Medicaid Non-Emergency Transportation Request for Proposals. Responses to Questions Received by the March 11 Deadline (Posted March 17, 2011)

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Marylou Gallagher
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1 Medicaid Non-Emergency Transportation Request for Proposals Responses to Questions Received by the March 11 Deadline (Posted March 17, 2011) 1. Could the MPO please provide a link to (or an electronic copy of) the Quality Improvement Program for Transportation that is referenced in the RFP? Is this something that we need to develop internally? The Commission does not currently have an approved Quality Improvement Program document to reference. Pursuant to the contract, the Quality Improvement section starting on page 50 should be followed. 2. Will the PARC and Foster Parent programs continue to be administered and funded directly by the MPO? The PARC and Foster Parent trips are funded out of the total Medicaid allocation. During the past 6 months, this cost has been between $400/month and $715/month. These trips are expected to be provided and funded as they are currently and will likely be administered and paid for directly by the MPO (out of the full monthly allocation) unless otherwise negotiated through the contract negotiation process with the selected provider. 3. Pg. 5, 13.0 refers to Additional Services. Could the MPO please elaborate on what these additional services may entail? No additional services are currently anticipated. This clause is here in the event that additional, unanticipated services become necessary or desired. As stated, an amendment to the Agreement would be necessary. Any amendments require the approval of both parties. 4. Pg. 8 Please describe the mechanics and cost of obtaining and distributing passes to clients. Currently, the Management Entity provides the MPO with an order for bus passes needed for the upcoming month. MPO staff transmits a PO to PSTA, which fills the order. Passes are distributed by either the Management Entity by mail or office pickup OR by PSTA at their 3 ticket outlets. Clients may choose which method they prefer to obtain a pass. The MPO has an agreement with PSTA for bus passes in which the MPO purchases passes from the PSTA at a reduced cost. With the sole service provider contract, however, it will be the responsibility of the Provider to negotiate a bus pass cost with PSTA and a method of purchasing and distributing passes. The current full-price cost of Medicaid bus passes is as follows: 31-day $65.00, 10-day, $45.00, 5-day $22.50.

2 5. Could the MPO please provide a current listing of the software used in the operation of the services outlined in this RFP? The currently contracted Management Entity uses proprietary software that they call Mobility Manager. According to Commission staff, other packaged software is available for purchase to provide the necessary functions. All Encounter Data requirements as described in the Scope of Services and attachments must be met. Microsoft Word and Microsoft Excel are also used regularly Page 2, last sentence in section 1.0 Legal Notice: Please provide any information pertaining to the requirements of the US Department of Homestead Security s E-Verify System so the proposer s can ensure their compliance. The E-Verify form and language the MPO must include in all contracts is on page 106 of the RFP package. Additional information can be obtained from the U.S. Department of Homeland Security s website: 7. Page 5, Section 12.0 Certificate of Insurance: Does the MPO want each proposer to provide a copy of the required certificate of insurance within the proposal as an attachment or will this be requested to be supplied after contract award? The Certificate of Insurance will be required upon contract execution. 8. Page 13, Section III.A. Technical Approach: Does the MPO desire a response to every single task in the Scope of Services or does the MPO want merely a broad description of the proposer s approach, capabilities, and means to be used in accomplishing the tasks in the Scope of Services? The MPO does not desire a response to every single task in the Scope of Services, but does desire a fairly detailed description of the required services described in the scope and outlined on page 10 of the RFP, under Intent. The responses should also address the points listed on pages 13 and 14 of the RFP under Technical Approach. 9. Page 131, Exhibit D: Please cite some examples of other Credit References, besides the bank, the Pinellas MPO would like to have each proposer submit. In the past the following have been acceptable: banks, accounting firm that provides financial audits for the company, fleet fuel card companies, financial institutions that have provided credit/loans to the proposer.

