FEATURED
6 Major Changes to Healthcare Post-Covid
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NEMTAC Certifications Help Reduce Risk PAGE 24
ALSO
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A Letter from NEMTAC's Executive Director
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Effie Carlson President
Melissa Jankowski Executive Director
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Julie Correll Board Secretary
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Chris Kelly Board Member
Board of Directors
Michael Shabkie NEMTAC Founder
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NEMT is Going Digital
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Peter Hicks Board Vice President
On a Mission of Compassion with a Hunger for Excellence
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67 days and counting... Who’s ready to hear some amazing educational topics? Who’s ready to see all the smiling faces we have missed over the last 18 months? Who’s ready to network with our fantastic exhibitors? I know I am! Our conference planning has been in full swing. With just a little over 2 months away from our “Survived. Ready to Thrive. NEMTAC Conference 2021â€, the excitement is palpable. If you haven’t done so already, register before August 1st for early bird pricing. You can register to attend HERE. Our conference speakers have been chosen, and we are thrilled with the topics dedicated to helping the owner/operators succeed. You can catch a sneak peek of the speakers HERE. The exhibitor packets are rolling in every day, and we are excited to see the momentum building. So if you are interested in exhibiting at the conference, don’t delay – spots are filling up quickly! You can download your exhibitor packet HERE. Over the last month, another significant initiative for NEMTAC has been creating the NEMTAC Technology Survey for NEMT Companies. The NEMTAC Technology Advisory Board developed a survey to better understand the technology needs of the rural and urban NEMT providers. From NEMTAC’s perspective, technology is the foundation to enhance on-time performance, reduce Fraud Waste and Abuse, and is an essential part of our accreditation standards. Help us capture this important data! We will be providing the results of the survey in a white paper and a panel discussion at the conference as well as creating a national discussion around the technology challenges NEMT providers face daily. You can complete the survey HERE. I’m looking forward to meeting many of you in person whom I have spoken to on the phone over the last 18 months. And, of course, it is always fun to see familiar faces. Our next NEMT Today edition will be released the first week of September and will be a special conference edition highlighting speakers, sessions, and exhibitors.
Eliot Kalter Board Treasurer
NEMTAC Certifications Help Reduce Risk
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David Marhoffer, Board Member, not pictured 

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Skills Entrepreneurs Need to Have
Bill George Board Member
How National Accreditation Improves Service Delivery
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Are You Running Your Business with the Right Vehicles?
Table of Contents
Recognizing our Industry's Transportation Heroes
Transportation Access for Prenatal & Postnatal Care
The Shopaholic
NEMTAC Advisory Board Members
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8 Things You Must Build to Reach Your Full Potential as a Leader
Accreditation Michael Shabkie and Eric Lane, Co-Chairs Carlos Ayestas, Priority Transportation Services Frank Ciccarella, Synergize Consulting, LLC Mindy Ginsberg, FR Conversions Max Gorin, LifeLine Ambulance Melissa Jankowski, NEMTAC Eric Lane, Bankers Insurance Valerie Lefler, Feonix Mobility Rising Danielle Mezera, MTM Michael Pinske, AmeriCare Mobility Van Michael Shabkie, NEMTAC Jim Smith, JC Paratransit Solutions Roddrelle Sykes, 3rd Millennium Insurance William van der Linde, Old Dominion Transportation Group Scott West, NEMT Solutions, LLC Compliance and Regulatory Julie Correll and Dan Reid, Co-Chairs Maggie Adams, EMS Financial Services Michael Adelberg, Faegre Drinker Biddle & Reath LLP Julie Correll, NEMTAC Jennifer Cross-Hodge, Volunteer Transportation Center, Inc. Laura Fleet, SendaRide, Inc Crystal Ford, Orange County EMS Melissa Jankowski, NEMTAC Martha Kendall, Tennessee Carriers Tammy, Mihm, State of Tennessee Edward Platt, Coordinated Transportation Solution, Inc. (CTS) Mark Porterfield, Careavan Transports Dan Reid, Grove Transit Kevin Teasdale, Secure Medical Transportation Tammy Wright, MTM Certification Peter Hicks and Jim Adkins, Co-Chairs Kelly Addy, Clear Choice Express, LLC Jim Adkins, SouthStar Emergency Medical Services Howard Berkowitz, H&S Personal Car Service & Consulting, Inc Jeremy Geyman, ModivCare Peter Hicks, NEMTAC Melissa Jankowski, NEMTAC Courtney Muchugu, United Transportation Group Jennifer Place, MAS Dan Reid, Grove Transit Pete Schwartz, Safety Training Solutions - SafetyServe Cris Sierra, ComfortCare Transportation Resource and Conference Christopher Kelly and Travis Draney, Co-Chairs Stephanie Barton, TripSpark Medical Howard Berkowitz, H&S Personal Car Service & Consulting, Inc Mike Chatelain, Risk Services of Louisiana, a Leavitt Group Co Travis Draney, Nonpareil Care, LLC Melissa Jankowski, NEMTAC Christopher Kelly, NEMTAC Gabriel Lullo, BiTS Misti Mills, Two M Insight Group Stephen Newman, 360 Quality Care + Transport Svc Jason Stempin, VMI Technology Michael Shabkie and Jack Hayes, Co-Chairs Jonathon Anthon, Route Genie Kyle Archer, Passio Technologies Arthur Attal, Via Tony Bradshaw, Bradshaw Consulting Services (BCS) Dominic Buono, UZURV Holdings Inc Sufian Chowdhury, Kinetik Healthcare Solutions, Inc Imran Cronk, Ride Health Jack Hayes, BiTS Melissa Jankowski, NEMTAC Brendan McNiff, Roundtrip David Reinkensmeyer, Schedule Viewer, LLC Michael Shabkie, NEMTAC Ben Salter, SafeRide Health Joe Tovar, TripSpark Medical
Advisory Boards
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Emerald Sponsors
Some NEMT companies view accreditation as a luxury. Others see it as an unfunded expense with little return on investment. Yet the benefits are undeniable. Today’s NEMT organizations face more competition than ever before. If they want to truly succeed, they need to find ways to help them outshine their competitors. One way to do this is by becoming NEMTAC accredited. NEMTAC recently announced the successful completion of their accreditation pilot program and “grand opening†of the process for the entire NEMT industry. The program has been well received with the first round of NEMT companies completing the application process and over 80 other companies expressing interest. I recently detailed the benefit of individual NEMT drivers obtaining national certification through Non Emergency Medical Transportation Accreditation Commission (NEMTAC). The focus of the article will answer the question “why is national accreditation important for a medical transportation companyâ€. As a non-profit accrediting body, Non Emergency Medical Transportation Accreditation Commission (NEMTAC) serves as the neutral, unifying resource for the NEMT industry and is working hard to ensure providers and operators are recognized as healthcare professionals. Designated by ANSI as the Accredited Standard Developer (ASD) for the industry, NEMTAC is the one place where providers, regulators, payers, brokers, and other vital stakeholders collaborate on several key initiatives. Achieving national accreditation announces to the world that the NEMT organization strives to be the best it can be. There’s hard work on the front end, but this process sets them on the course for long-term greatness. Benefits of Achieving NEMTAC Accreditation Builds confidence and Increases trust in the company. Demonstrates competency to regulators and decision makers. Provides a marketing advantage. Improves the quality of NEMT service delivered to the community. Improves compliance, reduces the opportunity for fraud, waste, and abuse. Accreditation leads staff to higher quality performance. Increased Revenue Opportunities NEMTAC accreditation improves business profitability in numerous ways. As noted, it sets the company far apart from their competitors. This means healthcare facilities; hospital systems and insurance payers are more likely to choose an accredited company rather than their competition. Also, accredited companies generally attract a higher level of employee or independent contractor that want to work for the organization. The more positions that can be filled, the more revenue the company is going to earn. According to The Joint Commission, a prominent healthcare accrediting agency, the accomplishment beefs up providers bottom line by encouraging organizations to focus on quality improvement which payers and stakeholders are increasingly demanding. It also boosts referral volume. The Joint Commission contends that accreditation increased the “ability to work with a broad array of clients†that improves “an organization’s ability to participate in referral networks, thus potentially increasing the value of referralsâ€. Payers want to work with organizations that provide high quality services, which helps elevate their brand and pay public relations and marketing dividends. 

