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NEMT Commission MeetingJuly 19, 2022Lindsey Lux, OMPP Chief of Staff &Deputy DirectorIndiana Family and Social ServicesAdministration1

IntroductionNew Commission MembersBrian Carnes, INARF RepresentativeMaureen Lindsey, Dialysis RepresentativeFern Mirkin, Member RepresentativeDr. Eric Yazel, Physician RepresentativeStaff UpdatesGary Jones, FSSA - promoted to OMPPTransportation Manager in May of 2022Mike Hanner, SET- named Interim Indiana StateDirector2

NEMT Commission MembersNameBrian CarnesAndrew VanZeeEric Yazel, MDGary MillerKim DodsonAssociationIndiana Association ofRehabilitation FacilitiesIndiana HospitalAssociationDept of HomelandSecurityPROMPT MedicalTransportationArc of IndianaJim Degliumberto Southeastrans, Inc.James FryFern MirkinSteadfast Transportation,LLCFee For Service MemberNameSherri HamptonKristen LaEaceMaureen LindseyLindsey LuxRep. Jim PresselRep. Mitch GoreAssociationAmerican SeniorCommunitiesIndiana Association ofArea Agencies on AgingFresenius Medical CareFamily & Social ServicesAdministrationIndiana House ofRepresentativesIndiana House ofRepresentativesSen. Vaneta Becker Indiana SenateSen. Jean BreauxIndiana Senate3

Agenda Welcome and IntroductionsLindsey Lux, FSSASlides 1-4 Program UpdatesLindsey Lux, FSSASlides 5-7 SET Performance & AccessJim Degliumberto, SETSlides 8-26 SET Corrective ActionGary Jones, OMPPSlides 27-31 SET Pay for OutcomesGary Jones, OMPPSlides 32-45 SET Pay for Outcomes VoteLindsey Lux, FSSASlides 46-47 Wrap Up/AdjournmentLindsey Lux, FSSASlides 48-504

Program UpdatesLindsey Lux, FSSA5

Program UpdatesHCBS Transportation Grants Investing American Rescue Plan Act funding for Home andCommunity Based Services to expand critical NEMT fleet inIndiana Grantees required to participate in State NEMT Network andservice members living in their homesGrant Details Bariatric Ambulance Grants - awarded Wheelchair Van and Lift Grant – applications due 8/126

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SET Network Performance &AccessJim Degliumberto, COOSoutheastrans Inc.8

NEMT by the 95%Monthly AverageInbound callsMembers servedTrip VolumeStanding Orders (Dialysis)Trips less than 10 MilesTrips 11-25 MilesTrips 26-50 MilesTrips greater than 50 MilesActive ProvidersActive VehiclesClaims ReceivedClaims Paid %9

Trip AugSepOctNovPre-CovidCY3DecJanFebMarAprCY410May

High Risk Trips by Appointment Reason50%48%45%40%35%30%25%20%15%10%5%2%1%1%Wound CareChemo/RadiationSurgery0%DialysisHRM11

Jun-21Jul-21 Aug-21 Sep-21 Oct-21 Nov-21 Dec-21 Jan-22 Feb-22 Mar-22 Apr-22 May-2299.9% complaint free trips12

Member Experience – Call Center Satisfaction rate averaged 98%. Six of 12 months were at 100% satisfaction on96%100%96%92%100%100%94%100%94%100%98%100%13

Member Experience – Transportation Provider Satisfaction rate averaged 2%98%98%92%88%94%96%80%94%98%86%94%14

Transportation Areas of Need Six counties removed(light green) Johnson LaPorte Monroe Vigo Vanderburgh Warrick Four counties added(highlighted yellow) Bartholomew Delaware Elkhart loydGrantLakeHamiltonMadisonMarionPorterSt. JosephTippecanoeWayne15

Transportation Provider Network Growth New Transportation Providers (June 1st) 8 in credentialing 119 vehicles in pipeline Focused recruitment in areas of need Existing Transportation Provider Network Currently 207 active providers Offering incentives to promote expansion Offering premium rates to serve areas of need Promoting wheelchair vehicle and lift grant programs16

