Agenda 03/27/2012 Item #11D3/27/2012 Item 11. D.
EXECUTIVE SUMMARY
Recommendation to not renew the Subcontracted Transportation Provider (STP) Agreement with
the Florida Commission for the Transportation Disadvantaged (FCTD) due to expire on Jane 30,
2012, for the provision of transportation for qualified Medicaid recipients.
OBJECTIVE: To not renew the Subcontracted Transportation Provider (STP) Agreement with the
Florida Commission for the Transportation Disadvantaged (FCTD) and discontinue providing Medicaid
Non Emergency Transportation (NET) services effective day end June 30, 2012; and, to direct staff to
provide notice to the FCTD of this direction to meet the required notice in order to provide sufficient
time for FTTD to contract with another provider.
CONSIDERATION: Chapter 427, Florida Statutes requires that within each ' Florida County, all
publicly funded human service transportation be coordinated by one entity, the Community
Transportation Coordinator (CTC). In Collier County, the Board of County Commissioners functions as
the CTC and provides coordinated transportation services through Collier Area Paratramsit (CAP).
Transportation services are currently provided by CAP with the funding assistance from three programs:
Medicaid, Transportation Disadvantaged (ID) and Americans with Disabilities Act (ADA). These
funding sources do not fully fund paratransit services and are annually supported by local dollars
provided through the General Fund. In order to continue receiving this funding assistance, CAP must
comply with the following guidance and requirements.
Medicaid services: The program provides medical trips to qualifying Medicaid transportation
recipients and requires the recipient to pay a maximum fare of $1.00 per trip. Collier County has
an existing contract with the FCTD to provide these non - emergency transportation services and
by contract, is prohibited from denying a qualifying trip. Trips under this program are provided
both inside and outside the County.-'Medicaid ridership represents approximately 23% of the
paratransit system ridership.
• Transportation E smdvantaged (TD) services: The program provides transportation services to
persons that reside. in areas where Fixed Route service is not available and do not have other
means of transportation and/or have limited income. Persons qualifying under this program are
required to pay a fare ranging from $0 to $6 based on income level. Collier County has entered a
Grant Agreement with the FCTD to provide this service to the transportation disadvantaged but
is not limited to a fare structure of the types of trips provided. - The Transportation
Disadvantaged program follows the trip priority guidelines established by the Local
Coordinating Board (LCB). TD ridership represents approximately 52% of the paratransit system
ridership.
• Americans with Disabilities Act (ADA) services: The program provides transportation services
to persons who 1) have disabilities (certified by a licensed medical professional); 2) are unable to
utilize the Fixed Route system; and 3) live within a % mile of a Fixed Route corridor. Recipients
of this service are required to pay a fare of $2.00 per trip. Collier County has entered a Grant
Master Agreement with the Federal Transit Administration (FTA) to provide this service as a
requirement of providing Fixed Route service to the community. Although trips can be denied
under this program, the origin and destination of the trips under this program must be with the %
mile ADA corridor noted above. The maximum fare that can be charged under this program is
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twice the Fixed Rbide full fare. ADA ridembi
system ridership.
As part of the continuous Collier Area Transit (CAT)
trend has been identified over the past three years fa
county is experiencing, it has become. evident. that. if tl
increase of *; the eouy vuill exceed its budgeted 1
3/27/2012 Item 11.D.
represents approximately 20/6 of the pardansit
CAP ridership as increase. in trips
Paratransit. With the t* 4=wad , trend ; that the
c county continues this annual of an average
tips in FY 2012 and again in FY 2013.
fiscal Year
Budgeted
Trips
Actual Trips
20ft-09
105,000
112,692
2009 -10
101,800
117,752
202411
120,000
122,914
2411 -12
120,000
128,322*
2012-13
120,000
133,968*
* Forecasted trips based on existing trend of 4.4'%a.
