Auditor examines whether Broward got best deal on COVID-19 tests, vaccines in 2020

In its rush to help the public at the start of the COVID-19 pandemic, Broward County struck an agreement with two ambulance companies that let them charge the county tens of thousands of dollars for being on call with no work lined up, a county review found.

Starting in 2020, the program aimed to provide at-home COVID19 tests and vaccines to homebound seniors and the disabled who weren’t able to travel to get tested or vaccinated.

Broward paid millions of dollars for the services over a two-year period. But Broward’s auditor, Robert Melton, said that two ambulance companies billed county taxpayers a combined $82,467 for 94 days — even though they performed no services on those days because they were on call with no appointments.

But it’s what the contract allowed the companies to do, the county says.

The contract had been set up to have staffing ready to provide service; the contract did not take into account the work that was actually performed, according to the county.

The auditor’s report also found that the ambulance companies were compensated on an hourly basis “rather than on a unit-ofservice basis, without adequate consideration of ” the hours allowed to be billed.

Offering examples, the county said it wasn’t clear whether a contractor could bill for the transportation time between clients, the lunch time for employees or the time needed to pick up supplies and drop off paperwork with the state health department — or if one or two persons were required for those services.

The findings, in a report dated Jan. 26, prepared by the county’s auditor: “We conclude that services provided were not commensurate with the costs of the program.”

Ensuring help was available

The service worked like this: Callers reached out to the Florida Department of Health in Broward County, which scheduled the services, and the providers showed up to the patients’ homes.

The county signed with American Medical Response, of Colorado, and Century Ambulance, of Jacksonville, both of which had been emergency backup ambulance services for the county since 2016, to run help for the homebound in the program that ended in November. The providers billed the county $100 an hour per employee.

In the two years reviewed, between May 2020 and May 2022, the county spent $3,443,867 for the services from its general fund, although the money originally came from federal grants meant to help communities cope with the pandemic. In return, there were 1,054 COVID vaccines and 20,469 COVID tests given out.

The county determined one company tried to minimize staffing when it had no appointments: Records show American Medical Response billed $5,600 for 56 hours when it had no appointments on a day in July 2021, according to the report.

But Century Ambulance billed $76,867 for more than 768 hours, even though it had 93 days with no appointments, which was nearly 13% of its final bill to the county for $606,817, according to the report.

Neither company could be reached by email or phone for comment.

“The companies would not contract in a per unit of service [per vaccine or COVID test], which would have alleviated these situations,” Melton said. “That’s not what happened.”

Facing urgency during pandemic

When the program was designed, “contracting for units of service was not an available option,” said Michael Ruiz, assistant county administrator, in response.

“We acknowledge that under more traditional market conditions and potential future events, the county would likely insist on contracts paying only for completed tests and vaccinations as recommended in the Auditor’s Report,” he wrote in a memo.

Ruiz wrote that at the time it was a lifesaving program and there was an urgent need “to ensure maximum availability of limited resources.” He said the public was best served by reserving the ambulance services, not on a per-vaccine cost.

“Had we not done so, we do not believe we could have guaranteed Broward County residents who were homebound with access to the successful in-home testing and vaccinations this program provided,” Ruiz wrote. “However, in hindsight, we acknowledge that additional performance standards may have reduced some of the payments to vendors.”

What could have been done?

The lesson learned: Broward County could have “incorporated performance standards into the contract to help guard against paying for days no services [were] provided,” Melton said.

The report recommends that management, with consultation with the county attorney’s office, “evaluate the feasibility of recovery of overbillings.” He also recommended management “investigate specific identified days with a high number of billed hours as compared to the units of service completed.”

Melton wrote the report was an “assessment,” not an official audit.

“Had we conducted an audit, we may have identified additional findings and concerns,” he wrote.

Lisa J. Huriash can be reached at lhuriash@sunsentinel.com. Follow on Twitter @LisaHuriash