# Gaston County ACCESS Transportation: How Private Carriers Get Its Medicaid Overflow Trips

Canonical URL: https://nemtguide.com/states/north-carolina/gaston-county/ · Updated 2026-10-06

Gaston County ACCESS Transportation is the county's own ride department in Gastonia. It books rides for NC Medicaid Direct members, drives them in county vans when it can, and hands the overflow to private carriers it picks by request for proposals. The latest, RFP 2026-003, closed August 24, 2026, and the county commissioners approved four carriers on September 22, 2026.

- ACCESS drives Gaston County Medicaid Direct trips itself when it can and buys the overflow from private carriers under contracts that set rates only.
- The county opened its last NEMT bid for just 20 days, from August 4 to August 24, 2026, and approved four of 12 proposals.
- Three of the 12 proposals in 2026 were not scored because the forms were not completed as instructed.
- The 2023 bid required an NCTracks approval letter for taxonomy 343900000X before the county would issue a contract.
- Under its 2023 contract terms, ACCESS does not pay carriers for Medicaid no-shows or driver wait time.

## Gaston County NEMT at a glance

| Fact | Details |
| --- | --- |
| Who arranges county rides | ACCESS Transportation, the county ride department inside the Gaston County DHHS Social Services Division in Gastonia |
| Booking line | 704-866-3206. Riders call at least 3 business days ahead; ACCESS vans run 4 a.m. to 6 p.m. on weekdays. |
| When carriers get trips | ACCESS drives a request itself unless requests are far more than it can handle; then it uses private carriers |
| Latest NEMT bid | RFP 2026-003, posted August 4, 2026, due August 24, 2026. 12 proposals, 4 awards approved September 22, 2026. |
| Bid before that | RFP 2023-TRANS001, due December 22, 2023. 5 proposals, 4 awards approved April 23, 2024. |
| What a contract sets | Rates only, with no dollar total. Carriers bill NCTracks, and the county can award more than one contract. |
| How rates are quoted | Price per mile inside Gastonia, inside the county, and to 13 other NC counties, plus wheelchair, geri chair, and stretcher (2023 form) |
| Auto insurance asked | $1.5 million for vehicles seating 15 or fewer, $5 million for 16 or more (2023 packet) |
| Trip standards | No more than 0.25% of Medicaid trips missed in a contract year and no more than 5% late drop-offs in a month |
| Gastonia for-hire license | None on the books. Ordinance 18-670, adopted August 7, 2018, repealed the city code division on vehicles carrying passengers for hire. |

## Who arranges rides here

- [Gaston County ACCESS Transportation](https://www.gastongov.com/164/ACCESS---Transportation): Books county and NC Medicaid Direct rides; appointment desk 9 a.m. to 4 p.m. weekdays. (704) 866-3206
- ACCESS Transportation Administrator: Runs ACCESS and takes complaints about trips and drivers. (704) 866-3254
- [Gaston County DHHS Social Services business office](https://www.gastongov.com/Bids.aspx): Sends the NEMT proposal packet and takes proposals when a bid is open. (704) 869-6907
- [Gaston County DHHS Social Services Division](https://www.gastongov.com/487/Economic-Services): Decides Medicaid eligibility for county residents. (704) 862-7500

Gaston County runs its own ride department. ACCESS Transportation, which the Board of County Commissioners created in 1981 as Central Transportation, is the clearinghouse for every county human service agency. It looks for the cheapest suitable ride for each request, drives riders in county vans when it can, and turns to private carriers when requests are far more than it can handle. That overflow is how a private NEMT company in Gastonia gets county Medicaid work.

Statewide, NC Medicaid's ride page (modified September 28, 2026) sends NC Medicaid Direct and EBCI Tribal Option members to their county social services office, while health plan members book through their plan's ride line, such as [Modivcare's North Carolina network](https://nemtguide.com/brokers/modivcare/north-carolina/). The state manual MA-2910 (revised March 16, 2026) makes every county vendor sign a written contract, enroll in NCTracks, pay for its own random drug and alcohol testing, and face a yearly county review; the [North Carolina guide](https://nemtguide.com/states/north-carolina/) covers those rules.

## How ACCESS books Medicaid rides

The state's county directory lists 704-866-3206 as Gaston County's Medicaid transportation number, which is the ACCESS line. The ACCESS service policy (PDF dated January 6, 2025) sets the rules riders hear before you ever pick them up:

- **Booking.** The appointment desk takes calls from 9 a.m. to 4 p.m., Monday through Friday. Riders call at least 3 business days ahead, and a shorter request needs the Transportation Administrator's approval.
- **Paperwork.** Medicaid riders need a verification form completed and signed by the doctor or treatment center they visit.
- **Pickup windows.** Riders must be ready one hour before an appointment inside the county and two hours before one in Mecklenburg, Cleveland, or Lincoln County.
- **Waiting.** County drivers wait 3 minutes for a rider who walks to the van and 5 minutes for a rider in a wheelchair.
- **Cancellations.** Riders cancel at least 24 hours ahead. Three late cancellations can bring a suspension, a small fee, or loss of service.
- **Curb to curb.** County drivers do not help riders past the curb, and riders who need help bring their own escort.

