Medical transport services result in complaints over safety issues

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Photo by Seth Ogilvie/Idaho Reports

Note: This is part one of a series exploring non-emergency medical transport services for Medicaid patients in Idaho.

By Melissa Davlin, Idaho Reports

On a cold night in November, a state contracted service “could have led to the death of a special needs child,” according to documents obtained by Idaho Reports.

After a medical appointment, a driver with a transportation company for Medicaid clients dropped off a teenager with special needs at the wrong Owyhee County home.

No one knows what happened in the two hours between when the driver left and when the teenager’s mother found him near a busy street. The young man, a Medicaid client, is non-verbal. The driver, an employee of a Meridian-based transportation company, claims he walked the young man to the back door of the house. That’s unlikely; There were people home at the time who didn’t see him.

“Most likely the driver let him out of the vehicle and drove away,” says a complaint filed with the state. The incident “resulted in stress and trauma for everyone involved in the incident,” and forced the client, who has a compromised immune system, to spend two hours standing outside in the cold.

The incident, confirmed via an Owyhee County Sheriff’s Office report, is one of almost 400 lodged over Idaho’s non-emergency medical transportation services in the last six months. An Idaho Reports investigation revealed issues including tardiness, poor customer service, inadequate safety measures, alleged sexual assault, and life-endangering mistakes — but issues with the transportation services started well before last year.

A necessary service

Some Medicaid patients are entitled to transportation to doctor visits, therapy sessions, and other medical appointments. The broker of those transportation services: Veyo, the California-based company that provides non-emergency transportation services (NEMT) for Idaho Medicaid patients. Veyo works with commercial transportation providers, like Freedom Shuttle, as well as hundreds of independent drivers in an Uber-like model.

Last year, Veyo won a $71 million contract to provide transportation for medical appointments, beating out AMR, the previous NEMT contractor. That contract went into effect July 1, 2016.

The complaints, which Idaho Reports obtained via public records request, started that day. Some involve Veyo and its services, while others are aimed at the local commercial providers.

Priest River resident James Bayles said his 28-year-old daughter, Caitlin, has cerebral palsy, and relies on a local transportation company to give her rides from her care center to medical appointments. His frustrations with Veyo began almost right away. Though the transportation service is locally owned and has worked with Caitlin in the past, Bayles has to go through Veyo to schedule rides. Any changes takes 48 hours, even if the change is the result of Veyo’s mistake — a scenario that Bayles said played out in late December, when Veyo’s computer system automatically kicked Caitlin off the schedule because of a glitch.

The rural area has only one transportation service, and that service has only one van with a wheelchair lift. If that van is already booked or out of commission, Bayles, a disabled veteran, must transport Caitlin himself — a task that causes him severe back pain. He has to pick her up to place her in and out of the car, and secure her heavy motorized wheelchair to the back of his vehicle.

Bayles trusts the local company to take care of Caitlin, but is concerned for other families in the community that rely on the independent drivers dispatched by Veyo.

“We’re talking about the most vulnerable population in the state,” Bayles said. Clients with autism, bipolar disorder, or other conditions rely on consistency.

“With changing the driver, just whoever happens to be there with their Uber ready to pick them up? These people don’t do well with change,” Bayles said.

Christine Pisani, Executive Director at the Idaho Council on Developmental Disabilities, said relationships and trust are critical when working with vulnerable populations. Small frustrations and changes can upset clients, sometimes resulting in behavioral issues.

A pattern of complaints

Bayles isn’t alone in his concerns. Most grievances involve drivers who are late, far too early, or totally absent, but some mistakes have endangered clients’ lives.

During one transport in late November, a male client got into a pill bottle and chewed up multiple pills of Risperdal, a drug taken for bipolar disorder.

“No one saw this?” the complaint says. Staff at the facility noticed the white powder on his face and took him to the hospital, where he was admitted for supervision after a bad electrocardiogram.

“The facility supervisor called Veyo and asked for the name of the driver that transported and they said they would talk to family directly,” the complaint says. “We needed the information for doctors at the ER but were unable to get it.”