3 10. Page , Exhibit H: Please verify that this form is not required to be signed by the Proposer s Authorized Official Per #1 of Exhibit H, signing the proposal is effectively completing the certification, By signing and submitting this proposal, the prospective lower tier participant is providing the certification set out below. 11. Will the Pinellas County Metropolitan Planning Organization allow Key Personnel (personal resume) information to be submitted as confidential information? No Could you detail the telephone system that is currently in place for the system as far as sophistication? (Automated call distribution, reporting functions, etc.) The telephone system is Avaya. It does call distribution, call data reporting (call hold time, average call length, longest waiting, etc), There is also a recording software to record all calls and store them for six months. 13. What percent/number of the clients pays the optional fare? We do not currently request optional co-pay from Medicaid clients, therefore the percentage is 0. The Proposer may propose to reinstate the optional co-pay. 14. Given the state and federal discussion on Medicaid and Medicaid funding in general, and understanding that much of this is conjecture, what relief would the successful proposer have if funding for this program is significantly reduced or eliminated? The contract will be subject to the availability of funding. Payment by the MPO will not be made until the MPO receives payment from the Commission for the Transportation Disadvantaged. Should the contract between the Commission for the Transportation Disadvantaged and the MPO be terminated, so would the contract between the MPO and the Provider. Page 126 of the RFP provides additional information on the Termination and Default Procedures. 15. When describing out of service area trips, can you give a current detailed description of these trips? This would include daily counts of one-way trips, destinations, and frequencies (whether trips are grouped and provided only on certain days). In Pinellas County, we consider out of service area trips, those that cannot be provided through one of our contracted providers, which generally can provide trips to and from Pasco and Hillsborough counties as necessary due to a lack of certain services in Pinellas County. Only 1 trip was provided in the last six months out of the service area by Greyhound. In the past couple years, there has been an occasional trip from Orlando and Tampa wherein we paid the Medicaid service provider in those counties to return a client to Pinellas county at their Medicaid NET rates. We have found over the years that most Medicaid services are available in

4 Pinellas County. Trips to certain cancer treatment services and pain management clinics in Hillsborough County are often necessary but these are covered under our current rate structure (ambulatory is a per-mile rate and wheelchair is a flat trip rate plus $2.40/mile for out of county trips). Because of this rate structure, we do not track out of county trips to adjacent counties for ambulatory trips. For wheelchair trips over the last six months, between 1,000 and 1,500 out of county miles/month were logged. We have not limited these trips to certain days or grouping requirements but that is something that could be used under this RFP to control costs (see page 25 of RFP). 16. Please provide clarification regarding the integration of service with DART and the MPO Medicaid program. The MPO and PSTA are currently discussion the integration of DART and the MPO s Transportation Disadvantaged Program. The Medicaid NET Program will be kept separate and will be provided for as described in this RFP. 17. Can you provide detailed data on trips that would indicate the percentage of group trips provided in the system (i.e., sheltered workshops, meal sites, etc.)? We do not provided group trips for the Medicaid NET program, which is the subject of this RFP. Multi-loading of passengers may be done by the providers but we do not schedule group trips. 18. What type of radio system is being employed in the current system? Is a partnership for tower use a possibility with other county agencies? (Fire, police) The MPO does not specify a type of radio system. The transportation providers are required to have 2-way communications in their vehicles but nothing beyond this is specified. 19. Can you provide any information on the number of trips that fall outside of normal service hours, i.e. after 8 p.m.? Number on Saturdays and number on Sundays? Looking at the month of January 2011 as an example, weekday one-way trips were between 500 and 610, Saturday one-way trips were between 150 and 170 and Sunday one-way trips were between 15 and 30. In the same month 143 one-way trips or 1.13% of trips occurred after 8 p.m. 20. Can you provide any information on the number of same day (urgent care) trips? Using January 2011 as an example, there were 675 (5.3%) one-way trips that were same day urgent and 441 (3.5%) one-way trips that were next day urgent. 21. On page 9 of the RFP document there is a table depicting trips by service type for the most recent 7 months available at the time of the RFP release. Can the MPO quantify these trips into revenue hours, defined as the time from the first pick up to last drop off, for a typical month? The MPO does not collect data on revenue hours. Most trips are individual taxi/sedan and wheelchair van trips. Average miles per trip is tracked and for the

