After just one day Badger Cab is walking away from its contract with Logisticare, an Atlanta-based company that took over the coordination of rides for state Medicaid patients on Friday July 1. Previously rides back and forth to medical appointments had been coordinated by the state's 72 counties. The state's $60 million three-year contract with Logisticare has been criticized by patient advocates and some transportation providers as being one more example of the state government rushing into privatization, which the state claims will save millions of dollars, without considering the disruption it could cause to patient care and to the carefully coordinated system of rides built up over the years. 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. Local transportation companies helping to fill the gap left by Badger Cab's decision to drop out also report difficulties. "There's been a fair amount of confusion," says John McNamara, the marketing manager for Union Cab. For example, he says, his company got orders for the same ride from several call centers across the country. But McNamara says his company, so far at least, welcomes the work. "This is all part of trying to switch a really complicated system over into a new way," he says. Rick Nesvacil, general manager for Madison Taxi, says his company got a flood of calls over the weekend from Logisticare. But Nescvacil also welcomes the business. "We're not opposed to helping out," he says. "They're going through some growing pains." Officials with Logisticare and the state health department did not immediately return a reporter's phone calls and e-mails seeking comment. However, just last week the state health department sent out a glowing press release about the new service headed "Access to Medical Ride Service for Medicaid Enrollees to Increase." In it, Deputy Secretary Kitty Rhoades promised Medicaid enrollees "better ride coordination and service quality," noting that the company now employs 87 people at its Wisconsin call center, including Spanish and Hmong speakers. And in interviews a couple of months ago, a Logisticare spokesman predicted that such bumps would occur in the first few days of getting started here in Wisconsin, but would smooth out quickly as the company took over the arrangement of 125,000 rides a year in the state. The company, which has a booming business managing similar non-emergency transportation contracts for 37 other states, claims it has a complaint rate of less than one percent. But other areas have experienced similar problems. In Washington DC, officials severed the contract after a series of articles in the Washington Post about disabled patients left stranded for hours, and last winter in Michigan poor service after Logisticare took over Medicaid trips there sparked embarrassing news accounts and public protests. Badger Cab was the only transportation company in Dane County to sign a contract with Logisticare, according to Schneider and a couple of other local cab company officials. Schneider delivered a copy of the contract to Logisticare on Wednesday but never received a copy back with signatures from Logisticare officials. A clause in the contract allows Badger to turn down any ride it is given within 48 hours, he says. And there is also a provision that Badger can formally cancel the entire contract with 30 days notice. Over the weekend, he says, Badger sent Logisticare an e-mail. "Don't send us any more rides. We're not going to accept them," he says the e-mail said. "They were dismayed," Schneider says. Badger Cab officials aren't happy about it, either, he says. In the past, Medicaid patients made up to a fifth of the billable hours the company took in, and the company has already invested what Schneider describes as several hundred hours of his time and "tens of thousands of dollars" in equipment and training for drivers to qualify for the contract. But the company president decided that the hassles of working with Logisticare aren't worth it, he says. "This was a potentially large amount of business," he says. "But it was just being too disruptive to our other customers. It wasn't working. The relationship is irreparable at this point." In an interview two months ago, Tom Melms, who has owned Badger Cab for 33 years, explained that he was nervous about working with Logisticare from the start. "The system is predicated on them getting a fee to provide a service as cheaply as they can," he said. "So it is in their best interest to grind everybody down." Passengers, he predicted, would be pushed into taking rides from busses instead, while cab companies like his would be forced to submit a cheap bid without knowing how much business it would get them. "All you're doing is creating a middleman trying to compete for another piece of the pie," he said. He wasn't sure then if he wanted a piece of that pie, and now, he's walking away from it. "We're well aware of the needs of these customers," he said back then. "If you threw out a name of a rider at one of my drivers, they'd know their needs and they'd know their rides. We feel very personal and responsible for them. For us, it's a lot more than a name and a ride."
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