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A Special Thanks to our Corporate Sponsors
How National Accreditation ... continued
Creating a Culture of Excellence Without question, accreditation signals to healthcare leaders and those who contract for NEMT services that the organization adheres to high standards and exemplary service delivery. Gaining accreditation from NEMTAC also demonstrates a commitment to reach beyond the minimum licensing standards and maintain strong management, consistency in service delivery and continuous improvement. The results of a survey on accreditation, sponsored by the Council on Accreditation, affirm these assertions: 94 percent of respondents agree that the process “improves transparency and accountability.†86 percent contend that it “improved outcomes for the people they serve.†90 percent acknowledge that it “improved their quality of services.†According to Kevin Teasdale, President of Secure Medical Transport in Kansas City, MO, "Accreditation is a bridge for providers into a new era of NEMT. For too long, medical transportation has operated in the shadows, with little oversight. Promoting standards and establishing best practices will help NEMT providers understand what a safe and quality operation is supposed to look like. This process also educates payers to recognize and reward companies that have chosen to operate the right way.†He further believes “the NEMT industry needs to evolve, and providers must be equipped with knowledge and industry expertise, which was previously hard to find. NEMTAC is playing such a crucial role in speeding up the evolution process and helping NEMT get more recognition in supporting healthcare.†As a business owner or operator that may still be undecided if accreditation is the right move for their organization, I would like to share one last survey sponsored by CARF International, a health and human services accrediting body. They compiled impressive data showing that CARF-accredited programs experienced a significant improvement in operational standards and a 37 percent increase in revenue from programs comparing their first survey as compared to their latest survey. The Accreditation Journey Starts Today The NEMTAC accreditation journey begins with downloading and reviewing the NEMTAC Accreditation Standards Self-Assessment Tool. NEMTAC’s comprehensive accreditation process often exceeds those established by state or local regulators and are designed to increase utilization, serve as a market differentiator, and decrease liability. The self-assessment tool helps organizations evaluate their operations and determine if they are ready to begin the accreditation process. For a complete “step by step†overview of the accreditation process please visit www.nemtac.org/accredit. This is a big decision for company leadership to make but the opportunities are unprecedented. There is no better way for a NEMT company to demonstrate to the passengers they serve, the families that care for them, the payers that pay them and the entire healthcare industry that they are a professional healthcare organization.
 
 
 

Andrés Rodriguez, VIP Transportation

Christopher Rousseau, Great Brook EMS
Okey Okafor, Devine Elevation LLC
About MTM MTM is the nation's most trusted and qualified partner for healthcare, transportation, and logistics solutions. Since 1995, MTM has managed NEMT for state and county governments, managed care organizations, health systems, and other programs involving transportation for the disabled, underserved, and elderly. Leveraging technology to streamline processes and improve the user experience for all stakeholders, MTM's wide spectrum of services help clients improve health outcomes, promote independence, reduce costs, and increase satisfaction. In 2009, MTM's leadership established MTM Transit, an affiliate that provides direct paratransit and fixed route transit services. Every year, MTM and MTM Transit collectively remove community barriers for twelve million people by providing more than 20 million trips in 32 states and the District of Columbia. MTM and MTM Transit are privately held, woman-owned business enterprises.

