Average call hold time vi. Late cancellations by mode vii. No-shows by mode viii. Missed trips by mode ix. OHA Form I for grievances x. Denials by mode c. Quarterly The following data shall be submitted within thirty (30) days after the end of the quarter for which data is being reported. i. All trip records from the quarter, disaggregated by trip leg, in spreadsheet (.csv) format. 13 P age

16 Exhibit C: Operating Statistics for January December The following is the list of providers that SKT has used to provide NEMT services to WVCH members: AJ MEDICAL TRANSPORTATION AZEAL B & R MEDICAL TRANSPORT BRONSON MEDICAL TRANSPORT CHERRY CITY TRANSPORT CODE ONE MEDICAL COMMUNITY AMBULANCE DIAMOND CAB CO FOUR SEASONS FRALEY MEDICAL TRANSPORTATION GOLD STAR TRANSPORT MPY TRANSPORT INC MTN RETREAT SECURED ODEC MEDICAL TRANSPORTERS OREGON COAST TRANSPORTERS SHEEHAN S CLASSY CRUISER TAMMIE S HELPING HANDS TL MEDICAL TRANSPORTATION WILLAMETTE VALLEY TRANSPORT YELLOW CAB COMPANY DHS VOLUNTEER DRIVER PROGRAM Due to missing data and data quality issues in the months of January, April, and July, data for these months is not included in the quarterly average for Tables 2 6. Table 2. Monthly average WVCH member enrollment & NEMT utilization Utilizers Bus Utilizers All other modes Total Unique Utilizers Enrollment Overall Utilization Q ,202 2,290 99, % Q ,147 2, , % Q ,307 2, , % Q ,400 2, , % Q ,504 2, , % Q ,559 2, , % Q ,588 2,702 97, % Q ,698 95, % Disclaimer: If a member had a bus pass and used any other service during the quarter they were only counted once, therefore the difference when adding column 1 and P age

17 Table 3. Historic ridership (average number of unlinked trip legs per month) by mode* Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Average Ambulatory 10,666 10,795 11,859 12,780 13,543 13,882 14,326 14,006 12,732 Secure Stretcher Volunteer Wheelchair 3,508 3,374 3,911 3,958 4,039 4,161 4,171 4,112 3,904 Total 14,515 14,546 16,264 17,251 18,020 18,529 18,936 18,577 17,080 *Bus trips and member mileage reimbursements are not included in this table. Table 4. Average cost per trip by mode* Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Average Ambulatory $29.36 $30.69 $30.88 $30.01 $29.85 $29.59 $30.36 $30.64 $30.14 Secure $ $ $ $ $ $ $ $ $ Stretcher $ $ $ $ $ $ $ $ $ Volunteer** $- $- $- $- $- $- $- $- $- Wheelchair $37.74 $39.64 $39.42 $39.85 $41.79 $40.65 $41.80 $41.96 $40.62 Grand Total $32.43 $33.99 $33.83 $33.30 $33.61 $33.18 $34.26 $34.56 $33.69 *Bus trips and member mileage reimbursements are not included in this table. **Volunteers are currently reimbursed at a rate of $0.56 per mile. This cost is not included in this historic data. Table 5. Average cost per mile by mode* Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Average Ambulatory $3.45 $3.61 $3.54 $3.44 $3.45 $3.42 $3.44 $3.52 $3.47 Secure $6.32 $6.16 $5.01 $5.78 $7.76 $9.01 $8.21 $14.68 $6.34 Stretcher $18.75 $21.36 $21.67 $20.78 $20.86 $21.60 $24.28 $20.75 $21.09 Volunteer** Wheelchair $4.51 $4.54 $4.88 $4.84 $4.79 $4.84 $5.02 $5.15 $4.85 Grand Total $3.70 $3.84 $3.75 $3.74 $3.78 $3.75 $3.84 $3.96 $3.80 *Bus trips and member mileage reimbursements are not included in this table. **Volunteers are currently reimbursed at a rate of $0.56 per mile. This cost is not included in this historic data. Table 6. Average distance per trip by mode Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Average Ambulatory P age

18 Secured Stretcher Volunteers Wheelchair Overall Avg *Bus trips and member mileage reimbursements are not included in this table. Table 7. Historic reimbursement utilization Mode Reimbursement Mileage (ridership) Reimbursement Mileage Average Cost per Claim (.25/mil)*** Meals (unique members/quarter) Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Avg $65.59 $78.75 $72.19 $64.79 $66.58 $68.70 $66.15 $71.89 $ Lodging (unique members/quarter) ***Mileage reimbursement is not tracked by individual rides/legs. Submissions and claim payments may be for multiple rides over a time span, not to exceed 45 days from the oldest ride date on the submission form. DISCLAIMER: Formulas for Tables 4, 5, and 6 used weighted averages to calculate utilization costs. Additional detail available upon request. 16 P age

19 Exhibit D: Required Policies and Procedures The successful Proposer will be required to produce the follow policies and procedures prior to the Call Center Soft Opening date described earlier in this RFP. Proposers must submit examples of at least five (5) of the following policies and procedures as part of the proposal package. WVCH may add to or modify this list once a Proposer has been selected and depending on changes in state or federal regulations. 1) Accident and incident reporting 2) Business continuity and disaster recovery 3) Code of conduct for employees 4) Code of conduct for transportation subcontractors 5) Communicable or potentially communicable diseases 6) Compliance program 7) Conflict of interest 8) Customer service training 9) Disclosure authorization and power of attorney 10) Fraud, waste and abuse program 11) Grievances and appeals handling 12) HIPAA 13) Inclement weather and disruption to service 14) Insurance requirements 15) Member no-shows 16) Member reimbursement 17) Member rights and notification 18) Policy for scheduling rides requested greater than 30 days in advance 19) Provider no-shows 20) Restraint and seclusion per CFR ) Same day rides 22) Significant events 23) Transportation providers background check and screening 24) Transportation providers training 17 P age