5 first six months of fiscal year 2010/2011 were 6.6 miles/trip for wheelchair van trips and 7.3 miles/trip for taxi/sedan trips. 22. Can you provide a description of the complaint intake and resolution process currently being used? Complaints are provided to the Management Entity, which addresses in the field service complaints immediately (i.e. provider late) and researches other complaints within a couple days of the complaint. The complaint and resolution is documented on a simple complaint form and sent to MPO staff for review and filing. Complaints may also be called into MPO staff or the Commission for the Transportation Disadvantaged Ombudsman Line (these are referred down to MPO staff). MPO staff address complaint, resolves, and files. 23. Can you provide/explain the current system in place for application/screening for the Medicaid program? Medicaid eligibility is determined through phone intake. A series of eligibility and gatekeeping questions are asked and the Medicaid number taken. The Medicaid number is run to verify eligibility. If eligible, the client is asked how many appointments they have in the upcoming month. If able to ride the bus, they are provided a 5, 10, or 31-day bus pass based on the number of expected appointments. If they say they can t ride the bus, a form is sent to their medical providers asking for verification that they are unable to ride the bus. Upon receipt of a completed form, the client is then provided either door-to-door taxi/sedan or wheelchair van service. 24. Can information be made available regarding the wages and seniority of the current administrative staff? Please provide a staffing plan and organization chart for the current broker The MPO does not have this information. 25. Can information be made available regarding the average wages and seniority of the current driving staff for each provider? The MPO does not have this information. 26. Is the current broker routing the trips for the subcontracted transportation providers? If so, how many subcontracted providers are in the network at this time.? Does the broker manage the solicitation process for securing the providers? The broker assigns trips to transportation providers, which are procured by and under contract with the MPO, not the broker. At this time, there are 3 ambulatory providers and 4 wheelchair van providers. Under the single Provider contract, however, the MPO will no longer procure and contract with transportation providers. It will be up to the new Provider to provide transportation services itself or subcontract for transportation services.

6 27. How often do out of state trips occur? Very rarely. None have occurred in the last year at least On the call in-take part of the contract (GPTMS current function) what are the winning providers days and hours of operation (government holidays, weekends) expected to be? On Page 47 of the RFP package, it states, The Service Provider shall provide Transportation Services twenty-four (24) hours per day, seven (7) days per week, as set forth below. The coverage shall consist of an answering machine, call forwarding, or Service Provider call coverage. The Service Provider shall obtain the MPO s written approval for any other means used to ensure call coverage before implementation. The successful proposer will be considered the Service Provider. 29. Please explain the scope of educating the public about the program (page 10). The Provider will be expected to fulfill reasonable requests for participating in public events and/or speaking engagements to describe the Medicaid NET Program to potential clients. In the past this has included health fairs, speaking to case managers, speaking directly to a group of clients (i.e. organized by an assisted living facility, health organization, etc.) MPO staff does this currently and averages 1-2 speaking engagements/events per month. 30. On page 3 of the RFP it states Wednesday March 25, 2011 was that to be Friday March 25 th? Yes, it should read Friday, March 25, If the Proposal Selection Committee requests an oral presentation and or further documentation from a Bidder, how much notice will be allotted to the Bidder? No time has been established for such requests but notice will be given with as much time as possible for proposers within the constraints of the RFP process timeline. 32. Do the Bidding Providers need to be present at any of the Selection Committees review meetings? No. 33. Will the winning Provider use the current Medicaid / TD phone number? Not. This RFP is for Medicaid only and currently the Medicaid and TD Programs share a phone number. The TD Program will still be using the existing phone number as of July 1 when this contract is anticipated to start. 34. Is this contract door to door or door through door? (Please explain). Door-to-door.