Transportation Provider Network Growth Nursing Facilities as Transportation Providers Lutheran Life Villages Hooverwood currently transporting CarDon currently transporting from eight facilities Two additional nursing homes in pipeline Community Center interest SET continued outreach with facilities to discuss: Benefits of being transportation providers Review reimbursement processes Enrollment and onboarding processes Facility portal training Customized solutions for unique transportation needsIf you are a nursing facility and would like to enroll as a transportationprovider, please contact Mike Hanner at mhanner@southeastrans.com 17

Network Growth Opportunities Rising costs Insurance Fuel Supplement Staffing ALS/BLS (Ambulance) Geographic needs Residential pick up Bariatric Working with providers to accommodate needs18

Provider Safety Vehicle Inspections 2,746 inspected 99.5% pass rate Spot Inspections 1,177 completed 100% pass rate Wheelchair securement inspections 398 completed 99.5% pass rate Accidents and incidents 104 reported this CY 99.99% trips completed without an accident/incident19

EMS Billing Update Allow direct 837 file integration Built into existing portal Companion Guides / Instructions available Actively promoting to EMS network20

Facility Outreach Conducting more face-to-face visits Facilitated multiple facility workshops Exhibited at three industry conferences IHCA INARF Leading Age annual conference These efforts resulted in Opportunities to further build relationships Increased facility staff knowledge Successful transportation strategies for complex needs Reduced complaints21

Conference and Exhibits IHCA Annual Convention and Expo - August LeadingAge Indiana Conference - September INARF Annual Conference - October22

Problem Solving Complex transportation requests Oversized wheelchair / bariatric Geographic / rural area Long Distance trips Crossing state lines Member specific FSSA Care Management Coordination Identify the specific need and coordinate with medicalfacility, member, and provider to find a solution23

BiosJodie Little – Facilities Outreach Manager Southeastrans since 2018 15 years in healthcare Leadership roles in a variety of medical practicesLinda Potts – Facility Outreach Manager Southeastrans since 2020 16 Years in healthcare Executive leadership roles in a variety of longterm care settings including skilled nursing,assisted living, continuing care, retirement, andmemory care facilities.24

BiosMichael Jones – Provider Relations Manager Southeastrans since 2018 15 years EMS industry Advanced EMT Trainer Director of Operations for multiple EMS companies25

Community Engagement Wheeler Mission Ongoing volunteer opportunity Donation of Personal HygieneKits Walk to End Alzheimer's Donated 25 iPads to localChildren’s Hospital Other Local ActivitiesQuarterly26

Results of Corrective ActionGary Jones,Medicaid NEMT Manager27

SET Corrective ActionOMPP placed SET on corrective action in October of2021 to address two areas of concern related to Facility Outreach; and Network Adequacy following the loss of 2 largeprovider fleets.SET created and implemented a plan to address each areaand then met with OMPP staff weekly.The corrective action was successfully completed andclosed in May 2022.28

SET Corrective Action ResultsIssue 1: Facility RelationsSET Action Plan: Proactive outreach to nursing facilities to ensure effective service delivery. Build and improve relationships with facilities that have experiencedtransportation issues. (ongoing) Monitored facility-based complaints and implement site plans in accordancewith current performance metrics. Promote nursing facilities as transportation providers. (ongoing)29

SET Corrective Action ResultsIssue 2: Network AdequacySET Action Plan: Conducted root cause analysis in areas of need to identify specific networkissues. Created and implemented a formula-driven process to increase provider ratesto address industry challenges including gas prices, workforce shortages andrising costs to providers. Worked with existing providers to expand hours of operation and geographicareas served. Promoted Gas Mileage Reimbursement30

SET Corrective Action ResultsIssue 2: Network AdequacySET Results: 50 providers received rate increases 5 new providers added to the network 46 new vehicles added to the provider fleet 6 counties no longer reported as areas of need: Johnson, LaPorte, Monroe, Vanderburgh, Vigo and Warrick 2 nursing facilities enrolled as providers: Cardon (8 locations) and Hooverwood31

