St. Johns County Council on Aging Transportation: How Its Rides Work and Where Ride Companies Fit

The St. Johns County Council on Aging has run the county’s coordinated rides since October 1983, when it accepted the job after a December 1981 county resolution and a 1982 county plan. It later tried to share the work. In 1992 it asked private for-profit carriers for proposals, and after three rounds it had found no contractor for non-emergency medical trips after hours and on weekends. So in 1994 the council took over wheelchair lift service itself, because St. Johns County EMS no longer had enough vehicles for both emergency and non-emergency calls, and EMS trained the council’s drivers. That history still shapes the county today: one nonprofit plans, books, and drives nearly every public ride.

Florida’s Transportation Disadvantaged program buys rides for residents who cannot drive or pay for one because of age, disability, or income, through one community transportation coordinator per county. The statewide rules, Medicaid enrollment, and vehicle standards are on the Florida guide.

What the Council on Aging runs

The council’s transportation department works from its transit center at 2595 Old Moultrie Road in St. Augustine and runs two public services:

• Paratransit. Door-to-door rides for ambulatory and wheelchair riders, and door-through-door rides for stretcher riders, booked one at a time or as standing trips. Under the service plan, trips run Monday to Saturday from 5:00 a.m. to 6:00 p.m., though the council’s rider guide lists reservations and dispatch Monday to Friday only. The council’s goal is to keep drivers and dispatchers on until 8:00 p.m. as funding and staff allow.
• Sunshine Bus. Deviated routes the council runs for the Board of County Commissioners, Monday to Saturday from 5:30 a.m. to 8:05 p.m. A bus leaves its route by up to a quarter mile on request for a flat $4.00, and the routes connect with transit in Duval and Putnam counties.

A third line, Coastal Transportation, offered private car, bus, and shuttle trips to individuals and small groups. It closed on June 30, 2026.

Who qualifies and how booking works

A ride paid by the state’s trip grant goes to a St. Johns resident with no car in the household and no other program to pay. The rider also needs a disability that rules out the bus, or household income at or under 200% of the federal poverty guidelines. The council asks for proof of income and medical verification and recertifies riders every three years.

Riders call 904-209-3710 between 7:30 a.m. and 4:00 p.m., ideally by 4:00 p.m. the day before. Same-day rides depend on space and need at least two hours’ notice, and nothing books more than seven days out. The service plan sets the pickup window from 30 minutes before to 15 minutes after the scheduled time, and drivers wait five minutes. A cancellation less than an hour ahead counts as a no-show, and suspensions climb from one week for the second no-show in a calendar year to four weeks for the fifth.

The plan caps time on board by the length of the direct drive: 60 minutes for a drive of up to 28 minutes, 90 minutes for one up to 58 minutes, and 120 minutes beyond that. Its on-time goals are 80% of all trips and 90% of appointment arrivals.

Who drives St. Johns County’s trips

The council does. Its service plan says it provides every trip with its own fleet, and the state’s operating report for FY 2024-25 lists no transportation operators and no coordination contractors. That year the council carried 135,694 trips for 3,589 riders, 90,436 of them on the Sunshine Bus and 45,258 door to door. Medical trips made up 18,917, the state’s trip grant paid for 26,275, and Medicaid paid for none. Expenses came to $3,639,407, or $26.82 a trip, against revenues of $3,334,824.

Wheelchair riders account for almost half of the door-to-door work, and stretcher riders for very little:

Door-to-door trips	FY 2024-25	April to June 2026
Ambulatory	23,504	5,425
Wheelchair	21,636	4,991
Stretcher	118	2

The council’s vehicle list, with mileage read on July 30, 2026, counts 39 vehicles, each with a Braun lift or ramp. Only one has a stretcher position: a 2012 Ford E350 with 153,912 miles, listed for retirement in 2022. The service plan says local ambulance service supplements the council for stretcher trips. In the April to June 2026 quarter, the council served 344 door-to-door riders over 71 service days, and 4,003 of those trips were medical.

The 2026 coordinator bid

The council’s term ran to June 30, 2026, so the Northeast Florida Regional Council, the county’s planning agency, issued a request for proposals under chapter 287 of the Florida Statutes. It ran in a local newspaper and the Florida Administrative Register. A committee of regional council and North Florida TPO staff chose the Council on Aging, the coordinating board agreed unanimously, and the regional council adopted Resolution 2026-08. On April 8, 2026, the state Commission for the Transportation Disadvantaged designated the council from July 1, 2026 to June 30, 2031, after its staff confirmed that St. Johns and the nine other areas in that consent vote each drew a single respondent.

