GRITS provider guide: Audubon Area's Medicaid rides in Kentucky Regions 1, 3, and 4

GRITS in brief

Owensboro’s community action agency, Audubon Area Community Services, Inc., runs GRITS, the Green River Intra-county Transit System. Audubon formed in 1975 by merging two agencies started in 1966, one in Henderson and one in Owensboro. Through GRITS it holds the Medicaid broker contract from the Transportation Cabinet for three HSTD (Human Service Transportation Delivery) regions with 22 counties, and it has carried nonemergency riders for over 30 years. GRITS also runs public transit across Region 3’s seven counties, a per-mile service anyone can buy, and paratransit on behalf of the Owensboro Transit System.

GRITS and Head Start are Audubon’s two largest programs. Three figures give the scale of GRITS:

• Trips. The 2023-2024 annual report credits GRITS with 411,062 trips, about 1,100 a day, over 5,432,742 miles, for 8,890 individual riders.
• Money. In the fiscal year that closed June 30, 2025, Audubon’s audit shows the transportation program spending $22,222,418 and earning $20,735,588 in transportation service revenue. GRITS brought in about 29 percent of Audubon’s total revenue, and Medicaid about 27 percent.
• Vehicles. The Cabinet’s transit asset plan, updated August 25, 2026, lists 101 Audubon vehicles: 52 cutaway buses, 40 vans, 8 SUVs, and one minivan.

Every Kentucky subcontractor goes through the same statewide steps, from operating authority to Medicaid enrollment and the payment calendar, and the FTSB provider guide lays them out. For the program overall, see the Kentucky state guide. This page sticks to GRITS.

Regions, booking lines, and two time zones

GRITS gives each of its regions two rider booking numbers, and Region 4’s office keeps Eastern time while the other two keep Central.

The time zone line in 49 CFR 71.5 cuts through Region 4. Hardin, Larue, Marion, Meade, and Nelson counties keep Eastern time, while Breckinridge and Grayson keep Central, as do all of Regions 1 and 3. Region 4’s office and service hours are stated in Eastern time, so a carrier with a pickup in Leitchfield or Hardinsburg should check which clock the trip time was booked in.

The three regions are not one block. Region 1, the far west around Paducah and Murray, borders just one other HSTD region, Region 2, held by Pennyrile Allied Community Services. Regions 3 and 4 meet where Hancock and Ohio counties border Breckinridge, and Ohio borders Grayson. 603 KAR 7:080 merges touching regions held by one company into a single region for operating and monitoring, so that rule reaches Regions 3 and 4 but leaves Region 1 on its own. Region 4 also borders LKLP’s Region 5, FTSB’s Region 6 around Louisville, and Region 8.

Outside carriers in the GRITS network

GRITS fills Medicaid trips with outside carriers as well as its own buses. Paducah offers the clearest public example. The Paducah Area Transit System (PATS) at 850 Harrison Street operates a Medicaid service whose riders reserve through GRITS on the Region 1 numbers, with 844-575-4590 listed for TTY callers. PATS sets its own closures for that service: the six HSTD holidays, Martin Luther King Jr. Day, and any day the roads are hazardous.

The audit shows where the transportation dollars go. Of the program’s $22,222,418 in fiscal 2025 spending, contracts and consultants took $14,401,129 and salaries $3,576,405.

Two rules affect how trips are shared:

• Rider choice. Under KRS 281.874, a rider certified for Type 07 or Type 08 service can pick the provider, and GRITS’s own fleet is one of the options; the booking still goes through GRITS.
• Requests for a particular driver. GRITS’s reasonable modification policy allows it to refuse a request for a specific vehicle or driver, along with requests that would leave a vehicle unattended for an extended period or put vehicles in harm’s way.

What to settle on your first call to GRITS

Before calling, have your Kentucky motor carrier certificate (Taxi or Disabled Persons Vehicle) in hand. Subcontracts go through the transportation office at 222 St. Elizabeth Street in Owensboro, 270-686-1651, which is also the broker number the Cabinet lists for all three GRITS regions.