One complaint, also in November, alleges sexual assault of an adult female passenger by the driver. Several complaints regard children or special-needs clients being dropped off without supervision. In a December incident, a client with Down syndrome was dropped off alone in front of her home. She wandered into her own back yard, where she was found. “Family and service providers have repeatedly told Veyo driver must, for safety reasons, walk her to the door and ensure she gets safely into the house,” the complaint says.

Numbers and context

Matt Wimmer, Administrator for the Division of Medicaid at the Department of Health and Welfare, said the department works closely with Veyo to address concerns.

Issues with NEMT aren’t new, though. Wimmer pointed out the raw numbers of complaints against Veyo line up with complaints against AMR, the previous contractor — and if anything, are slightly fewer.

In October 2015, when AMR held the contract, the Department of Health and Welfare received 99 complaints. In October 2016, four months after Veyo took over, the state received 70 complaints.

That month alone, Veyo administered 101,697 trips in Idaho, of which 6,366 were from independent driver providers, Wimmer said.

“(Seventy complaints) is actually not bad, considering the level of service,” Wimmer said.

So if this was the standard all along, are Medicaid workers comfortable with the complaints and safety issues?

Wimmer said due to the nature of transportation and all the related variables — traffic, weather, car maintenance — there will always be complaints about tardiness. He also pointed out the number of logistics involved with what seems like a basic transportation service: Getting appointment information from clients or third parties, making sure that information is entered correctly, and relaying the correct information to the driver.

But even a single complaint regarding the safety of a client, Wimmer said, “is one too many.”

Aiming to improve

Josh Komenda, the San Diego-based CEO of Veyo, said his company takes every complaint seriously, especially those involving client safety.

“We’re really aware of the problems and frustrations,” Komenda said, adding he realizes tardiness can add to a client’s stress. “Honestly, our heart breaks if someone has a frustration or failure.”

Komenda said Veyo has completed more than 525,000 trips in Idaho since taking over in July. Of those, majority — 93 percent — have been carried out by local contracted companies.

He acknowledged hiccups in the transition, as well as challenges unique to Idaho. Some rural addresses, for example, don’t show up accurately on maps. The Veyo team is addressing this, Komenda said, and is working on rolling out a new GPS tracking system that will help clients and Veyo call center staff locate where drivers are in real-time.

“We’re 110 percent committed to continuing to improve the quality,” Komenda said.

The chairman’s view

House Health and Welfare Chairman Fred Wood, R-Burley, said he’s heard almost no complaints over Veyo’s services. While he does want to hear the concerns, he said he wasn’t going to get too excited until he’d studied the issue.

“Any time there’s change, people really seem to have a problem,” Wood said, pointing to past transition issues with Medicaid contractors Optum and Melina. Those issues were ironed out, Wood said, and he expects the same will happen with Veyo.

And if it doesn’t? That’s up to the Department of Health and Welfare to deal with, Wood said.

“The legislature is not going to interfere with a state contract,” Wood said. But, he said, his primary concern is making sure Medicaid patients get to their appointments safely.

Bayles, the Priest River father, said he has contacted his lawmakers, and is paying attention to who will help him fix the problem. He said Rep. Heather Scott and Sen. Shawn Keough have been responsive and interested in helping him.

“I know it’s going to be a political process,” Bayles said. “I’ll find the ones who are on our side.” And for those who aren’t, he said, he’ll work to get them voted out of office.
Next week: The business side of medical transportation

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US Attorney Wendy Olson stepping down Feb. 25

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US Attorney Wendy Olson. Source: Idaho Reports

 

By Seth Ogilvie, Idaho Reports

U.S. Attorney Wendy Olson will step down on February 25th. She has served almost twenty years in the U.S. Attorney’s Office, including the last six in charge of the district of Idaho.

It’s customary for political appointees to serve at the discretion of the president. Having been sworn in by President Barack Obama, Olson anticipated a change would be coming under the new Trump administration. “I wanted to be able to chose my own departure date and move on at a date that worked for me,” Olson said.

Days after she decided to resign her post, Olson charged Kelly Schneider on federal hate crimes, alleging assault based on the victim’s sexual orientation after the beating death of Steven Nelson in April 2016. “It is my case, and I will get as much done on it as I can before I have to leave.” Olson said. Schneider pleaded guilty on Jan. 25.

The indictment is a good mirror of her service in the office, working until the last minute and focusing on civil rights violations. “Any of the lawyers we have in this office are outstanding and folk will make sure this (case) has an orderly transition.” Olson said.