Of the total _ 122,914 P atransit program trips provided in FY 2011, 27,606-trips (22 %a) .were Del eliraid
trips, :of which 3,344 were out of county trips traveling as far as Tampa, Jacksonville, Qrlaudo,
and Tallahassee: During FY 2011 the Paratransit program traveled atotal of 1,4$6,235 vehicle miles, of
which .Medicaid trips e4wered 518,604 miles (350 %) with approximately fifty percent :of the miles
( 260, 881) traveling out of the county.
In FY 2011 the approximate cost of the Medicaid program was $1,192,58€1 wig ._gam . fending
representing 43% of the costs ($ 507, 270). Wlile the Contribution being allocated through the-Modicaid �
contract for FY 2412 incrwtsed slightly it will not ailete the impact on local budget. The Amathat the
Medicaid Agreement pla ,s limitation on the fare that tan, be assessed to riders to help Iotfset the cost of
operating the Pmt coupled with the restrictions pled on the provider to (manage than #ips. -being
provided .under this program, the ability to continue to support this program isilifEcult.
During the FY-2,012 bum adoption, approximately 120,000 trips were planned at a total cost of
$3,873,800 for the Paratrais t program. The total nuinberof trips that can be provided fot is monitored
throughout the year closely to account for fluctuationsin farebox revenues, grantor sponged reenue:s
trip demand and fleet costs including fuel. All of thosp factors replicate ongoing changes in the current
economic conditions.
Final trip counts for FY 2011 were 122,914. It is anticipated based on the past. two years of ridership
trends that gips will continue to increase an °estimated'. 4.4 % per year equating-to 128;320 trips. in FY
2012 and 134,970 trips in FY 2013. Even though a focus on farebox, recovery efforts has resulted in a,
favorable increase of 30%, the monetary result is less than $50,000 annually. In addition, the total swn
of annual revenue received from federal and state granlrs to support parat sit services has declined
over the last two fiscal yews. As a result the burden for fund the TD program has shifted to local f w ding
sources which continue to decline countywide, while operating costs increase.
Based on the TY2012 -first quarter operating cost results, the average cost per parEnsit trip equates to
$31.10 ; per- trip It should be noted that the first quarter of each fiscal year falls during the off season and
represents a nob in time that produces the lowest quarterly trip rate during the fiscal year. Though the
cum budget at first glance could support 124,500 trips based on the first quarter average cost per
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3/27/2012 Item 11.D.
paratransit trip, it is known the this cost will increase by year end to account for seasonal ridership
variances as well as fluctuating fuel prices. An optimistic target would be to support no more than FY
2011 trip levels which would still leave a funding shortfall for approximately 5,400 trips in FY 2012
($174,300) and 11,050 trips in FY 2013 ($356,700). The transfer from the General Fund (001) will be
reduced by 5% pursuant budget guidance. The transfer from the General Fund (001) in FY 2012 is
$2,501,900 and the planned transfer for FY 2013 is $2,376,800. The delta of $134,100 is not expected
to be met by additional grant revenues and brings the anticipated funding shortfall for FY 2013 to
$490,900. Based on those facts, staff is recommending discontinuing providing Medicaid trips as of the
expiration of the Agreement on June 30, 2012. It is anticipated that a number of the existing Medicaid
riders that are being provided transportation service within the County will qualify under the TD
program. Consequently, a portion of the local fund allocated to this program would be needed to
compensate for this ridership shift. Conservatively speaking, if the County only realizes the savings of
the out of county trips (3,344) there will be a saving of approximately $81,326 in payment to the
contractor per trip plus an estimated $101,744 in cost per mile (fuel and vehicle maintenance) an
estimated total of $183,070 in savings just by eliminating Medicaid out of county trips.
Staff is currently working with a consultant to complete a Fare Equity Analysis. The FTA Circular
4702.1A requires all FTA recipients whose service area contains 200,000 or more residents to conduct a
Title VI equity analysis in the course of planning a major service change or any magnitude of fare
change. Equity analyses are required regardless of whether proposed changes would be detrimental or
beneficial to riders. Financial exigencies and other special circumstances do not exempt recipients from
the requirement to conduct equity analyses.
