People for People provider guide: Apple Health rides in central Washington

People for People in brief

People for People (PFP) is a Yakima nonprofit that has worked in central Washington since 1965. Its own history dates its Medicaid ride brokering to 1989, when it expanded service to six counties. That was the same year Washington set up its broker model. Today PFP holds the Health Care Authority (HCA) broker contract for nine counties. The organization also runs Meals on Wheels in Yakima County, job training programs, the Greater Columbia 2-1-1 help line, and fare-free public bus routes.

Keep PFP’s two transportation roles apart. Its Community Connector bus routes and its non-Medicaid door-to-door service reach Adams, Grant, and Lincoln counties, but Apple Health riders in those three counties book through Special Mobility Services. A subcontract with the PFP brokerage covers Medicaid trips in the nine counties above. Our Washington state guide lists every broker by county.

How People for People picks the ride

PFP looks for the cheapest option that works for the rider, and a van is often not the first answer. Riders who have a car get a gas voucher or mileage reimbursement. Everyone else is matched to local transit or paratransit, volunteer drivers, train, Greyhound, a nonprofit carrier, a cabulance, or a taxi company, and trips may be shared.

State rules set this order. Under WAC 182-546-5200, the broker decides both the mode and the level of assistance, from curb-to-curb to hand-to-hand, and it must choose the least costly mode that is accessible and suits the rider’s condition. WAC 182-546-6200 bars paying for a ride when the rider has a car or an informal ride that suits their needs, or when a fixed bus route runs within three-quarters of a mile on foot. The broker can waive the bus rule when a need for more specialized transportation is documented, such as a portable ventilator, a walker, or a quad cane.

The money works for providers in one way and against them in another.

• Trip money passes straight through. HCA pays each broker a negotiated administrative rate and handles trip costs separately. The broker keeps none of the trip money.
• There is no state rate. Trip costs swing widely from one part of Washington to another, so HCA leaves pricing to each broker and provider to negotiate.
• Brokers are paid to push costs down. HCA’s sample contract adds up to 5 percent to a broker’s monthly administrative payment when its average service cost per trip falls compared with the same quarter a year earlier. A separate incentive of up to 5 percent rewards a rising share of bus, gas voucher, mileage, volunteer, commercial bus, and train trips, with a small bonus for more shared rides.

In practice, your rate, your service area, and your willingness to carry shared rides decide how much work reaches you.

Asking for a subcontract

Brokers sign their own providers. HCA tells companies that want to carry Apple Health riders to reach out to the broker covering the counties they plan to serve, and WAC 182-546-6200 lets a broker pay only providers it has subcontracted. For these nine counties, that means the PFP brokerage in Yakima.

1. License the business first. For-profit fleets need a Washington business license with a Department of Licensing (DOL) for-hire endorsement. That means a $55 certificate for each vehicle, plus a $110 for-hire permit in places where the city or county issues no for-hire license of its own. Registrations carry use class F/H or CAB. Liability coverage on the insurance certificate starts at $325,000 combined single limit, with split limits of $300,000, $100,000, and $25,000 as the alternative. A private nonprofit that carries people with special transportation needs can instead hold a permit from the state Utilities and Transportation Commission (UTC).
2. Build complete driver files. Before a driver’s first trip, the file needs a current license, an abstract of the driving record, proof of insurance, and the Washington State Patrol check described below. Screen owners and staff against the OIG exclusion list, because brokers must screen you before contracting and keep screening afterward. Our driver file checklist covers the paperwork.
3. Call the brokerage. The NEMT line is 509-248-6793 (toll free 800-233-1624) during call center hours, and the home office answers at 509-248-6726. Be ready to name the counties and hours you would cover and the vehicle types you run.
4. Ask where the gaps are. Good questions: which counties run short of vehicles, whether wheelchair or ambulatory trips are harder to place, how often long-distance trips go unfilled, and whether weekend coverage is needed.

Our guide to NEMT broker contracts covers how to pitch a broker once you have its attention.

Terms HCA writes into every provider subcontract

Exhibit I of HCA’s sample broker contract spells out the minimum each broker must write into its provider subcontracts. They fall into two groups.

Terms in your favor

• You get paid within 10 calendar days of the day the broker’s monthly HCA payment comes in.
• A rate adjustment is possible at least once a quarter, and you get an appeals process.
• If you run an authorized trip and the clinic cannot see the rider through no fault of yours, you are owed a negotiated fair rate.

Your obligations

• Keep written procedures for preventing, spotting, and reporting suspected fraud and abuse, plus a quality assurance plan. Our fraud prevention guide shows what those procedures cover.
• Ask riders only for the information the trip needs, and protect everything you learn about them.
• Treat drivers as your own employees. They are not employees of the broker or the state.
• Hold written authority to do business in Washington, plus every license, certificate, and permit the work requires.
• Carry the insurance set for your license type. For-hire carriers regulated under RCW 46.72 meet the legal minimum, while companies outside public regulation match the coverage HCA demands of the broker itself.
• Repay anything you were paid for a trip that used a driver or vehicle the broker had not approved, within 30 days after the problem comes to light.
• Keep service, billing, and accounting records open to the broker for six years past the end of the subcontract.
• Never bill HCA, a rider, or another provider for a subcontracted trip, and never offer the broker cash, gifts, or kickbacks for referrals.
• Keep up with workers compensation premiums, unemployment insurance, and your state and local tax filings.

Driver and vehicle checks

HCA’s contract makes the broker verify each driver and vehicle before its first trip and then on a fixed schedule.