By Dawn Kotva, Chief Operating Officer, MTM
Throughout the Covid-19 pandemic, non-emergency medical transportation (NEMT) providers and their staff nationwide have stepped up to the plate, putting their own health on the line to ensure their passengers can access healthcare safely and on time. Without excellent service from transportation provider partners, members served by NEMT brokers like MTM would be unable to travel to their critical healthcare appointments. Their integrity and commitment is key to helping MTM remove community barriers nationwide. In recognition of their contributions, earlier this year, MTM launched a new provider recognition program: the MTM Transportation Hero designation! This exciting program recognizes top performing transportation provider companies for their service and achievements as they work harder than ever to provide a high quality transportation experience. Every quarter, the program recognizes 10 regional winners, with one winner taking home the status of National Transportation Hero. Winners are selected based on performance data like turnbacks, no shows, and complaint rates. Congratulations to the first National Winner, Medical Transport Solutions out of Florida! Regional Winners so far have included: Area Wide Transport (Michigan) De-Ride (Rhode Island) Devine Elevation (Texas) EZ Ride LLC (Missouri) Great Brook EMS (New Hampshire) Midway Transit (Wisconsin) MVP (Illinois) Southern Cascades (California) VIP Express (Nevada) Your Golden Transportation LLC (Mississippi) Here’s what some of the winners have to say about their company’s achievements: “This award has been earned by the efforts of each of our employees. As a small, very rural community service district, it is our privilege to serve a huge geographic area with a very small diverse population. Our employees always consider the member first, and we are proud of that.â€â€¨-Dan Bouse, Southern Cascades “Being a partner of your company has been one of the great privileges of my life. We feel deeply honored by this wonderful recognition. MTM has provided us with a rare opportunity to contribute to the welfare of our community while earning a living. Our performance would not have been possible without the help and support of MTM’s Logistics team. Our Transportation Manager and VAM are very supportive of our vision and goals towards a fruitful and mutually rewarding partnership with MTM.â€â€¨-Okey Okafor, Devine Elevation LLC Please join MTM in congratulating these Transportation Heroes for their outstanding work and dedication to providing a top-tier transportation experience in the communities they serve! Thank you for going above and beyond in your efforts to help members of your community access healthcare. 


Having the right drivers will change you and your business. When I took a job in business development for a non-emergency medical transportation and paratransit company I had very little concept for the importance of the service that the industry facilitates or the quality of the people who make it possible. As a salesperson, I could clearly see that the safe, reliable, and sophisticated transportation service the company provides would be a relatively simple value proposition to communicate to agencies and clients. From a macro perspective, the expansion of Medicare, an aging population, and rapid innovation in the broader mobility space looked like clear catalysts for success for a hungry young salesperson. I made the jump and my life changed, but not for the reasons I expected. According to the Center for Disease Control and Prevention, six in ten adults in the United States have a chronic condition, which means they are suffering from heart disease, cancer, chronic lung disease, Alzheimer’s, diabetes or chronic kidney disease. Even more staggering, four out of ten American adults are managing two or more of these debilitating ailments. These statistics highlight the importance of the work we all do to help many sick and hurting people access medical care. In our organization, business development’s role is to capture the essence of what differentiates our operations from the competition and clearly communicate those advantages to new and existing clients. Using content from past proposals and sales collateral, we were fortunate enough to win a large paratransit contract in Cleveland, Ohio in my first three months on the job. I was thrilled with the early success until I got a call from the CEO a few days after award notice and was informed I would be moving to Cleveland to help with the project implementation. I asked how long I needed to be there and was told to not book a return flight. I thought to myself, “I’m a sales guy, I don’t want to actually do the work!†Over the coming weeks, there were many long days, followed by even longer evenings as our project manager and her team cleared seemingly impossible hurdles and successfully delivered on the promises I signed them up for in our proposal months before. I watched the team bring in cutting-edge technology, beautiful new mobility vehicles, sharp uniforms, and years of operational expertise, but none of the great resources appeared to be the engine that drove success. As we interviewed over 120 candidates for the 50 open driver positions, it began to dawn on me that none of the advanced equipment and systems really mattered if the tools were in the hands of the wrong people. I left Cleveland with a newfound sense of the importance of the individual operator, and I began to spend time at all our project sites getting to know the driver teams and the things that made them tick.After three years of analysis, I can confidently say that the most important ingredient in the “secret sauce for a successful NEMT business†is the heart of the operator in the vehicle. I submit that if NEMT business leaders focus on identifying drivers with an insatiable hunger for excellence and a mission of compassion that is core to their being, their businesses will realize incredible organic growth. Hiring correctly really boils down to employing someone for their heart and training them for job aptitude. As an aside, NEMTAC offers an excellent ANSI accredited training program for NEMT drivers! A Hunger for Excellence Bobby Barnes and Bill Flemming were two of the first drivers we hired in Cleveland. Both gentlemen came over from the prior contractor and as they were going through training it was obvious that they had a lot to learn and that there was a lot we could learn from them. During the implementation, we introduced new routing software and tablets, that even as a millennial I can admit were somewhat confusing. For two weeks, Bobby and Bill stayed late every day after their runs to learn how to use the software and take incredibly detailed notes that they could reference in the field. They explained that their decades of experience with paper manifests would not help them with the new technology and that if they expected to be the best drivers on the roster it was going to take extra effort from them. As they learned the new software, they both started working doubles or coming in on their off days to help keep us staffed and our on-time percentage up. The excellence that both drivers expected from
By Caleb Smith, VP Business Development, GC Logistics
COVID. It's a terrible word, and one that we are ALL too familiar with. It has been an incredibly tough time, for such a long time, for almost everyone on our planet. Our healthcare workers have been stretched to (beyond) their limits, and most of us have been negatively impacted, in one way or another, by the devastating pandemic. It's time for COVID to just go away - so that we can get back to our real ("normal") lives and celebrate the positives that remain - our families, our friendships, and our health. While the return to normal may be the ultimate goal, and the light at the end of a dark tunnel, the face and future of healthcare will see some major transformations in the months and years to come. NEMT is here for the long haul Just look at Non-Emergency Medical Transportation (NEMT). Although this service was severely (negatively) impacted at the onset of the pandemic, NEMT services quickly pivoted to accommodate the changing needs of its members. Services like meals on wheels, or trips to and from Covid testing centers, have become part of NEMT's standard services. Today, many new and improved services have emerged, and one thing has become crystal clear - individuals need more choice when it comes to how NEMT is accessed and delivered. Individuals who do not drive and need access to medical care, will still rely on public and private transportation to get to and from medical services and appointments. And NEMT services funders will still require data to make payments. While these facets of NEMT won't change, we need to recognize that some individuals have been forever changed by the emotional effects of the pandemic. Even after vaccinations are completed, member behavior will guide the path of the sector. Grief, uncertainty, and fear will likely drive members to behave very differently in the recovery phase, enhancing the need to meet members where they are and deliver post-pandemic care on member terms. Also, access to NEMT services will move increasingly from traditional telephone call centers, to online self-service functionality.