Staff's preliminary evaluation in reviewing this matter includes recommending a fare increase to help
offset the impact of the local budget together with the discontinuation of Medicaid transportation service
�\ to further alleviate the fiscal impact to the County. During public meetings for the Fare Equity Analysis
riders have emphasized the value of the paratransit service to the maintenance of their quality of life.
Riders understand the financial issue that the County is facing and agree that an increase in fare would
be warranted. Riders have also repeatedly expressed their support for the continuation of all paratransit
services, including Medicaid, and indicated that they would rather the Board of County Commissioner
increase fares for the service instead of eliminating the Paratransit program.
Staff offered the following recommendations to the Local Coordinating Board (LCB) at its March 7,
2012 meeting:
❑ Provide Notice to the Florida Commission for the Transportation Disadvantaged and the
community of the intent to discontinue providing Medicaid transportation service in Collier
County.
❑ Effective July 1, 2012, discontinue providing Medicaid trips.
❑ The BCC to continue its role as the Community Transportation Coordinator for Collier County
providing TD and ADA trips.
❑ Bring back a proposal for the implementation of a fare increase for FY 2013 upon completion of
the Fare Equity Analysis.
At the LCB special meeting held on March 21, 2012, the LCB Board voted 6 to 4 recommending the
discontinuation of the Medicaid program.
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3/27/2012 Item 11.D.
Neighboring transit agencies such as Lee County and Sarasota County have experienced similar
challenges and have decided not to offer Medicaid trips. Instead, the Medicaid trips are performed by
private service providers such as Good Wheels and TMS. Please see matrix below illustrating status of
neighbor counties.
The Paratransit program is an essential service provided to the many citizens and visitors to Collier
County. Without it many of our residents would have no access to medical, nutritional and other
essential services. Recognizing the fiscal challenges that the County will continue to face in the
upcoming years, the elimination of the Medicaid NET program is being recommended rather than a
more drastic cut to the Paratransit program or the elimination of the program all together. By continuing
to be the Community Transportation Coordinator for Collier County, the BCC will be able to operate a
coordinated system and continue providing over 100,000 Transportation Disadvantaged and ADA trips
to the citizens of Collier County. The Board of County Commissioners should also consider that the
provision of Fixed Route Transit in areas not currently being serviced by that system will be an
additional means for providing transportation services in a more efficient and cost effective way.
FISCAL IMPACT: Discontinuing the Medicaid NET services contract would result in a cost savings of
approximately $412,697, which is the total local contribution of $687,827 minus a potential 40%
($275,130) that would be utilized to compensate for the potential shift of riders to the TD program. Trips
from out of county account for $183,070 alone.
LEGAL CONSIDERATIONS• This item has been reviewed and approved by the County Attorney's
Office, is legally sufficient for Board action and only requires a majority vote for approval —SRT.
GROWTH MANAGEMENT IMPACT• There is no Growth Management Impact associated with this
Executive Summary.
Packet Page -244-
ti
�,y
4
Provide
Tfi�1la�Sli�rovitles
tNw'� 3
a
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47icaid
medicaid*
ledicaitlPacvadeE �s
ransportation,
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ws.
