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Harnett commissioners direct staff to continue talks with MotiveCare on Medicaid non‑emergency medical transportation
Summary
County transportation staff briefed commissioners on MotiveCare, a Medicaid non‑emergency medical transportation (NEMT) broker, describing how brokered trips are assigned and the potential for HARTS to contract as a provider; the board authorized staff to continue negotiations and legal review.
Harnett County transportation staff updated the Board of Commissioners on May 13 about MotiveCare, the Medicaid non‑emergency medical transportation (NEMT) broker operating in the county, and requested direction to continue contract negotiations. Commissioners directed staff to proceed with negotiations and legal review.
Why it matters: NEMT brokers coordinate Medicaid trips statewide; county transportation systems can contract with brokers to receive trip requests and be paid per trip. County staff said MotiveCare has a significant footprint in Harnett County and that brokered trips frequently require ADA‑equipped vehicles and out‑of‑county travel.
What staff said - Background: Transportation staff explained that the Medicaid managed‑care transition (July 2021 and later managed‑care phases) moved many Medicaid trips from county DSS scheduling to brokers; MotiveCare is one of two large brokers operating in North Carolina and handles more trips in Harnett County than the other broker. - Operational issues raised: Staff said brokers sometimes contract private drivers who arrive in unmarked cars, which raised passenger comfort and safety concerns. MotiveCare, staff said, also reported a shortage of ADA lift vehicles among broker providers in the county. - Financials and contracting: Staff reported that broker rates are tiered by trip distance, include provisions for shared rides and are paid per trip. County staff said the rates MotiveCare offered in negotiations appeared reasonable compared with HARTS’ trip costs and that a county contract could be year‑to‑year.
Questions and controls Commissioners asked about origin volumes (staff cited roughly 1,700 MotiveCare trip origins per month in the county), driver vetting, vehicle standards, insurance and audits. Staff said MotiveCare conducts audits of its contracted providers, that the county requires background checks for county drivers, and that MotiveCare manages assignment decisions when the county turns a trip back to the broker.
Board direction and next steps The board instructed staff to continue negotiating contract terms with MotiveCare, to have county legal review draft agreements and to return when negotiations are complete. Staff said negotiations include rates, audit provisions and assurances on vehicle standards and driver vetting.
Ending County staff said potential grant opportunities could offset start‑up or vehicle costs and that continuing the negotiations could expand available transport options for Medicaid recipients without reducing existing HARTS service. No final contract was executed at the meeting.