From Healthcare to Wellness Care COVID-19 has revealed how vulnerable the health care industry is to change, and its need for structural and technological transformation. Traditional NEMT has already started to adjust to more non-medical style services, as a shift is happening, from healthcare services to wellness care. This includes the potential for more trips to grocery stores, shopping jaunts and even shuttle rides to social events. And NEMT is just one of the areas making a shift. 

 

themselves permeated the Cleveland project from the beginning and has led to one of the most successful projects on our resume. A Mission of Compassion Roberto Lopez drives with us in Arizona and is simply a rockstar. He presses his uniform, details his vehicle every day, and has literally written our customer service training module. Roberto has been an NEMT driver for 12 years and has been offered and subsequently turned down almost every administrative and management role in our operation. Unlike many people I have met, Roberto is driven by a burning desire to really know people and to find the way to help them the most. He understands the critical nature of each transport he provides, and he gets fulfillment knowing that his role makes a very tangible difference in peoples’ lives. Roberto does not “clock out†at the end of his shift. Numerous times we have heard that Roberto has gone on his own time and picked up groceries for someone that rode with him and just expressed the need. He is organized, responsible, selfless, and most importantly he is compassionate. Roberto could undoubtedly make his living doing anything he set his mind to, but he chooses to continue to drive out his mission of compassion. When I first started spending time with our drivers, I thought I could teach them a thing or two about being an ambassador for our company. Honestly, I have learned that to be a great ambassador for the company, I need to be more like our drivers. I must pursue excellence in every single task and most importantly, my mission has to be compassion. I strongly recommend that all NEMT leaders carefully screen and select drivers with these characteristics and then invest significant time learning from them. The investment will pay off. Caleb Smith is Vice President, Business Development for GC Logistics. GC logistics operates more than 120 company owned vehicles and manages a network of subcontractors across Arizona, Ohio, and Mississippi. In the Phoenix market the company owns and operates Quality Transport Services of Arizona and Phoenix EI Transportation. 

On a Mission ... continued
By Kris Lyon, Senior Manager, Business Development, NEMT, TripSpark
6 Key Areas According to a recent research article by Deloitte about the future of health, we can expect 6 key areas to collectively transform the existing health system from treatment-based and reactionary care, to prevention and well-being: Data sharing Interoperability Equitable access (including NEMT) Empowered consumers Behavior change Scientific breakthrough The traditional boundaries of the healthcare industry will start to dissolve, and new roles will emerge in the future of health due to exponential innovation. Here are just a few examples: Data analysis will identify pockets of need as well as commonalities and opportunities for shared services Data integrity and security will become increasingly important as there is more interoperability between systems (API connectivity) The move from physical storage to cloud based systems readily available to respond quickly for service expansions, will become even more of an area of interest in the NEMT software arena Covid is Changing Healthcare for the Better Seemingly overnight, the COVID-19 pandemic rapidly changed the course of health care’s future, and from an innovation standpoint, for the better. While disease will never be eliminated, through science, data, and technology, we will be able to identify it earlier, intervene proactively, and better understand its progression, to help individuals more effectively and actively sustain their well-being. The future will be focused on wellness and managed by companies that assume new roles to drive value in the transformed health ecosystem.
By Howard F. Berkowitz, Transportation Expert, Entrepreneur, Consultant, Speaker
6 Major Changes ... continued
It takes a lot of drive and determination to set up and manage a successful business. But those characteristics alone will not guarantee you success. In addition to being determined to make your business successful, you will also need to possess or develop some entrepreneurial skills. It has been proven many times before that you do not need a university degree in business management to be a successful entrepreneur. Even so, you will need to develop some business acumen. Here are ten skills that you might have to work on if you want to turn your ambition into success. Sales Even if you do not plan on being the salesperson for your business, your sales skills will be called upon frequently as an entrepreneur. To begin with, you may need to sell your business idea to financiers or banks. Then you might have to sell the benefits of your business to potential business partners. Understanding sales will also help you bring your product to market, manage your sales team, and negotiate contracts. Networking The ability to network is an essential skill in business. But you will not be able to expand your network of useful contacts unless you work at it. To grow your contacts list, you will need to attend business events, build relationships, and you will need to approach networking with a purpose. You will need to learn to be patient, too, because networking is a long-term strategy that will pay off in the end. Finance You are going to need to be good with numbers to be an entrepreneur. You may not need to understand the intricacies of accounting principles. Still, you will need to be able to calculate a return on investment (ROI) and a gross margin. When you are in a negotiating situation, you may not have time to defer a decision until you can run it by your accountant. So, you are going to need to be able to make quick calculations in your head and get your math right. Time Management Entrepreneurs are busy people, so you will need to learn how to apply the 80/20 rule to your task list. That is the rule that says that 20% of your tasks will deliver 80% of the results. You will not have time to waste on unproductive tasks, so you will need to prioritize the most important jobs each day. Time management comes with careful planning. So, you can add planning and self-discipline to your growing list of entrepreneurial skills that you will need to develop. Communication Part of your role as an entrepreneur will be to inspire people. So, you will need good written and verbal communication skills. Excellent communication skills will also be a prerequisite when you want other people to turn your ideas into reality. It would also be a good idea to practice communicating with people at all levels. You will need to be able to convey your message as effectively on the shop floor as you do in the boardroom. Delegation An entrepreneur needs to be able to manage the resources that they have at their disposal to achieve the best outcome possible. You cannot possibly do everything yourself, so you will need to learn how to delegate. However, delegation is more than merely dumping work on someone else's desk. You will need to learn how to delegate tasks to the right people, and you will need to be able to communicate what needs doing and when it must be done. People Management Delegation is only one of the people management skills you will need to master if you want to be a successful entrepreneur. You will also need to learn how to hire the right people, manage and motivate employees, and understand when it is time to fire people. When your business becomes successful, you may be able to have a human resources department. Even so, you still need to be able to manage the top executives that work for you. Deal Making As an entrepreneur, you will be striking deals throughout your career. The value of those deals will increase as your business grows, but the principals of deal-making will remain the same. Striking a deal is like a game of chess. You make opening moves, you make sacrifices, and you may take gambles. Unlike chess, though, the best deals are made when you win you what you want, but your opponent also goes away happy.
Strategic Planning If you start a business expecting to get rich in year one, you will likely be disappointed. Entrepreneurs need to be able to spot an opportunity and then strategically plan how they will exploit that opportunity in the long term. You will need to develop short-term and long-term plans for business ventures. You will need to have a goal in mind and a strategy of how you are going to achieve that goal. Stress Management Finally, you will need to learn how to manage your stress. You are going to have a lot of pressure on you when you are running a business, and sometimes things will not go your way. If you let stress get the better of you, you may make bad business decisions, and it could make you ill. So, you are going to have to learn to take the rough with the smooth, and you will need to learn how to unwind. Conclusion If the above looks like a lot of skills to learn, there is no need to panic. You do not have to become a master of these skills to be a successful entrepreneur. The one ability that is not mentioned above is team building. If you can build a team around you that jointly possess the right blend of entrepreneurial skills, you can still lead that team to success. Howard F. Berkowitz is the Managing Partner for H & S Personal Car Service & Consulting, Inc. is a public transportation consulting firm specializing in improving operational management, comprehensive analysis, financial performance, and quality of service. We bring over 30+ years of public and private transportation experience and a network of industry associates to each assignment. Contact Howard at (561) 719-5541 or consulting@handspcs.com