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REP,!,
t�„4t�, `"'�
�sadvarge
LEE COUNTY
N
N
Good Wheels
$1.00
N
Good
$2
Wheels
MANATEE
COUNTY
Y
N
TMS
$1.00
Y
MCAT
$2.00
oq
COLLIER
CollierArea
COUNTY
Y
Y
Paratransit(CAP)
$1-�
Y
CAP
$0to$6.00
SARASOTA
COUNTY
Y
N
Logisticare
$1.00
Y
SCAT
$1.50
The Paratransit program is an essential service provided to the many citizens and visitors to Collier
County. Without it many of our residents would have no access to medical, nutritional and other
essential services. Recognizing the fiscal challenges that the County will continue to face in the
upcoming years, the elimination of the Medicaid NET program is being recommended rather than a
more drastic cut to the Paratransit program or the elimination of the program all together. By continuing
to be the Community Transportation Coordinator for Collier County, the BCC will be able to operate a
coordinated system and continue providing over 100,000 Transportation Disadvantaged and ADA trips
to the citizens of Collier County. The Board of County Commissioners should also consider that the
provision of Fixed Route Transit in areas not currently being serviced by that system will be an
additional means for providing transportation services in a more efficient and cost effective way.
FISCAL IMPACT: Discontinuing the Medicaid NET services contract would result in a cost savings of
approximately $412,697, which is the total local contribution of $687,827 minus a potential 40%
($275,130) that would be utilized to compensate for the potential shift of riders to the TD program. Trips
from out of county account for $183,070 alone.
LEGAL CONSIDERATIONS• This item has been reviewed and approved by the County Attorney's
Office, is legally sufficient for Board action and only requires a majority vote for approval —SRT.
GROWTH MANAGEMENT IMPACT• There is no Growth Management Impact associated with this
Executive Summary.
Packet Page -244-
3/27/2012 Item 11.D.
RECOMMENDATION: That the Board of County Commissioners not renew the Subcontracted
Transportation Provider (STP) Agreement with the Florida Commission for the Transportation
Disadvantaged (FCTD) and discontinue providing Medicaid Non Emergency Transportation (NET)
services effective day end June 30, 2012; and, to direct staff to provide notice to the FCTD of this
direction so that it is able to have sufficient time to contract with another provider.
Prepared by: Glama Carter, Public Transit Manager
Attachments: 1) Notification letter to the FCTD; 2) Medicaid Analysis
Packet Page -245-
COLLIER COUNTY
Board of County Commissioners
Item Number: 11.D.
3/27/2012 Item 11. D.
Item Summary: Recommendation that the Board of County Commissioners not renew the
Subcontracted Transportation Provider (STP) Agreement with the Florida Commission for the
Transportation Disadvantaged (FCTD) due to expire on June 30, 2012 for the provision of
transportation for qualified Medicaid recipients. (Michelle Arnold, Director, Alt Transportation
Modes)
Meeting Date: 3/27/2012
Prepared By
Name: CarterGlama
Title: Manager - Public Transit,Altemative Transportation Modes
3/7/2012 11:00:31 AM
Submitted by
Title: Manager - Public Transit,Altemative Transportation Modes
Name: CarterGlama
3/7/2012 11:00:32 AM
Approved By
Name: BetancurNatali
Title: Executive Secretary,Transportation Engineering & C
Date: 3/9/2012 8:29:45 AM
Name: ArnoldMichelle
Title: Director - Alt Transportation Modes.Altemative Tr
Date: 3/9/2012 11:01:38 AM
Name: LaPierreBarbara
Title: Management/Budget Analyst,Transportation Administr
Date: 3/9/2012 11:26:07 AM
Name: OberrathKaren
Title: Senior Accountant, Grants
Packet Page -246-
,,-IN Date: 3/9/2012 12:06:12 PM
Name: FederNorman
Title: Administrator - Growth Management Div,Transportati
Date: 3/9/2012 1:09:37 PM
Name: TeachScott
Title: Deputy County Attorney,County Attorney
Date: 3/9/2012 2:27:51 PM
Name: MarcellaJeanne
Title: Executive Secretary,Transportation Planning
Date: 3/13/2012 3:56:06 PM
Name: StanleyTherese
Title: Management/Budget Analyst, Senior,Office of Management & Budget
Date: 3/14/2012 2:53:43 PM
Name: TeachScott
Title: Deputy County Attorney,County Attorney
Date: 3/15/2012 4:51:14 PM
�-. Name: StanleyTherese
Title: Management/Budget Analyst, Senior,Office of Management & Budget
Date: 3/16/2012 1:21:30 PM
Name: KlatzkowJeff
Title: County Attorney
Date: 3/16/2012 3:38:27 PM
Name: OchsLeo
Title: County Manager
Date: 3/19/2012 2:29:40 PM
Packet Page -247-
3/27/2012 Item 11.D.