She was involved with several high profile incidents, including the terrorism case against Fazliddin Kurbanov, reviewing the Corrections Corporation of America incident involving falsified documents, filing an amicus brief on Idaho’s public defense system, and investigating the officer-involved shooting of Jack Yantis.

Olson had a diverse tenure but said “an office of outstanding lawyers and support staff that work hard every day for the U.S. and the people” and “civil rights enforcement” are the legacies she is most proud of.

The office will not change significantly in her absence, Olson said. “The goals of the people who work in this office are not to do what I want, it is to follow the law and to follow the constitution.” No matter who fills her position, she added, “I’m confident things will continue to be done that way.”

The future is open for Olson but she does plan to stay in Boise. “I have family here and I anticipate I will go into private practice,” she said. “I am not going to run for political office. I have no interest in running for political office.”

So moving forward the people of Idaho will have to pay Wendy Olson out of their own pockets for her legal expertise.

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Right to Life of Idaho distances itself from recent anti-abortion proposals

Updated Jan. 31

By Melissa Davlin, Idaho Reports

In Idaho, two similar proposals are generating chatter: One from freshman Sen. Dan Foreman that would classify abortion as first-degree murder, and a petition circulating that would do the same. Both would open the door for charging doctors and women with murder for providing or seeking an abortion.

But neither has the backing of one of the state’s most influential anti-abortion organizations.

Right to Life of Idaho does not support any action that would criminalize women for abortion, said Kerry Uhlenkott, legislative coordinator for Right to Life of Idaho.

“Subjecting women to criminal penalties for an abortion is inconsistent with the historic pro-life position,” Right to Life of Idaho said in a statement sent to Idaho Reports. “We have never supported legislation containing criminal penalties for women. We stand with women and men to offer them realistic alternatives to abortion.”

Abolish Abortion Idaho responded to RTLI’s opposition with two statements: One addressing whether most women are coerced into abortion, and one addressing whether women who seek abortions should be exempt from murder charges.  You can read both on AAI’s website.

Read RTLI’s full statement below.

“Right to Life of Idaho does not support any legislative action that would subject women to criminal penalties for an abortion.

Based on our experience and the experience of our 19 Idaho Pregnancy Care Centers and hearing the stories of thousands of post-abortive women and couples, we are convinced that abortion is most often a tragically desperate act. Available research indicates that coercion is often a factor in over 64% of the cases when women experience abortion. Despite rhetoric from advocates of abortion on demand, abortion is most often NOT freely chosen by women. Many woman come to deeply regret the loss of their child to abortion.

Subjecting women to criminal penalties for an abortion is inconsistent with the historic pro-life position. We have never supported legislation containing criminal penalties for women. We stand with women and men to offer them realistic alternatives to abortion. We stand with our Pregnancy Care Centers that daily provide compassion and hope to women who consider abortion in a moment of desperation.”

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Who lost the most on Thursday? District 1 constituents.

 

 

In the hours after Rep. Heather Scott, R-Blanchard, was stripped of her legislative committee assignments, some Idaho conservatives are unhappy with the move.

Scott lost her committee assignments after being accused of publicly saying women lawmakers get leadership positions only if they “spread their legs.” (Read more, via Betsy Russell of the Spokesman-Review, and Kimberlee Kruesi of the Associated Press.) And regardless of whether people blame Scott or House leadership, District 1 constituents has one fewer voice in legislative committees to represent their interests.

Some of those constituents are criticizing House Speaker Scott Bedke, not Rep. Scott.

“With the action of Speaker Bedke today 55,000 citizens have lost their voice in the Idaho legislature,” wrote Victoria Zeischegg, president of Bonner County Republican Women Inc., in an e-mail to House members on Thursday afternoon. “I would like to know by what authority Speaker Bedke has the right to remove Rep. Heather Scott from all of her committees, and why has he not explained his actions?”

“We are a representative government and it sickens me to think you need to be reminded of that,” Zeischegg continued. “I strongly urge you to return Heather to her committees and give us our voice back.”

“I can barely contain my fury at the actions off Speaker Bedke today,” wrote Anita Aurit in another e-mail to legislators. “An entire district of voters have lost their voice in the Idaho legislature and I would like to knew, in detail, the reasoning and more importantly, the facts regarding this travesty.”