Skills Entrepreneurs ... continued
A growing number of US healthcare providers are focusing on addressing health equity. As defined by the Robert Wood Johnson Foundation, “health equity means that everyone has a fair and just opportunity to be as healthy as possible. This requires removing obstacles to health such as poverty, discrimination, and their consequences, including powerlessness and lack of access to good jobs with fair pay, quality education and housing, safe environments, and health care.†One of the patient populations that most acutely suffers from a disparity in education and resources, including medical transportation, is pregnant women. Experts recommend early and routine prenatal and postnatal care to ensure a safe and healthy pregnancy, childbirth, and postpartum experience. However, most women have not received education on the importance of prenatal care. Certain barriers can prevent them from getting women the care and support they need: ranging from difficulty getting transportation, to finding a provider that takes their insurance, to going to a provider with available appointments. Nearly 5.8 million Americans miss or delay their healthcare due to a lack of transportation, according to a study in the American Journal of Public Health. It’s critical to ensure that all women have ready access to health care in their community to not only help prevent complications, but also to prevent existing complications from becoming life threatening. The importance of prenatal care during pregnancy is huge. Prenatal care aims to look for any risks or complications, while simultaneously seeking to improve the overall health of the mother. This is a highly effective way to reduce negative health outcomes and curb infant mortality. A recommended schedule of prenatal visits: Weeks 4 to 28: 1 prenatal visit a month Weeks 28 to 36: 1 prenatal visit every 2 weeks Weeks 36 to 40: 1 prenatal visit every week Babies of mothers who do not get prenatal care are three times more likely to have a low birth weight and have birth complications. NBC News says the CDC has found that about 700 women die from complications related to pregnancy or childbirth every year, putting the U.S. in last place among all developed nations in terms of maternal mortality. Researchers found that of the 658 women who died of maternal causes in 2018, black women fared the worst, dying 2.5 times more often than white women. The transportation barrier goes beyond prenatal care, a California study found that only 49.4 percent of its Medicaid mothers attended a postpartum visit.This may be explained by the fact that women struggle to get to crucial prenatal & postnatal appointments because they don’t have reliable access to transportation. As Medicaid enrollment and Medicaid eligibility expansion occurs, the need for NEMT services focused on access to maternity care grows as well.Recent statistics from CMS show that from February 2020 through January 2021, Medicaid enrollment climbed by 9.67 million. Removing obstacles to accessing healthcare for this population will only become more important as Medicaid membership increases. The need for medical transportation providers and the technology to efficiently coordinate rides for patients is estimated to grow at a rate of 6.5% per year for the next 5 years, based on recent industry reports. Increasing access to maternity care is urgent for this and future generations.
By Megan McGinley, Marketing Manager, Roundtrip
Challenges when Going Digital The biggest challenges include time invested, software monetary expense, and employee adoption.What does this mean for your operation? Upfront Investment: Your upfront investment goes far beyond the money. Depending on the size of your business, you’ll be spending time transferring all your key information into your new digital platform. As an owner/operator your time is precious. Making the decision to dedicate your time to invest into a digital platform can be difficult. This is time well spent.Once your information is set-up and you start learning how to use your new platform to handle your daily operations, you’ll start to realize what so many others that have made the switch already know: making the switch to digital is something they wish they did sooner. If you have concerns about the time investment, make sure your vendor of choice will guide and assist your staff with set up and training. Some digital platforms provide personalized guidance to guide you through your transition, but some do not. If no personalized guidance is available, plan to dedicate more time to get up and running. Employee Adoption: People tend to resist change. If that change involves using new technology, they’ll want to feel comfortable with their new tools. Anticipate and plan for this. Otherwise, you could face challenges with adoption and usage. Let the team know that your choice to go digital is a welcome and necessary change to both survive and thrive as a business. Big Picture Embracing software tools and modifying the way you’ve run your daily options in the past are going to make you more effective operator. The perceived challenges can be mitigated with proper preparation and planning. The benefits of going digital outweigh the challenges, especially over the long-term. Many larger transporters have gone digital out of necessity because their operations have gotten to a level where paper is no longer manageable. Smaller fleets who are getting by today, should consider making changes now, on their own terms, before their hands are forced by regulatory requirements. Not doing so today risks putting you in bad position tomorrow. Next Steps Do your research! Ask your broker or state Medicaid representative when they will be requiring you to go digital. Start looking at options that work for your company. Set up free demos with product experts, ask detailed questions, and commit to making the change on your own terms. Many NEMT digital platforms will help you with scheduling, dispatching, driver tracking, and billing. Though conceptually similar, there are distinct and subtle differences that you will find are better suited to your company than others. The NEMTAC Technology Advisory Board has published information and guidelines to help: https://www.nemtac.org/technology-advisory-board Commit to the change, select your platform, and prepare your employees for this positive change. Let your team know that the organization is committed to digitization, clearly communicate timelines, and how their daily activities will be different moving forward. And most importantly, how this will benefit the entire company.