County vans run from 4 a.m. to 6 p.m. on weekdays. They stop on nine holidays and on staff training days, the third Friday of March, June, September, and December. The 2023 contract terms reached past those hours: carriers were asked to cover 4 a.m. to 8 p.m. on weekdays, every holiday but Christmas and New Year's Day, and some evening and weekend work on notice, and to get dialysis riders to treatment on time even outside normal hours.

## How the county picks its carriers

ACCESS buys overflow service by request for proposals. Its notice for an August 25, 2026 public hearing on its yearly NCDOT transit grant application says county transportation is provided by ACCESS and private vendors together.

### The two most recent bids

- **RFP 2023-TRANS001.** Issued November 28, 2023, and due December 22, 2023, it covered seven service areas, from Medicaid NEMT and senior services to Work First, veterans, rural general public, elderly and disabled, and contracted transportation. Five proposals for Medicaid trips came in. One was not scored because the pricing form had no authorized signature. Commissioners approved four carriers on April 23, 2024.
- **RFP 2026-003, Non-Emergency Medicaid Transportation.** Posted August 4, 2026, with questions due August 17 and proposals due by email at 5 p.m. on August 24. The DSS business office sent the packet on request. Twelve proposals came in, three were not scored for not completing the documents as instructed, and two reviewers scored the rest on August 28. Commissioners approved four carriers unanimously on September 22, 2026.

The board item for each award says the contracts carry no dollar amount, because they only set rates and Medicaid pays through NCTracks. It also says the county can award more than one NEMT contract.

### How proposals were scored

The 2023 packet weighted value for cost at 30%, the proposal response at 25%, qualifications and experience at 25%, references at 10%, and disadvantaged business efforts at 10%. An evaluation committee sends its pick to the county's Transportation Advisory Board, which recommends the award to the county manager or the commissioners. Its 2026 roster includes a member representing private transportation providers.

The ACCESS procurement policy, approved August 26, 2025, matters for timing. An unsolicited proposal does not by itself lead to a contract, and while a bid is being scored, companies may not discuss it with evaluators or staff other than the designated Social Services director. A pitch between bids would have to be opened to competing proposals before any award. The general approach to bids like this is in [how to win government NEMT contracts](https://nemtguide.com/guides/government-nemt-contracts/).

## What the contract asks of you

These requirements come from the 2023 packet, the last one posted in full. Ask for the 2026 packet to see what changed.

1. **NCTracks first.** You must show an approval letter from NCTracks for taxonomy 343900000X, non-emergency medical transportation, before the county issues a contract.
2. **Driver files.** For each driver: a North Carolina license, a motor vehicle record, a criminal background check, and pre-employment and random drug and alcohol test results. Drivers must be at least 21 with no points for moving violations in the two years before the contract, which is stricter than the state manual's minimum age of 18.
3. **Testing.** Random drug and alcohol testing under 49 CFR Parts 655 and 40, at your cost. See [NEMT driver drug testing](https://nemtguide.com/guides/nemt-driver-drug-testing/).
4. **Training before the first trip.** First aid and CPR, drug and alcohol awareness, OSHA bloodborne pathogens, ADA equipment and safety, ADA sensitivity, and defensive driving, with yearly refreshers, all at your cost.
5. **Vehicles.** A current North Carolina inspection on every vehicle, a list with mileage and service records, daily pre-trip and post-trip condition reports, and random inspections and quarterly audits by ACCESS. You must be able to field two vehicles at once, one of them wheelchair accessible, and reach most county locations within two hours.
6. **Insurance.** Auto liability of $1.5 million for vehicles seating 15 or fewer and $5 million for 16 or more, general liability of $1 million per occurrence and $1.5 million aggregate, and workers' compensation with $1 million employer's liability.
7. **Performance.** No more than 0.25% of Medicaid trips missed in a contract year and no more than 5% of drop-offs late in a month. You report no-shows daily and keep a log of rider complaints within your control.
8. **No hand-offs.** You may not subcontract any part of the service without the county's written consent. See [NEMT subcontractor work](https://nemtguide.com/guides/subcontract-nemt-trips/) before you plan to share trips.

### How you get paid

The 2023 pricing form asked for a price per mile in each zone you choose to serve: inside Gastonia, anywhere in the county, and from the county to Mecklenburg, Lincoln, Cleveland, Cabarrus, Iredell, Catawba, Rowan, Forsyth, Guilford, Durham, Orange, Wake, and Franklin counties, plus separate lines for wheelchair, geri chair, and stretcher trips.