SET Pay for OutcomesContract Year 4Gary Jones, OMPP32

Pay for Outcomes Guidelines1.The broker’s contract includes Pay for Outcomes criteria that aremonitored on a quarterly basis.2.Three percent of capitation is withheld and must be earned backby meeting or exceeding the performance metrics.3.The NEMT commission reviews the performance metrics achievedand annually votes on paying the earned amount.4.Funds are paid out once per year and do not roll-over.33

Pay for Outcomes – NEMT Categories1.Quality2.Safety3.Call Center4.Transportation Scheduling5.Transportation Requests6.Provider Services7.Member Education8.Encounter Data Completeness & Timeliness9.Report Accuracy & Timeliness34

SET Pay for Outcomes PerformanceMeasure4th Q1st Q2nd Q3rd QAvailableMetric Achieve Met Achieve Met Achieve Met Achieve Met PayoutQuality1. No more than 1% ofcompleted one-waytrips shall have anassociated validmember complaint 1% 0.12%2. The Contractorinvestigate, remedy andclose 95% of complaintswithin 15 days ofreceipt.95% 97.8% nedPayout 41,119.7835

SET Pay for Outcomes PerformanceMeasureSafety1. 0% of vehicles used for transportwill be out of compliance. (Out ofcompliance if overdue for inspectionor if vehicle removed due to out ofcompliance, but is still used)2. Contractor will conduct random,unannounced, spot inspections on atleast 1/12 of authorized vehicles perquarter.3. Quarterly, Contractor will conductat least 75 separate wheelchairsecurement inspections.4. One hundred percent (100%) ofTransportation Providers’ Drivers whoprovide services in a given quartershall meet the Contract’s licensingand training requirements (metric isnot met if a driver is out ofcompliance during a random audit orif a driver still provides services afterdiscovering non-compliant driver, butprior to remediation)Metric1st QAchieveMet2nd QAchieveMet3rd QAchieveMet4th QAchieveMetAvailablePayoutEarned Payout 121,622.35 73,308.290%1.8%N0%Y0%Y0%Y Y100%100%Y100%Y100%Y100%Y36

SET Pay for Outcomes PerformanceMeasureMetric1st QAchieve Met2nd Q3rd QAchieve Met Achieve4th QMet AchieveAvailableMet PayoutCall Center 121,622.35 121,622.351. Quarterly average speed to answer calls 60shall not exceed 60 secondssec202. Monthly 85% of calls will be answeredwithin 45 seconds or less 85% 87.1%3 (A). The quarterly lost call(abandonment) rate shall not exceed fivepercent (5%) 5% 2.7%3 (B). No calendar week shall have anabandonment rate greater than %Y91.5%YY2.6%Y1.9%Y2.5%YYPASSYPASSYPASSY37

SET Pay for Outcomes PerformanceMeasure1st QMetric AchieveCall Center (Continued)4. An answering machine, voice mailor answering service must beavailable for after-hours calls. Onehundred percent (100%) of afterhours calls must be returned withinthe next business day.100%5. Eighty-five percent (85%) of allissues from callers should beresolved on the first call based onrandom monthly call center surveys.If information cannot be provided toa caller in a timely manner, the CallCenter representative should requesta name, phone number and/oraddresses (if necessary) and respondto the caller within one (1) business day from the time of contact.85%2nd QMet Achieve3rd QMet Achieve4th QMet AchieveAvailableMet 38EarnedPayout

SET Pay for Outcomes PerformanceMeasure3rd QMetric 1st Q Achieve Met 2nd Q Achieve Met AchieveTransportation Requests1. The Contractor shall employ anauto-routing system and shall assignat least 90.0% of requested trips thatqualify for auto-routing to atransportation provider using theauto-routing system within 48 hoursof receipt of the transportation request.90%2.* The Contractor shall furnishappropriate transportation, asoutlined in the Contract, for at least90.0% of valid membertransportation requests based on theContractor’s knowledge of providerno-shows as determined bycomplaints or other known instancesthat a trip was not provided asscheduled as detailed in a “missed trips.”90%4th QMet AchieveAvailableMet PayoutEarned Payout 75.5%N*The calculated rates include member cancellations and no-shows for all reasons.39 0.00