Medical transport companies given until Dec. 31 to comply with regulations
Germaine Simonson began her non-emergency transportation company, Turquoise Trail Transport, in 2014 and it has grown from one vehicle to eight. Originally from Hardrock, Arizona, Simonson said when she began her business she was able to do it with the help of a loan she acquired from her husband, Marvin James.
Now her company, which has a staff of seven, has hit a snag with policies that were approved by the 23rd Navajo Nation Council and are being implemented by the current administration. “We are busy daily navigating business ownership and recently, by the actions of our own government, the Navajo Nation, we have been caused a tremendous amount of unnecessary stress,” Simonson wrote in an email.
Simonson’s is just one of many Navajo owned non-emergency transportation businesses that did not make the cut on a list the Navajo Department of Health submitted to the Arizona Health Care Cost Containment System in an attempt to regulate them. This list included only five Navajo-owned and -operated non-emergency transportation companies.
The rest of the 30 are non-Navajo/Native owned. So she met with Department of Health Director Jill Jim and the president’s Deputy Chief of Staff Milton Bluehouse and Jeff Davis, owner/operator of JD Transport, but Jim stayed with the decision. Disappointed, Simonson and other Navajo owners of non-emergency transportation had planned to attend a Health, Education, Human Services Committee meeting to hear Jim’s report on the issue. Jim was on travel and so the owners went straight to President Jonathan Nez to discuss what they saw as a roadblock for their companies.
“We had about a handful Navajo owned non-emergency medical transport company and they were concerned about not being on the list sent to AHCCS so they could get their reimbursements,” said Nez. “They told us we aren’t big companies like many that are on the list, and they couldn’t afford all the fees.”
During the 23rd Council, concerns for needed regulations were expressed. Symposiums were held at the Navajo Nation Museum for the new regulations to be presented to owners and drivers of non-emergency medical vehicles. This is the first time NDOH had been given power to regulate.
Complaints of bootlegging, reckless driving, drug dealing and awful customer service had all been reported by many patients and other customers. Twenty-one requirements were suggested along with the application to run a NEMT business on the Navajo Nation. The regulations include a $3,000 application fee for a permit. For non-Indian preference NEMT the fee is $6,000. “They said the policy is confusing,” said Nez of the owners he met with. “They said they didn’t have enough time to go through the whole application process, and they missed the deadline. Our administration supports small businesses.”
JT Willie, director of the Division of Economic Development, said there was a miscommunication of how the application process worked in the previous administration, and this has since been corrected. But, while Simonson and others were meeting with Nez, a couple of other Navajo owned transportation company owners were presenting to the Health, Education and Human Services Committee.
Ted Allen told the committee that there is a misconception that as an owner he is making enough money to pay the fees but said that is not the case. He even offered to show the committee his tax returns. He said although they did comply with the new regulations, and reinvested in buying new vehicles, he said other companies are still operating even though their vehicles are unsafe, who aren’t in compliance, or those companies aren’t paying anything compared to what he is paying.
“It’s an unfair playing field,” said Allen. “It’s a joke. We have to pay the payroll, taxes, fees and vehicles. We abide by tribal policies. We get no help or assistance.”
Bluehouse said what they are looking to do now is an open enrollment up until Dec. 31. This will give businesses the chance to come into compliance with NDOH regulations and be permitted to conduct non-emergency services on Navajo. So they are not prohibiting small businesses from operating, but they are requesting they become certified, permitted and regulated by NDOH. “We are working with NDOH from the now until Dec. 31 to develop the requirements that these non-permitted companies would need in order to conduct business,” said Bluehouse.
But the open enrollment is seen as unfair for businesses like Allen’s who has complied with the policies and regulations. “The concern with permitted companies is they abided by the rules,” said Bluehouse. “There is no financial injury directly impacting these permitted companies, other than the market will be more competitive and clients will have the opportunity to choose a service that is timely, safe, that meets their needs. The winners are the client because they will have improved services that are regulated, and will have a larger field to select their medical transport.”
NDOH and Navajo Nation EMT program is the point of contact for any questions related to enrolling in the program, including being permitted by NDOH to conduct NEMT business within Navajo Nation.
To recive an application and supporting documents, and to answer any program related question, email: nemt@email@example.com or call 928-871-6350.