CASE STUDY - The recent growth of Medicaid Transportation Brokerages has meant that many NEMT companies that used to rely heavily on Medicaid trips for much of their revenue have seen their contract work reduced and their trip reimbursement lowered. Such companies have had to cut back operations, some going out of business all together. All the while, others such as D&J Ambulette continue to survive…and thrive. D&J Ambulette Service of Bronx, New York is an example of a NEMT company that has aggressively sought out new markets in order to broaden it's customer base. The following 10 min. video shows how they have used their size and expertise to seek out new business. For example, D&J worked closely with the Adult Day Health Care Director at Providence Rest Adult Day Health Care to identify the program's specific transportation needs, standards, and concerns. The day program wanted clients to be on the bus no longer than 1 hour. They wanted the drivers to show a high degree of professionalism working with the elderly, with attention to safety. They wanted a service that was dependable, and one that would continue to listen and work with the day program. D&J won the contract by showing that they were ready to listen and adapt their service to meet the needs of the day program. Not all ambulette companies would be able to promise a 1 hour on-board ride time, but D&J utilized their size and scheduling expertise to meet this specific prioity. This is also something that ADA Paratransit would not be able to commit to. Paratransit programs are there to compliment transit and fill-in the service gaps in regards to accessibility. It is not mandated to provide customized services for any one particular facility, but this is something that private non-emergency medical transportation providers such as D&J Ambulette can do - and do well.