On that call, pin down three things:

1. The region. Regions 1, 3, and 4 are separate service areas with their own booking lines, and Region 1 does not touch the other two.
2. The certificate types. Find out whether GRITS needs more ambulatory, escort, or wheelchair capacity before you buy a vehicle.
3. The rates. Get the current subcontractor rate for every certificate type in every region you would cover.

Then the Cabinet’s statewide process applies. GRITS walks through the contract, checks each vehicle, takes copies of your insurance and certificate papers, and signs each MAP-811 before you enroll with Kentucky Medicaid as Provider Type 56. A new provider needs three or more approved drivers, matched by as many vehicles in running order.

How riders book GRITS trips

Medicaid riders book at least 72 hours in advance unless the visit is urgent care. The booking lines answer weekdays from 8:00 to 4:30 and Saturdays from 8:00 to 1:00, and vehicles are out from 6:00 a.m. until 8:00 p.m. Monday through Friday, plus the Saturday morning window. Regions 1 and 3 quote those hours in Central time, Region 4 in Eastern. GRITS caps each call at three trips to keep hold times short, so a rider with several visits coming up may call more than once.

GRITS publishes a short set of rider rules, which tells your drivers what riders have already been told:

• Every passenger wears a seat belt.
• Smoking, eating, and drinking are not allowed.
• Alcohol, illegal drugs, weapons, explosives, and flammable liquids stay off the vehicle.
• Animals ride only if they are service animals or travel in a kennel or carrier.
• Riders do not talk with the driver while the vehicle is moving.

Medicaid riders pay nothing for approved appointments. The Region 3 per-mile service is a separate product with its own prices.

Pay in the GRITS regions

GRITS’s Medicaid income is a per-member amount. Each month DMS sends the Cabinet a fixed sum for every Medicaid member, which the Cabinet distributes to regional brokers based on assigned enrollment. In the November 2025 briefing DMS and the Cabinet gave lawmakers, the monthly per-member rates were $8.33 for Region 1, $7.87 for Region 3, and $9.12 for Region 4. Rates across the 15 regions spanned $6.88 to $14.69, Region 4’s was the middle figure, and Regions 1 and 3 sat below it.

Your trip rate is not GRITS’s call. The Cabinet sets subcontractor rates by certificate type, region by region, and GRITS’s own vehicles are paid from the same schedule. The Cabinet’s fiscal 2023 report shows Regions 1, 3, and 4 all received subcontractor rate changes on May 1, 2023. The Kentucky Medicaid transportation rates guide explains how these rates relate to the DMS fee schedule, and billing NEMT brokers walks through reconciling broker payments against trips.

The 2026 House Bill 2 also calls for a performance-based payment model that holds back 2 percent of each broker’s capitation. GRITS can win that money back by meeting measures that include canceled, rescheduled, and delayed trips, so a carrier with a strong on-time record helps GRITS recover it.

Contacts

• GRITS Transportation (subcontracts): 222 St. Elizabeth Street, Owensboro, KY 42301, 270-686-1651.
• Audubon Area Community Services, main office: 1700 West 5th Street, Owensboro, KY 42301, 270-686-1600.
• TTY for Region 1 Medicaid booking: 844-575-4590.
• Paducah Area Transit System: 850 Harrison Street, Paducah, KY 42001, 270-444-8700.
• Kentucky Division of Motor Carriers (operating authority): 502-564-1257.
• HSTD customer service hotline: 1-888-941-7433.

Keeping three GRITS regions straight in HealthRide

When a company works more than one GRITS region, each region may pay a different rate, so each trip record has to hold up by itself. HealthRide saves GPS-recorded miles, the rider’s signature, and both pickup and drop-off times on every finished trip, and a CSV or PDF trip log from reports lets you line up a GRITS payment with what was driven. While trips are running, every vehicle appears on the live map.