By Becca-Fields-Poniskaitis, Marketing Manager of RoutingBox
When it comes to technology, the NEMT industry is playing catch up. For transporters who are still on paper and relying on manual processes, transitioning from pen and paper to a digital platform may seem overwhelming. The time has come to put this at the top of your To Do list. Many brokers and insurance companies are requiring NEMT providers to use a digital platform to comply with regulatory requirements. Whether you’ve procrastinated on going digital because of resources, time, or other concerns, now is the time to start planning for the change. Here is what you need to know about going digital: Going Digital Solves Two Issues Data Inaccuracy: When you’re receiving trips from your brokers or even private pay customers, you’re likely entering the same information into multiple areas: information for your drivers for scheduling, having drivers logging completed trips, and then transcribing that information so that you can get paid for your services. Transcribing all this detail by hand puts you at risk of having incorrect information and increases the chances of getting denied payments. This issue is compounded as your trip volume increases, more hands touching the information, and even things as simple as employee fatigue and poor penmanship increase inaccuracies. Even with the best, most experienced, staff, manually verifying every detail like names, addresses, times, and signatures, on your trip logs, you are falling victim to increasing operational inefficiency as your volume increases. Operational Inefficiency: Relying on your customers and brokers for accurate information also exposes you to simple, but costly, mistakes. Something as simple as an address typo costs time and money. Your recourse to ensure accuracy is to manually verify all the information you receive which is a time consuming and frustrating daily process. Reviewing all the information for the best schedules, routes, completed trip accuracy, and sorting out billing every day isn’t easy. There are better ways to manage all your important information with software tools already in use by thousands of other NEMT providers across the nation. Both data accuracy and verification are important. There are other logistical challenges for cost and time savings, that are easily overlooked without a digital platform in place.Are the routes you’re creating as efficient as possible? Are you maximizing the use of your fleet by doing the most transports with least miles? Are my dispatchers assigning the most effective trips to your drivers? Is the information being collected for completed trips accurate for billing? Do I risk getting payment delayed or denied? What will I have to do when I’m audited and how much time will I have to spend gathering the information required? Am I complying with HIPAA regulations for my paper records? Lacking a digital platform is making your business unnecessarily complex given these questions.
The public at large is making its way toward vaccination and attempting to resume life as we knew it in pre-pandemic times. While the economy is still in recovery mode, the auto industry is faced with inventory constraints due to chip shortages. Even the used vehicle market is struggling to keep up because consumers and businesses are racing to buy up the best used vehicles with limited available options. Transportation providers are impacted by the reduction in vehicle supply, and yet, the need to transport passengers safely remains very much in demand. The cost to build up and run a transportation operation is greater today as you face the inevitable—rising vehicle sticker prices. Whether you’re just getting started with your NEMT business or looking to refresh an aging fleet, challenging times bring opportunities to look at the possibilities from a different angle. A new perspective might mean looking at viable options beyond the traditional minivan, such as a well-equipped full-size van. CRITERIA FOR AN ACCESSIBLE VEHICLE WORKHORSE Beyond meeting the expected requirements of safety, accessibility, and dependability, a workhorse must provide extraordinary, consistent performance in reliability, capability and versatility. The VMI Ram ProMaster® 2500 accessible van is a full-size van that checks all the boxes and then some. The disparity in acquisition cost between a minivan and a full-size van were much bigger in the past, but that’s no longer the case with the rising costs of minivans today. The gap between the most basic trim model minivan has narrowed significantly, making the price tag for a full-size van only marginally higher and in return providing greater flexibility to fulfill broader transportation needs. This of course equates to more revenue opportunities for your operation. It's versatile. One of the most obvious benefits of the ProMaster is the ability to transport more passengers on a single trip. The ProMaster will accommodate up to eight passengers, including up to four wheelchair users. This versatile van is equipped with reinforced FlexFloor™ L-track flooring system which enables the driver to reconfigure seating positions to safely accommodate the maximum number of passengers whether they are ambulatory or in wheelchairs. 

