Is $175,000 too much to pay for transporting Brown County's Medicaid recipients to scheduled medical visits? Not according to Brown County Job and Family Services.
On June 12, the Brown County Commissioners approved contracts for fiscal year 2007 at the request of David "Mitch" Sharp director of Brown County Job and Family Services.
Among the contracts approved were annual contracts for $95,000 with Geno's Taxi of Maysville, Ky., and $80,000 with Brown County Senior Citizens of Georgetown, both to provide Medicaid recipients with transportation to medical facilities.
The transportation service they provide is commonly referred to as non-emergency transportation.
After many Brown County taxpayers became aware of the contracts for NET, The News Democrat received responses from members of the general public who questioned why Brown County paid $95,000 to Geno's Taxi service, rather than finding another source to provide Brown County's Medicaid recipients with rides to scheduled medical visits.
"How come we (Brown County taxpayers) are paying a taxi service not in Brown County to transport people at a rate of $95,000 when county officials, commissioners, Chamber of Commerce, etc., complain how we don't keep Brown County dollars here in Brown County?" one Brown County taxpayer questioned in a letter to The News Democrat.
Several other taxpayers of Brown County have also expressed their concerns regarding the amount paid to Geno's Taxi, claiming that $95,000 seemed too high for NET.
However, the $95,000 contract between Brown County Job and Family Services and Geno's Taxi is not actually a cost to Brown County, according to Mary Ann "Babe" Beasley, fiscal specialist for Job and Family Services. Beasley said Brown County Job and Family Services is reimbursed 100 percent by the State of Ohio Medicaid program for contracts with Geno's Taxi and Brown County Senior Citizens.
"If you are a Medicaid recipient going to a Medicaid reimbursable provider, the State of Ohio reimburses us for this," said Beasley. "This money that is paid does not come out of the county budget. It's 100 percent reimbursable by the state."
The money used to pay the contracts may not create a direct burden for Brown County taxpayers, but contracts that are reimbursed by Medicaid create additional costs for all Ohio's taxpayers as it impacts the state budget.
According to information found on the Health Policy Institute of Ohio's website, Medicaid has represented nearly 24 percent of the state's total federal/state expenditures in recent years, making it and education two of the most sizable items in the state budget.
Sharp and Beasley said Brown County Senior Citizens and Geno's Taxi provide a necessary service that benefits the county's Medicaid recipients who are unable to pay for or find their own NET for scheduled medical visits.
"It's not to go to the store or to get a haircut. It's for medical visits only," said Beasley. "This is a service that really needs to be provided."
Sharp explained that transporting Medicaid recipients isn't always as cheap and easy as it may sound, especially after gasoline prices have "sky rocketed."
"You're transporting people who are very ill a lot of the time," said Sharp. "You (as a Medicaid transportation service) are dealing with people who may become sick on the way (to their medical visits) or have various issues and I think, at this point, they (Geno's) have done a very good job at providing a service."
Why two contracts for Medicaid transportation?
According to Beasley, contracts with two separate transportation companies, Geno's Taxi and Brown County Senior Citizens, are necessary to adequately cover all hours of the day.
During its hours of operation, Brown County Senior Citizens typically transports Brown County's Medicaid recipients to their Medicaid approved medical provider. But when Brown County Senior Citizens is unavailable or has surpassed its hours of operation, Geno's Taxi is called in to provide rides for those on Medicaid who are scheduled for medical visits.
Beasley said Brown County Senior Citizens is used when at all possible.
"(Brown County) Senior (Citizens) does provide a lot of transportation for us, but they cannot provide all of it," said Beasley.
The high amount of Medicaid recipients in Brown County also contributes to the cost of Medicaid transportation.
According to Sharp, approximately 25 percent of the residents in Brown County receive Medicaid.
"It's in excess of 10,000 (people)," Sharp said regarding the amount of people receiving Medicaid in Brown County.
Beasley said Brown County has several Medicaid recipients that are on dialysis, requiring transportation to medical visits regularly, sometimes more than three times per week.
Adams County has a smaller population and less Medicaid recipients than Brown County. But Adams County Job and Family Services director Sue Fulton said her office also pays in excess of $100,000 per year for the transportation of Medicaid recipients. Geno's Taxi is one of the three NET providers for Adams County Job and Family Services.
Fulton said Adams County Job and Family Services, at one time, did contract with available NET providers local to Adams County, but the local providers found that they could not handle the time-consuming duties involved, leaving her office to contract with providers outside of the county.
"Brown County is probably like Adams County (being a rural area) and transportation is a big barrier," Fulton said.
Sharp said Job and Family Services is exempt from the competitive bidding process and the reason Geno's Taxi was selected rather than a local service was due to the fact that no one in Brown County, other than Brown County Senior Services, has applied for the contract in recent years.
"Title 20 contracts and Medicaid contracts are exempt from competitive bidding. Instead, people have the ability to call in here (to BCJFS) and submit in writing that they are interested in providing that service," said Sharp.
Sharp said many transportation providers have inquired regarding the contract, but did not submit their requests in writing when asked. According to Sharp, none of the providers that have gone as far as to submit applications for the contract in recent years have been local, with the exception of Brown County Senior Citizens, who has held a contract with BCJFS for at least 15 years.
Of the applications received, Geno's Taxi was the lowest offer next to Brown County Senior Citizens.
According to Sharp, finding a local transportation provider that conducts such a service can be a difficult task, as the majority of villages in Brown County do not have a taxi or transportation service.
Despite a spike in gasoline prices, Beasley said the costs of the contracts have not increased in recent years.
"The services have gone very well," said Sharp.
Beasley and Sharp both felt the costs paid for Medicaid transportation seemed to be reasonable when taking into consideration the details of the service provided by Geno's Taxi and Brown County Senior Citizens.
