New Hanover County Medicaid Transportation: The DSS Vendor Contracts, Taxi Insurance, and the Wave Grant

New Hanover County does not hand its NC Medicaid Direct rides to one operator. Department of Social Services (DSS) staff schedule every trip themselves and spread the work across a panel of taxi companies, wheelchair van companies, and Wave Transit, the Wilmington-area public transit authority. The county picks that panel through one bid it shares with its Senior Resource Center, so a single proposal can win both kinds of work.

North Carolina’s county DSS offices have arranged rides only for NC Medicaid Direct and EBCI Tribal Option members since July 1, 2021, and health plan members ride through Modivcare or MTM Health. The state manual MA-2910 (revised March 16, 2026) makes each DSS vendor enroll in NCTracks, pay for a random drug and alcohol testing program, and pass a yearly county review, and the North Carolina guide and the story on the 2025 rate cut reversal cover the statewide rules and pay.

Who books Medicaid rides in New Hanover County

DSS sits inside New Hanover County Health and Human Services at 1650 Greenfield Street in Wilmington. Riders call 910-798-3500 and choose option 7. As of October 2026, the county asks for three days’ notice for trips inside the county and five days for trips outside it, and a physician must verify that an out-of-county trip is needed.

DSS staff assess each rider and assign the least costly mode that fits, then pick the vendor after weighing the rider’s needs, the clinic’s location, and each vendor’s price. The bid says service runs 24 hours a day, every day of the year. DSS books trips up to 30 days ahead and sends each vendor its schedule as a spreadsheet file three days before the appointment. Same-day trips go out only when a doctor says the need is urgent.

The county’s answers printed in the March 2024 bid give a picture of the work:

• Volume. About 5,465 DSS trips a month in 2023, and about 65,580 in fiscal 2023.
• Wheelchairs. 13,116 of the fiscal 2023 trips, about 20%, were for wheelchair riders.
• Standing orders. About 35% of trips are for riders with a daily need, such as dialysis or Elderhaus, the local PACE program. See standing orders.
• Will-call returns. About 40% of DSS riders prefer a will-call trip home over a set pickup time.
• Distance. In-county trips average 12 to 18 miles round trip. Out-of-county trips are 15% to 20% of monthly trips and average about 300 miles round trip, to places such as Raleigh, Durham, Chapel Hill, Charlotte, and Jacksonville. See long-distance medical transport.
• No-shows. About 5% of trips. The county’s answers say riders must cancel 24 hours ahead.

How the 2024 vendor bid worked

The county published its request for proposals on March 1, 2024, held a pre-proposal meeting online on March 14, answered questions on March 28, and took proposals until 5 p.m. on April 11. The schedule set July 1, 2024 for service to begin. A company could bid on DSS work, Senior Resource Center work, or both, and the county issues the two as separate contracts. Only the DSS contract needs NCTracks.

Each contract runs one year, with up to four one-year renewals. A vendor may ask for a rate increase by February 1 for the year starting July 1, capped by the national consumer price index for urban consumers. In times of extreme inflation, a mid-year increase is possible only if the Wilmington-area index runs more than 8% above its baseline for three months in a row.

The price sheet prefers flat rates and lists ambulatory and wheelchair trips, each inside and outside the county, plus a group rate for five or more riders. A one-way trip pays half the round-trip rate. Proposals were scored on company experience and financial strength (25 points), the management team (20), the program and staffing plan (20), price (25), and fleet size with the number of wheelchair vehicles (10).

Who got in

Fourteen companies answered. On May 10, 2024, the review panel recommended 10. Port City Taxi ranked first with 92.17 points and Wave Transit second with 85.00. Two proposals were turned down as priced too high for the market, and two for incomplete bid packets. Seven of the ten appear on the list of DSS vendors printed in the bid’s answers, three do not, and the lowest recommended score was 36.33 of 100.

You did not need an NPI or NCTracks number to bid. The award letter is what lets a new company apply to NCTracks, and the county gives you 10 business days after the award to file, or it may move to the next qualified company.

What vendors need

Insurance, and the taxi question

For vans, the 2024 bid asks for:

• General liability. $1 million per occurrence, with New Hanover County, not the department, as additional insured on form CG 20 26.
• Auto liability. $1.5 million bodily injury per person, $1.5 million per accident, and $1.5 million property damage, covering hired and non-owned autos, plus $2,000 in medical payments.
• Workers’ compensation. Statutory limits with a waiver of subrogation, and employer’s liability of $1 million, $1 million, and $1 million.