 It’s capable.Time is money and efficient passenger pickup or drop off impact your bottom line and customer experience. One of the popular accessibility configurations on the ProMaster 2500 is a rear-entry ramp with a kneeling system. A 4-bag kneeling system quickly lowers the van, and the manual ramp is easily deployed by the driver in a fraction of the time and effort it takes to deploy the ramp in other accessible vehicles. In a head-to-head comparison with an accessible vehicle equipped with a traditional platform lift system, the simplicity of the ProMaster with a rear-entry ramp allowed users to enter and exit the vehicle in half the time. Watch the ramp system in action in this helpful video here. 

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The most efficient ramp system is the 36†or 42†wide rear-entry manual ramp with a kneeling capability. However, VMI’s ProMaster is also available with a rear or side-entry iClass platform lift that comes fully equipped with a door operator and electronic controls to meet your operational requirements. It’s Reliable.VMI sets the bar high with its ProMaster 2500 full-size van. The vehicle’s reliability and performance were validated through a series of tests in compliance as a GSA contract holder. In addition, it’s ADA compliant and meets the Federal Motor Vehicle Safety Standards (FMVSS). NEMT providers can be confident that this full-size van is a verified product designed to uphold the highest performance standards that is required of an accessible vehicle. THE BOTTOM LINE At the end of the day, an accessible vehicle is a significant investment that requires careful considerations. You might be tempted to settle for a basic model of a traditional minivan in order to meet short-term budget requirements, but it’s worth taking an extra beat to consider these few important questions: Is it easy to maintain and require little to no down time? Is it flexible enough to handle diverse transport needs? Is it capable of generating the desired level of revenue out of the gate and for the long haul?
 The VMI RAM ProMaster demo van is touring the country and could be coming to your city next. Contact Jason Stempin at jasons@vantagemobility.com or (314) 396-9322 for product information or to schedule a live demo. Ram ProMaster is a registered trademark of FCA US LLC.

Are You Running Your Business with the Right Vehicle?
In 2015, I was hired as an expert witness to help defend a personal injury case in Texas. A medical patient had slid out of her wheelchair en route to an appointment. After the driver and the non-emergency medical transportation (NEMT) company were each sued by the rider, the company went out of business. As I read the case file I felt terrible. I didn’t think the driver did anything wrong. He seemed like he knew what he was doing, though he had a tough time articulating what his training had been. The case looked pretty grim from the viewpoint of the insurance company and their attorney, who could not prove that the driver's training had conformed to state regulations and NEMT industry standards. The insurance company offered a reasonable settlement, but the plaintiff was suing for more than one million dollars. In the driver's deposition he made the following statement: "I did pass training." Everybody involved in the case, including the court reporter and both attorneys, thought the word "pass" was a verb. However, when I read it, I realized the driver was really saying, "I did PASS Training" a well-known passenger-assistance training program offered by the Community Transportation Association of America (CTAA). I immediately told the attorney to find out who was paying for the ride. That led us to the Texas Medicaid program, which led us to the NEMT broker who had a file revealing that the driver was not only certified by the CTAA, but also by the National Safety Council. Overnight the case changed. We argued the driver did nothing wrong, and we proved there was no negligence in the way the company operated or how the driver was trained. The case was quickly resolved. This story demonstrates that not only is certified driver training a valuable component of an NEMT operation, but the ability to document this training gives you a powerful defense against personal injury claims as well as frivolous lawsuits, as that Texas case turned out to be. I have now served more than 130 times as an expert witness on NEMT personal injury cases in more than 30 states. Most involve elderly passengers, or passengers with disabilities (or both) riding in NEMT vehicles. In EVERY case, the plaintiffs have claimed: The rider fell so it MUST be the driver's fault; the driver was not properly trained by his company; the NEMT company was negligent for not having a proper training program; NEMT industry standards were not met by the company; and on and on and on. Negligence, negligence, negligence. My role, whether on the side of the plaintiff or the defendant, is always the same: Was there negligence, and if so, what was it? If there was no negligence, how can I demonstrate that? While I am always able to handle this challenge, many NEMT companies have a difficult time in these lawsuits, sometimes because they don't have the proper training, and other times because the company representative, and/or the driver, cannot clearly describe or document the training that was conducted. With this unique view of the industry, I cannot overstate how valuable the National NEMT Certification offered by NEMTAC would be for defending insurance claims, seeking to buy insurance, or renewing insurance premiums. For some real perspective, let me take you back 40 years ago when I learned a powerful lesson about how driver training, with a certified trainer, can lower claims and insurance costs. From 1976 until 1981, in addition to my duties as General Manager of my company in Miami, I was also one of our company's accident investigators. One of the owners and I carried cameras and investigative equipment and split the duties between us. We typically had to investigate one or two accidents a week, but in many weeks we had none. Our company was self-insured at the time, and since we paid our own claims, it was very important to control and lower our insurance risk. My experience as a claims investigator enabled me to add components to our driver training program that addressed driver safety, as well as passenger safety, especially regarding the most common forms of accidents, incidents, and personal injury claims. 