 “Every citizen in Heather Scott’s district is due a detailed and complete explanation of the reason for this action, facts, not lies, innuendos or the less than reliable “reporting” of the not the  mainstream press),” Aurit wrote.

Though Scott will no longer serve on legislative committees, she is still able to vote and debate on the House floor, as well as propose legislation.

Whether or not committee chairmen will hear that legislation, however, is another issue — particularly the women who were the targets of Scott’s alleged remarks.

As to whether Bedke has the power to do this: He does.

Scott, Zeischegg and Aurit couldn’t be reached for comment. (We’ll update if that changes.)

North Idaho conservatives weren’t alone in their displeasure. In an e-mail sent to all House members, Maria Nate of Rexburg blasted lawmakers for not standing up for Scott on the House floor.

“I am disgusted and dismayed at the removal of Heather Scott from her committee assignments. I am even more dismayed that only one person rose to object to such a power move by Speaker Bedke,” Nate wrote in an e-mail sent just before noon on Thursday. “Apparently in the Idaho Legislature it is ok to commit adultery but it is not ok to talk about it. Time to drain the swamp.”

Maria Nate is the wife of Rep. Ron Nate, R-Rexburg. On Thursday, Rep. Nate attempted to object to Scott being taken off her three committees. When contacted for comment by Idaho Reports, Maria Nate said she had nothing to add to her e-mail remarks.

In late 2016, Reps. Nate and Scott launched growingfreedomidaho.com, which features a conservative legislative agenda and links to e-mail committee members. As bills get introduced, the site will offer conservative policy and impact analysis. 

In a statement posted to Facebook on Thursday afternoon, Scott theorized the timing of the scandal breaking in the news was no accident.

” It is probably no coincidence that the latest ‘stir’ from within the catacombs of ‘leadership’ comes on the heels of the recently published freedom website helping citizens to keep better tabs on legislation and legislators called www.growingfreedomforidaho.com,” she wrote.

Scott’s various controversies are well-documented, and other conservative Republicans have told reporters they disagree with her tactics and actions. “We’re here to solve problems, not create problems,” said Rep. Eric Redman R-Athol, in an interview with Betsy Russell of the Spokesman-Review. “A lot of areas we agree on, but you’re still part of the body. I think that’s very important. We can express our disagreements but not be belligerent.”

House Speaker Scott Bedke told Russell he wouldn’t comment on Thursday’s actions, other than to say it was the most difficult decision he’s made so far as speaker. 

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What’s on your mind?

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Record your message to lawmakers and upload it to YouTube. Send the link to melissa.davlin@idahoptv.org with the subject “Message To Lawmakers” by noon Thursday, Jan. 5, and we might feature your video on the Jan. 6 episode of Idaho Reports. Include your full name, town where you live, and phone number. We won’t share your number with anyone, but we may call in case we have any questions. 

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What’s new at Idaho Reports

 

Idaho Reports returns on January 6, with hour-long episodes through the end of the 2017 legislative session.

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In the last twelve months, we’ve focused on connecting the policies made at the statehouse in Boise with rural communities throughout Idaho. Our 2017 season will be no different. We’ll continue to bring interviews and commentary with the state’s political insiders, while spotlighting the Idaho citizens and towns affected by those decisions. While we’ll take a hard look at the Legislature’s 2017 priorities, we’ll also examine what is important to Idahoans, regardless of whether it’s being discussed in the Capitol. We’re currently looking into issues regarding transportation, health care, mental health, the economy, and education. Watch for updates.

On January 9, Idaho Public Television will air Gov. C.L. “Butch” Otter’s State of the State address live, with Idaho Reports providing commentary and analysis immediately following the speech.

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Idaho Reports Associate Producer Nishant Mohan

We have a new associate producer, Nishant Mohan. Mohan is a journalism student at the University of Idaho. He has worked for the Idaho Statesman, the Idaho Press Tribune, Idaho Public Radio, and the University of Idaho Argonaut. Follow Mohan on Twitter: @nishantrmohan.

If you’re not already connected with us on social media, you can follow us: @IdahoReports, @davlinnews, and @aaronkunz. You can also find us on Facebook. 

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