The bid’s separate taxi section asks for the same auto limits. A bidder pointed out that the contract then in force took $100,000/$300,000 for taxicabs, saying $1 million or $1.5 million was not obtainable for taxis in North Carolina. The county answered with the state manual: for-hire vehicles must carry $1.5 million on vehicles with 15 or fewer seats, but taxi limits are set by local ordinance, and Wilmington’s is $100,000/$300,000/$50,000. Those numbers match the financial responsibility G.S. 20-280 sets for every taxicab operator. Inland Sampson County asked for the same $100,000/$300,000/$50,000 auto limit in its August 2025 bid. Before you quote, get the county’s answer in writing on which limit applies to your vehicles. See NEMT insurance requirements and adding NEMT to a taxi business.

Permits, drivers, and vehicles

• City permits. The bid asks for a passenger vehicle for hire company operating permit and current City of Wilmington permits for every vehicle and driver. As of October 2026, a Wilmington Police Department taxi or vehicle-for-hire permit costs $15, and the driver also pays $18 to the FBI for a background check, brings drug screen results (a screen costs $25 to $35), and brings a letter of introduction from a taxi company.
• Drivers. At least 18, with a North Carolina license, no DUI or DWI in 10 years, no more than two chargeable accidents or moving violations in three years, no suspension in five years, and a clean criminal background check. DSS must approve every change to your driver list.
• Testing. A random 10-panel drug test and alcohol test for every driver at least once a year at your cost, and a post-accident test within two hours.
• Vehicles. ADA compliant, with a working two-way radio, and only the vehicles the county has approved. Your backup plan for a breakdown cannot use rental or leased vehicles.

Trip rules and pay

• Ride time. No more than 60 minutes on board, except on out-of-county trips. See maximum ride time.
• Pickups on call. The pickup for an outbound trip comes within 45 minutes of the rider’s call, and riders must arrive within their appointment times.
• Late fees. If your late arrival makes a clinic charge the rider a late fee, you pay it.
• Incidents. Report any accident by phone within 15 minutes, with the written form within 24 hours, and keep a contact reachable around the clock.
• No-shows and waiting. Neither is paid.
• Billing. Invoices and signed ride slips are due by the 5th of each month. Electronic signatures are accepted, and DSS asks for a completed DMA-5118 form confirming each Medicaid appointment.

Wave Transit and the 2026 state grant

Wave Transit, the name the Cape Fear Public Transportation Authority operates under, is both a DSS vendor and the county’s partner in a new state grant. Its June 2026 financial report shows $239,272 in fiscal 2026 revenue from New Hanover County DSS trips billed through NCTracks.

On June 4, 2026, the NC Board of Transportation approved project 27-CO-052, a $399,939 coordination capital grant paid entirely with state money, naming the authority and New Hanover County as participants. NCDOT’s July 2026 project list says it will combine Wave and county transportation services into one coordinated model to improve efficiency and provide ADA-compliant medical transportation. Wave’s August 2026 board report says the money buys an accessible vehicle built for long-distance trips to specialized care in other parts of North Carolina, names the Senior Resource Center as Wave’s partner, and sets service to start later in 2026. If long out-of-county runs are part of your work, ask DSS and the Senior Resource Center how the new service will change who drives them.

The Senior Resource Center arranges its own medical rides for residents 60 and older who are not on Medicaid, inside the county, booked at least seven days ahead and driven by local vendors from the same bid. In fiscal 2023 it provided 13,586 trips, and on August 27, 2026, Wave’s board backed $96,000 in Section 5310 money for the center’s rides, with a $19,200 local match.

What to do first

1. Get ready for NCTracks. Have your business, ownership, and vehicle papers in order so you can file within 10 business days of an award. MA-2910 lets a NEMT company enroll without an NPI.
2. Call 910-798-3500, option 7, and ask when DSS expects its next vendor bid and which trips it is short on, especially wheelchair and out-of-county runs.
3. Settle your insurance class. Decide whether you run as a taxi company or a for-hire van company, and price the matching limits.
4. Get Wilmington permits for every vehicle and driver before you bid.
5. Sign up for the county’s email bid alerts on its Bid Postings page, and bid on the Senior Resource Center contract too.