3/27/2012 Item 11.D.
Month
FY 2011 MEDICAID
Month
MD CAP
CC Subsid
Total Billed
Trips
Average Cost /
Trip
October
42,272
59,117
101,389
2,282
44.43
November
42,272
49,674
91,946
2,082
44.16
December
42,272
45,259
87,531
2,017
43.40
January
42,272
53,672
95,944
2,113
45.41
February
42,272
51,040
93,312
2,058
45.34
March
42,272
56,321
98,593
2,303
42.81
April
42,272
62,968
105,240
2,378
44.26
May
42,272
58,392
100,664
2,244
44.86
June
42,272
59,474
101,746
2,423
41.99
July
42,272
59,576
101,848
2,515
40.50
August
42,272
72,306
1141578
2,880
39.78
September
40,241
60,028
100,269
2,322
43.18
Total
505,233
687,827
1,193,060
27,617
43.20
Month
FY 2012 MEDICAID PROJECTED
MD CAP
CC Subsid
Total Billed
Trips
Average Cost /
Trip
October
40,241
54,937
95,178
2,321
41.01
November
40,241
54,870
95,111
2,349
40.49
December
40,241
49,621
89,862
2,306
38.97
January
51,006
48,642
99,648
2,611
38.16
February
March
April
May
June
July
August
September
Total
171,729
208,070
379,799
9,587
39.62
Annualized (Total /4 *12)
515,187 624,209 1,139,396 28,761 39.62
Packet Page -248-
3/27/2012 Item 11.D.
Co per County
Growth Management Division
Construction & Maintenance
Alternative Transportation Modes
March 2, 2012
Steven Holmes
Executive Director
Commission for the Transportation Disadvantaged
605 Suwannee Street, MS-49
Tallahassee, FL 32399 -0450
Subject: Notice of Collier County Community Transportation Coordinator Intent to Discontinue provision of
Medicaid Non - Emergency Transportation (NET) Services
Dear Mr. Holmes:
The Collier County Board of County Commissioners is the Community Transportation Coordinator (CTC) for
Collier County and has entered into an Agreement with the Commissioner for the Transportation
Disadvantaged (CTD) to provide Medicaid Non - Emergency Transportation (NET) Services to residents and
visitors in Collier County. The Agreement is due to expire on June 30, 2012.
Please be advised that the Collier County Alternative Transportation Modes Department is scheduled to bring
an agenda item to the Collier County Board of County Commissioners on March 27, 2012 recommending
discontinuing the provision of to Medicaid NET service for the community.
While the demand for these services has increased over the last 3 years ,funding remains stagnant at both the
State and Local levels. This makes providing Medicaid NET services under the current contract difficult to
continue.
Please accept this letter as the initial notice of Collier County's intent to discontinue the provision of Medicaid
NET service upon expiration of the existing agreement. Formal action must be taken by the Collier County
Board of County Commissioners to accept this recommendation. We will notify you of the Board's decision as
soon as one is reached. Thank you for your time and consideration.
Sincerely,
Michelle Edwards Arnold, Director
Alternative Transportation Modes Department
cc: Julia Davis, Transit Project Coordinator, Florida Department of Transportation
Glama Carter, Transit Manager r/
Thomas Stringer, General Manager, Keolis Transit America
ANnawe Transp d4m Nodes • 2885 South Horseshoe n i• "'—'°° ' "'04.239- 252 -8192 • FAX 239 - 252 -5899 • www.coiliiergov.net
Packet Page -249-
3/27/2012 Item 11.D.
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