But then this happened. In 1981, my company was involved in a merger. The company we merged with had the same size fleet as ours, (we each had 100+ vehicles) but their amount of insurance claims was 10-12 times our total. To deal with this level of accidents, this other company had three full-time accident investigators on their team. And I quickly found out why. Both companies had drivers who owned their own cars, and who were allowed to hire second shift drivers. But while OUR owner-operators could only deploy drivers who had completed our company's driver training program, the OTHER company allowed their owner-operators to provide their OWN training, which was usually not much, if there was any training at all. We realized we now had dozens of drivers out there who had never been through ANY formal driver training class, to say nothing of safety training and accident prevention. After a year, we analyzed the previous 12 months' accident records. We found that 90% of the accidents in our company were being caused by only 10% of our drivers, and most were drivers who hadn't been through our formal training class. We proved that our company's formal driver training class, taught by a certified driver safety trainer, wasn’t just producing more productive drivers, but safer ones. Soon, we required every driver in our company to go through our training class including part-time drivers hired by driver/owners. The following year, we cut our claims by 70%. Good training is not just important to keep your insurance rates low, but it is also an important component in battling claims. And this brings me to why NEMTAC's NEMT training certification program is such a valuable resource for your company, and for your drivers. Being certified has great value in itself, but the fact that the certification carries with it a comprehensive driver safety training program, with enhanced training for passenger assistance, is a game changer. In addition, it goes a long way towards reducing your insurance premiums and battling claims. Roddrelle Sykes is insurance executive at Nonemergencyinsurance.com. Mr. Sykes works with NEMT providers and helps secure the type of insurance policies fleets need to work with Medicaid brokers, transit agencies, and other clients who have medical patients, in particular the elderly and the disabled. In a recent conversation, he explained to me that insurance carriers and underwriters use metrics to rate the insurability of prospective clients. The underwriter takes into account the number of claims a company has had in past years and their corresponding costs. In other words, the more claims and loss runs you have, the higher your insurance costs will be. Companies with lower claims and loss runs are rated better, and get better rates. While Mr. Sykes tries his best to make sure everyone who contacts him secures the necessary insurance, some companies are so poorly rated that it is impossible. This is exacerbated by the fact that some insurance carriers won't even write policies in certain states. Mr. Sykes also agrees with me that NEMTAC's NEMT Certification Program will go a long way toward legitimizing NEMT providers to not just help to win contracts, but to help them defend claims, which will improve the company's overall fiscal health and longevity. Formal, understandable, published, NEMT certifications will not only provide your drivers with better training, but will PROVE they have been trained to industry standards. Documenting this fact may also help to preempt frivolous lawsuits from being filed in the first place. NEMT insurance rates are not going down anytime soon. Get the NEMTAC NEMT Certification now and make this part of your long-term plan to control costs, lower claims, and be more profitable. The Transportation Alliance (TTA) members can now take advantage of an exclusive offer and get 10% off the prices of the NEMTAC accreditation program. If you are not a TTA member, you can join right now during a special membership promotion giving you a 50% discount on your membership for the rest of 2021. Driver certification, company accreditation and key aspects of NEMT service will be hot topics at Mobilize 2021, TTA’s Annual Convention and Expo happening October 14-17 in Las Vegas, Nevada. You can find out more information on the agenda and register here. Editorial Note: This article was first published in the May 2021 issue of Transportation Insights, the monthly newsletter of The Transportation Alliance (TTA). It is reprinted here with TTA’s permission.
By Joseph M. Rubino, President, J.M. Rubino Transit Consulting
I’m addicted to golf. It feels good to say it out loud. I sneak out of the house to get my fix, I tip toe around the house to get a couple of swings in the basement where nobody can see me. But I can’t bring myself to part with my beloved set of Titleist DCI irons. They got me back in to golf after I quit the first time and they’ve been with me ever since. For those readers that aren’t golfers, swinging DC Is is like using a 1st Generation iPhone. So, every year I tell myself that I’m going to upgrade my bag because I “have to be losing significant distanceâ€. It’s the clubs for sure. So, every year I journey to the clubhouse for fitting days. The first couple of years they threw the kitchen sink at me. “This technology is revolutionaryâ€. “You’re already getting an extra 15 yards from your current setâ€. They brought a great price to the table. Discounts from the club, a “Fitting Day†discount. But this year was different. They saw me coming. The fitter didn’t spend any time trying to adjust the club to my garbage swing. They didn’t walk me through the specs of the new models. The quote they gave me didn’t even have the Fitting Day discount! You see, the club fitters had seen me so many times over the last couple of years that even though they wanted the sale, they knew that I was going to try them out, say how much I love them and how they’re going to change my game. And then when it came time to pull the trigger, I was going to pass. “Maybe next yearâ€. Insurance buying works the exact same. As a consumer, you’re bombarded with advertisements for your car insurance. You’re told in a thousand different ways that shopping your coverage is easy, can save you money and that you should do it. But here’s a little inside baseball. Personal auto coverage is almost exclusively underwritten by computer models. Commercial Auto coverage, like the type required to operate your NEMT business, is underwritten by human beings. The effort it takes to underwrite the commercial auto policy you buy is 100x the effort it takes to underwrite a personal auto policy. So when the underwriter has seen you every year for the last 3 years, what kind of effort do you think they’re going to exert in year 4? “Maybe next yearâ€. Shopping your insurance coverage with carriers every year is a fool’s errand. Marketing your insurance program is a strategic activity and it’s a strategy that should be formulated with your insurance broker that specializes in Non-Emergency Medical Transportation. There’s a significant difference between strategic quoting and “shoppingâ€. Make sure that your insurance marketing activities are part of a long-term strategic effort to ensure you’re paying the market rate for your business and are at, or below, the industry benchmark for insurance spend. Don’t get stuck holding the bag.

By Eric Lane, Commercial Risk-National Accounts, Bankers Insurance
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NEMT Today magazine is a quarterly publication with editions in the Winter, Spring, Summer and Fall. The publication is an 8.5" x 11" vertical interactive digital publication. We are interested in receiving articles that highlight educational topics related to Non-Emergency Medical Transportation (NEMT) business operations, industry trends, compliance & regulatory, technology and customer service. Submission Deadlines: Final copy for articles and advertisement is due on the following dates: Winter issue - January 15th Spring issue - March 15th Summer issue - June 15th Fall issue (Conference Edition) - August 15th Each issue will be published approximately one month after submission deadline. Article Specifications: Furnish articles in Word files format 1000 word maximum or less preferred All font will be Open Sans 9.6 pt. All articles must be submitted with author name and title All articles must be submitted with a title All articles must be submitted with a minimum of 1 photo relevant to the article Articles that heavily promote an organization will be considered sponsored content and the editor will contact you for approval and payment
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