Until 2031, the plan leaves one door open to outside carriers: a request for proposals for added operators when demand outgrows the council’s fleet. Two rules in the plan matter if you ever win one. The council must pay subcontractor bills within 15 days of receiving its own payment, and every driver passes an FDLE background check before hire. The draft 2026-2031 plan, on the board’s agenda for September 8, 2026, keeps the same language. For how public ride bids are posted and scored, see government NEMT contracts.

What the council charges

The coordinating board approved the council’s 2026-27 rate model on May 12, 2026, and asked staff whether rates could be reopened later in the year if fuel costs kept rising. The draft 2026-2031 plan, on the board’s September 8, 2026 agenda, lists the state trip grant rates beside the council’s private-pay rates, effective July 2026:

Rate	July 2024	July 2026
Ambulatory trip, state grant	$21.04	$22.04
Wheelchair trip, state grant	$36.06	$37.78
Stretcher trip, state grant	$75.13	$78.70
Private pay, ambulatory, per mile	$2.63	$3.94
Private pay, wheelchair, per mile	$2.63	$6.75
Private pay, stretcher, per mile	$2.63	$14.07

Private riders also pay a loading fee of $2.75 ambulatory, $5.50 wheelchair, or $60.00 stretcher, the same as in 2024. A 10-mile private stretcher ride from the council comes to $200.70 at the July 2026 rates, a useful benchmark if you price your own. The state’s draft trip and equipment grant for St. Johns in 2026-27, published in June 2026, is $768,203 plus an $85,355 local match.

Gaps a ride company can fill in St. Johns County

• Evenings, nights, and weekends. The council provides no after-hours service, door-to-door trips end at 6:00 p.m. and never run on Sundays, and its rider guide lists dispatch on weekdays only. That is the work three requests for proposals could not place three decades ago. See after-hours NEMT.
• Stretcher trips. One stretcher vehicle and ambulance backup leave room for a stretcher van company, including hospital discharges and rides home. Start with how to start a stretcher transportation business and stretcher van requirements.
• Specialist care out of county. The plan names the lack of specialized medical care inside St. Johns County as a barrier that sends many trips outside the service area, and the council runs them only when the funding source approves. See long-distance medical transport.
• Private pay. Coastal Transportation’s closing removed the council’s private car and shuttle line, and the council’s own paratransit page points Medicaid members who prefer it to private-pay rates. See private-pay NEMT.
• Medicaid trips. The plan counts the loss of Medicaid trips from the coordinated system as a barrier, and the council carried none in FY 2024-25. They now run through the brokers below.

Medicaid rides in St. Johns County

St. Johns is in Medicaid Region B under section 409.966 of the Florida Statutes. The state’s NEMT waiver for July 1, 2025 to June 30, 2027 assigns Region B members who have no health plan to MTM Health, which takes routine requests at 1-844-239-5974 at least three business days ahead. MTM’s 2025 capacity table for St. Johns lists 21 vehicles: 7 cabs, 12 lift vans, and 2 stretcher vehicles.

Plan members ride with their plan’s broker. Of the 15,207 St. Johns residents in the main Medicaid plans on August 31, 2026:

• Sunshine Health had 6,967, with rides through Alivi.
• UnitedHealthcare had 4,144, with rides through MTM Health since March 1, 2026.
• Humana had 3,171, with rides through Modivcare.
• Simply Healthcare and Florida Community Care had 925 between them, with rides through Ride2MD.

Counting UnitedHealthcare members alone, MTM Health reaches more St. Johns plan members than any broker except Alivi, before adding the members it serves outside a plan.

What to do first

1. Enroll with Florida Medicaid, then apply to Alivi and MTM Health, then Modivcare and Ride2MD. The owner screening and enrollment steps are on the Florida guide.
2. Call the Council on Aging at 904-209-3685. Ask whether it would buy evening, Sunday, or stretcher trips, and what insurance and driver files it would expect, since its plan allows a request for proposals when demand outgrows its fleet.
3. Price your private-pay trips against the council’s July 2026 rates, especially stretcher and long trips out of county.
4. Ask about the board’s private for-profit transportation seat, vacant on its 2026 attendance record. The Northeast Florida Regional Council takes interest forms at 904-279-0880.
5. Attend the coordinating board on November 10, 2026 at 1:30 p.m., the annual public hearing, at the Council on Aging Senior Center, 179 Marine Street, St. Augustine.

To the north, Duval County works differently: Jacksonville licenses vehicles for hire, and its coordinator buys paratransit trips from contract operators.