Driver standards

• Background. New drivers and volunteers are fingerprinted for a Washington State Patrol criminal history check, repeated every three years. For the two years in between, the broker runs a WATCH name search (Washington Access to Criminal History). A WATCH result can put a new hire to work before the fingerprint results come back, and brokers in regions that border Idaho or Oregon may use a comparable report from an appropriate government agency. Results must qualify the driver to be alone with children and vulnerable adults as RCW 43.43.830 defines them, and the broker also checks the DSHS Secretary’s List in WAC 388-113-0020.
• Conduct. Drivers wear visible company identification, get out to open doors, and announce their arrival, telling facility staff when a curbside pickup is not obvious. As needed, they assist riders to or from the destination’s main door, and they confirm belts and wheelchair tie-downs before the vehicle moves.
• Prohibitions. No headphones on duty. No food or drinks other than water in a closed container while driving or helping a rider. No smoking with clients aboard, and where possible a smoke-free vehicle in the 15 minutes ahead of each pickup. No accepting money or gifts from riders, and no discouraging anyone from filing a complaint.
• Training. Every commercial driver learns to fit and use child safety seats. HCA’s list of recommended courses adds first aid and CPR, defensive driving, fire suppression, and a passenger assistance class such as ADAPT or PAT.

Vehicle standards

Each vehicle carries a phone or radio link back to dispatch, heating and ventilation in good order, and a clean seat belt for every seat. Door handles and interior lights must work, the speedometer and odometer must be accurate, and mirrors go on both sides and inside. Riders should be able to see your company name and the vehicle’s number. Wheelchairs and child safety seats must be securable. If the two-way link or climate control fails, the vehicle is parked until the repair is done.

Inspection schedule

Brokers rotate which vehicles and drivers they pull, so a different sample comes up each round. Our broker audit guide and background check guide explain how to stay ready.

Rider rules your drivers enforce

PFP’s current passenger rules for Apple Health trips set the terms your drivers work under.

• Five-minute wait. Drivers wait no longer than five minutes at pickup.
• Straight to the appointment. Riders go directly into their appointment. Getting out somewhere else can cost them the return ride, and a rider who leaves the facility during the appointment is recorded as a no-show and must find their own way home.
• Cancellations. Riders cancel through PFP at least two hours ahead. Outside office hours they call the provider directly, so someone at your company has to take those calls.
• Passengers and animals. No extra riders without PFP approval, and only service animals approved in advance. Our guide to service animals covers what drivers may ask.
• Food and stops. No eating aboard (water is allowed), and drivers do not stop for food or errands. Drivers may refuse items that pose a safety concern.
• Recording. PFP tells riders that trips may be recorded on video and audio.
• Consequences. A first violation brings a written warning. A second can cut the rider back to gas vouchers or mileage reimbursement.

State rules back the no-errands rule. Under WAC 182-546-5600, the state pays for an extra stop only when it relates to the approved trip, such as a follow-up medical appointment or a pharmacy close to the usual route.

Rural trip patterns

Distance shapes work in this region more than volume does.

• County lines are crossed routinely. HCA told the Legislature in December 2024 that riders cross county lines as a matter of routine, especially in rural areas. Under WAC 182-546-5700, riders go to a local provider unless an exception applies. Exceptions include care that is not available locally, continuity of care (active cancer treatment, a transplant in the last 12 months, surgery scheduled within the next 60 days, major surgery in the last 90 days, or the third trimester of pregnancy), a payer network that requires a specific provider, and a lower total cost.
• Overnight trips are common. PFP arranged 17,674 nights of lodging in fiscal year 2024-2025. Under WAC 182-546-5900, brokers can approve meals and lodging for up to one calendar month, and any extension past that month needs the broker’s prior approval. Out-of-area requests need five business days of notice, which gives you time to plan a long run. Our guide to long-distance trip pricing covers how to cost them.
• Standards bend for distance, lateness does not. HCA’s performance standards allow documented exceptions for trips that start or end outside the rider’s local region and for exceptional rural distances. If the rider reaches the clinic too late for the appointment to go ahead, the trip still goes unpaid unless the delay was beyond your control.
• Rideshare is thin. The same HCA report says rideshare drivers are rarely available in rural areas, so rideshare seldom absorbs short-notice trips here.
• Tribal and behavioral health partners. WAC 182-546-5200 requires brokers to negotiate in good faith with any federally recognized tribe whose contract health service delivery area lies in their region. When HCA approves a tribe’s request, its members can ride with the tribe while the broker coordinates and pays. HCA’s report counts billing agreements with 22 federally recognized tribes statewide, and the program paid tribes more than $2.5 million for member trips in calendar year 2023. The same report counted four of the state’s five behavioral health facilities with broker billing agreements in central Washington.

PFP’s rider flyer names dialysis, cancer treatment, outpatient substance use treatment, mental health care, physical therapy, and dental visits among the trips it arranges. Several of those repeat on a fixed schedule, which rewards a provider that can hold a standing order week after week. Our rural NEMT guide covers routing and staffing across long service areas.

After hours and weekends

PFP’s call center closes at 4 p.m. on weekdays and stays closed on weekends and major holidays. In those hours, riders with urgent needs call the provider PFP lists for their county. The current list names just two companies: one for Chelan and Douglas counties, and one for the other seven.

WAC 182-546-5200 sets the rules for these trips. When the broker is closed and cannot approve a ride to urgent care or home from a hospital discharge in advance, the provider has two choices. It can carry the rider as the broker’s closed-hours guidance directs and then seek approval for the trip within two business days, or it can turn the trip down. A company that can answer phones and staff vehicles at night has an opening to raise with PFP. Our guide to after-hours NEMT work walks through pricing and staffing for that shift.

Contacts

Where software helps

Drivers on the HealthRide driver app can log pickups and drop-offs on remote stretches with no cell signal, and everything syncs once they are back in coverage. Every leg records GPS-verified miles, timestamps, signatures, and any no-show wait time, so the proof is on hand when PFP reviews your trips.