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.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.
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.
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."This should raise several questions for the reader.
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.
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.