Missouri taxpayers spend $30 million annually on a Medicaid program that transports the sick and poor to medical appointments.
KCTV5 has uncovered patient concerns about the safety of the vehicles in which they ride and the drivers who are behind the wheel.
This latest investigation follows two prior ones.
In February, KCTV5 began a series of reports revealing troubles inside the transport program, run by Atlanta-based LogistiCare Solutions, LLC. KCTV5 first exposed patient complaints about the hundreds of late or missed rides that led to medical complications for more than one client. In April, KCTV5 followed up on that report.
The list of complaints filed with the state of Missouri include reports of one transportation provider driving drunk and another reeking of alcohol. The patient accounts to the state include incidents of a driver getting in a wreck while texting along with drivers who speed, run red lights and use unsafe vehicles.
None of those accounts surprised Jackie McGlothen. She and her husband own Mill-Jacks, a LogistiCare-approved transportation provider out of Belton, MO. McGlothen said she's heard similar stories about other transport companies from her own clients.
"I know I've heard some horror stories," McGlothen said. "One lady told me that the driver had to use a screwdriver."
"A screwdriver to start the car?" asked KCTV5 investigative reporter Stacey Cameron.
"No. To get her out," McGlothen replied.
The state's Medicaid office, MO HealthNet, refused to respond to KCTV5's numerous inquiries about the safety complaints. A representative told Cameron it would be "inappropriate" for the state to comment about its contract company, LogistiCare.
No one from the Atlanta-based company would agree to address the issues on camera.
When former LogistiCare employee, Tamika Williamson, learned of the KCTV5 investigation, she agreed to an interview.
For two years, Williamson worked as a senior level manager at company headquarters in Atlanta, dealing with operations and compliance. Her job was eliminated in January. Williams contends she was let go because she had begun pushing back against the company attitude of putting profits ahead of patient safety.
"They probably will say I am disgruntled," Williamson told Cameron.
At its core, compliance means safety. Williamson said she was charged with making sure provider vehicles are licensed and pass inspections and that the drivers undergo background screening.
"We were responsible for compliance for all of the states that LogistiCare had a presence in," Williamson said.
"Including Missouri?" Cameron asked.
"Including Missouri," Williamson responded.
The safety requirements Williamson mentioned are actually spelled out in LogistiCare's contract with the state. But when LogistiCare took over the Missouri program last November, Williamson said things changed.
"The company made a decision to forgo compliance," Williamson said.
"Forgo compliance?" Cameron asked.
"Yes," Williamson replied.
"Across the board?" pressed Cameron.
"Across the board in the state of Missouri to get everybody up and running," Williamson said.
She said she was so disturbed by this that when LogistiCare eliminated her job, she refused to sign a confidentiality agreement and waived receiving a severance check.
"I was not going to sign an agreement that would basically close my mouth forever," Williamson said.
"If someone like me came asking questions?" Cameron asked.
"If somebody like you came asking questions for something, for things that I saw that I knew was not right going on," Williamson confirmed.
In order to get a response to Williamson's claims from LogistiCare, Cameron visited company headquarters in downtown Atlanta. A receptionist told Cameron that there was no one available to answer his questions. He offered to wait to speak to one of the company's employees meeting in a glass-surrounded room right off the reception area. The receptionist refused. Property management was called to escort Cameron from the building.
Following that visit, LogistiCare's attorney responded to Cameron in writing.
In the 14-page letter, the company first explained that it had "less than 30 days" to get its Missouri operations in place when it needed three to four months to complete the job. As for the patient complaints, which now top 1,000, LogistiCare called them "minuscule" for a company that manages about 100,000 trips a month.
And when it came to compliance, Missouri gave LogistiCare a "grace period." LogistiCare stated that safety inspections are now ongoing.
That's news to McGlothen, whose company has been driving for LogistiCare for six months.
"Our vehicles are still in default," McGlothen said. "We as drivers are still in default. LogistiCare still has not yet sent anybody out to inspect our automobiles."
Cameron asked Williamson why that might be the case.
"Would it cost LogistiCare more money to make sure that every transportation provider in the state was compliant?" Cameron asked.
"Most definitely," Williamson replied. "Most definitely. They would have to have more staff."
In its letter, LogistiCare claimed a staff of more than 70 people runs the Missouri program. That roster now includes a media consultant, who was hired after Cameron's visit to corporate headquarters. When the consultant last spoke with KCTV5 on May 2, he said he was trying to get a LogistiCare executive to talk on camera. That hasn't happened.
Copyright 2012 KCTV (Meredith Corp.) All rights reserved.
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