You bill each Medicaid trip to NCTracks against the county's authorization. The 2023 terms also asked for one invoice a month, due by the 9th of the following month, with trip sheets showing who requested the ride, the pickup and destination, and the mileage, plus a signed DHB-5118A verification form for every trip. A trip without the form is not paid. ACCESS does not pay for Medicaid no-shows or driver wait time, and checks the county itself pays come from its Finance Department, typically 30 days after it receives your invoice. If you drove county trips in late 2025, [North Carolina's reversal of its 3% NEMT rate cut](https://nemtguide.com/news/north-carolina-nemt-rates-restored/) explains how those payments were corrected.

## Local licenses in Gaston County

The ACCESS contract requires every license that the county and the cities where you operate demand. Gastonia, the county seat, no longer has one for ride companies: Ordinance 18-670, adopted August 7, 2018, repealed the city code division on motor vehicles carrying passengers for hire, and those sections now sit reserved. Other towns in the county keep their own codes, so ask the clerk wherever you plan regular pickups.

The county itself licenses ambulances. Section 10-50 of the county code makes it unlawful to run an ambulance service in the county without a franchise from the commissioners, except for ambulances passing through or coming in from outside the county. This matters only if you add ambulances to your fleet.

## What to do first

1. **Enroll in NCTracks** as a NEMT provider and get the approval letter, since the county will not contract without it.
2. **Build your compliance files now:** a random testing program, driver records, training certificates, and insurance at the 2023 limits.
3. **Sign up for bid alerts** on the Gaston County Bid Postings page and watch the DHHS Social Services Division category. The 2026 bid was open for 20 days.
4. **When a bid opens, request the packet at once,** send questions before the deadline, complete every form exactly as asked, and sign the pricing page. Incomplete proposals were dropped in both the 2023 and 2026 bids.
5. **Look for other trips in the meantime.** Health plan members in the county ride through their plan's broker, and next door the [Mecklenburg Transportation System](https://nemtguide.com/states/north-carolina/mecklenburg-county/) buys trips from contract vendors too.

## Frequently asked questions

### What is Gaston County ACCESS Transportation?

ACCESS is the county department that arranges rides for Gaston County's human service agencies and some general public riders. The Board of County Commissioners created it in 1981 as Central Transportation, and it was later renamed ACCESS. It sits in the DHHS Social Services Division, runs its own vans from 4 a.m. to 6 p.m. on weekdays, and books NC Medicaid Direct rides on 704-866-3206.

### Does ACCESS use private NEMT companies?

Yes, for overflow. ACCESS drives a request itself unless requests are far more than it can handle, and then it hands trips to private carriers under contract. The county picks those carriers by request for proposals. In September 2026 the commissioners approved four carriers from RFP 2026-003. In April 2024 they approved four from RFP 2023-TRANS001.

### When will Gaston County bid NEMT work again?

No date is posted. The 2023 packet set a one-year term starting February 1, 2024, with two optional one-year extensions, and the county bid again in August 2026. Sign up for alerts on the county's Bid Postings page, because the 2026 bid was open only from August 4 to August 24. The ACCESS procurement policy says an unsolicited proposal does not by itself lead to a contract.

### How does a contract carrier get paid for ACCESS Medicaid trips?

You bill each trip to NCTracks after the county authorizes it. The 2023 contract terms also asked for a monthly invoice by the 9th of the next month, with trip sheets showing pickup, destination, and mileage, plus a signed DHB-5118A verification form for every trip. A trip without the form is not paid, and those terms rule out pay for Medicaid no-shows and driver wait time.

### Do I need a Gastonia taxi or for-hire license?

The City of Gastonia code has no for-hire vehicle license now. Ordinance 18-670, adopted August 7, 2018, repealed the division that covered motor vehicles carrying passengers for hire, and those sections are reserved. The ACCESS contract still requires every license that the other towns where you operate demand, so check with each town clerk.

### What do Gaston County Medicaid riders call to book a ride?

NC Medicaid Direct members call ACCESS at 704-866-3206, the number the state's county directory lists for Gaston County Medicaid transportation. The appointment desk is open 9 a.m. to 4 p.m. on weekdays, and riders book at least 3 business days ahead. Members of a Medicaid health plan call their plan's ride line instead.

## Official resources

- [Gaston County ACCESS Transportation](https://www.gastongov.com/164/ACCESS---Transportation)
- [Gaston County Bid Postings (sign up for bid alerts)](https://www.gastongov.com/Bids.aspx)
- [Gaston County ACCESS Service Policy (PDF)](https://www.gastongov.com/DocumentCenter/View/7117/Gaston-County-ACCESS-Service-Policy-PDF)
- [Gaston County RFP 2023-TRANS001 packet (PDF)](https://www.gastongov.com/DocumentCenter/View/5323)
- [NC DHHS: MA-2910 county NEMT manual](https://policies.ncdhhs.gov/wp-content/uploads/MA-2910-.pdf)