7 35. Is any portion (money) from this RFP going to any non-profit providers? This RFP is for the Medicaid Non-Emergency Transportation Program only. Other than a small amount of funding used to fund PARC trips and foster parent trips (see question 2) the full monthly Medicaid NET funding will be available to the Successful Proposer to fulfill the requirements of the Scope of Services. 36. Please clarify the winning Bidders responsibilities for Medicaid stretcher Clients (page 38. section (3) By a Pinellas County ordinance, stretcher service in Pinellas County must be provided by Pinellas County Emergency Medical Services (EMS), which bills Medicaid directly for the trips it provides. (3) on page 38 comes directly from the MPO s contract with the Commission for the Transportation Disadvantaged and must be included although it is not currently applicable to the Pinellas County Medicaid NET provider. 37. If PSTA decides not take over the Transportation Disadvantaged Program (TD) in June 2011, how will that affect this contract? No impact on this contract is anticipated related to whether the MPO or PSTA operates the TD Program. 38. What are the Client pick-up windows for the winning Provider? Currently, the pick-up window is defined as follows: Passengers shall be picked up within one (1) hour prior to their scheduled appointment time, except when necessary for trips estimated to take longer than one (1) hour, and be delivered to their destination by the appointment time. An alternative pick-up window could be proposed, however, it is the desire locally to ensure that clients are being delivered to their appointments on-time or slightly early. 39. Explain the winning Providers responsibilities for the purchasing and distribution of Bus Passes The Successful Proposer will submit a proposal that defines how it will meet the demand for Medicaid NET trips and which transportation services will be employed to do so. This may include using existing network providers, new providers, inhouse vehicles, bus passes, or other appropriate means. It has been the local policy to provide bus passes to those who are able to access and utilize the fixed route transit system as this promotes independence and a greater overall mobility; however, the idea behind this RFP is to obtain a provider that can consistently meet the demand for transportation services while staying within the monthly Medicaid NET allocation. Therefore, this RFP does not require the use of any specific means of transportation. If the successful proposer utilizes bus passes to any extent to fulfill the contract requirements, the proposer would be responsible for negotiating a rate with PSTA, purchasing, and distributing the bus passes (or possibly negotiating a distribution strategy with PSTA).

8 40. On page 33 item 10 asks bidders how they plan to secure more funds please explain what the expectations will be for the winning bidder. In the past, there have been opportunities through the Commission for the Transportation Disadvantaged to meet with legislators and other decision makers to present a case for additional Medicaid NET funding. The Successful Proposer should be willing and able to work with the MPO, the Commission, and others and to identify and try to secure additional funding as appropriate and as opportunities present themselves. 41. Can a provider bid on this RFP, without being disqualified, if they have existing contracts with other Funding Agents ( Broker s ), such as TMS who also may be bidding on this contract. Based on the information provided, existing contracts with the current broker would not preclude a provider from responding to the RFP. Page 7 of the RFP package states, Where two (2) or more related parties each submit a proposal or multiple proposals are received from one (1) vendor, for any contract, such proposals shall be judged non-responsive. Related parties means proposers or the principals thereof, which have a direct or indirect ownership interest in another proposer for the same contract or in which a parent company or the principals thereof of one (1) proposer have a direct or indirect ownership interest in another proposer for the same contract RFP Section 1.2, Page 9; Can you breakdown the Level of Service (LOS) for the Pinellas Association for Retarded Citizens (PARC) trips? (i.e. ambulatory, wheelchair, etc.) The PARC trips are currently all ambulatory. 43. RFP Section 1.2, Page 9; Can you provide a breakdown of type of bus passes reported on the table on page nine? Although there are some discrepancies in the totals between this and the RFP document, the following is an accurate breakdown of # of passes by type by month: Month Jul Aug Sep Oct Nov Dec Jan MD MD MD TOTAL Section 3, Page 11; How are bus pass trips reported today, how many per monthly pass? For the purposes of the required Annual Operating Report, a monthly pass is considered 40 trips. Although they do not specify # of trips for 5 and 10 day passes, it would be safe to assume 10 trips for a 5 day pass and 20 trips for a 10 day pass.

9 45. Can you provide the current rate tables for rates paid to all transportation providers, including: PARC and foster parents? Ambulatory - $1.80/mile (currently $1.62/mile due to a 10% temporary rate reduction) Wheelchair - $28/trip (currently $25.2/trip due to rate reduction) + $2.40/mile for out of county trips Foster parents - $.50/mile PARC - $2.34/trip 46. Are the amount of trips reported on page nine of the RFP reported by gross or performed Level of Service? The # of trips reported on page nine are the # of trips completed and invoiced for payment.

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