BELFAST, Maine — Driver Winnie Fowler unlocked the maroon Waldo County Transportation minivan early Wednesday morning and double checked the list of her first pickups of the day — three people with special needs who live in downtown Belfast and needed a ride to work.
She and the other drivers from the Waldo Community Action Partners program help some of the most marginalized people in the county get to where they need to go. That includes chemotherapy treatments, dialysis appointments, physical therapy sessions, the grocery store, preschool, methadone clinics and more.
“I never knew how many illnesses there were until I started driving,” Fowler said. “There’s a lot of people hurting.”
In a large, rural state with limited public transportation options, services such as those offered through Waldo CAP is critical. But after the state switched to a new transportation brokerage system for its MaineCare patients on Aug. 1, officials say many of those marginalized people have started to slip through the cracks. The new broker that serves Waldo County and surrounding areas is Coordinated Transportation Solutions, a Connecticut-based company that recently opened an operations center in Lewiston. That company referred media calls to the Maine Department of Health and Human Services.
“It is a difficult transition,” Ed Murphy, the Waldo CAP transportation director, said this week. “It is a slow process.”
Last year, his organization served 2,021 people, with drivers logging a total of 2.6 million miles. But since the switch at the beginning of the month, the rides have declined by about half and frustrated riders have reported spending hours on the phone to the new brokerage company to get into its system. Although Waldo CAP and other transportation providers around the state have made efforts to ensure that people who need rides to medical appointments such as dialysis and chemotherapy have been getting there, it has been hard.
“It is a stressful situation, no question about it,” said Keith Small, executive director at Waldo CAP. “We’re doing what we can with our more limited authority, but whenever you setup a new system it’s fraught with unanticipated problems. I’m sure there’s some people no doubt falling through the cracks.”
Prior to the switch, it would take just a couple of minutes for clients to arrange a ride through Waldo CAP, and the change has been daunting to many. John Burns of Belfast has cancer and has an operation at PenBay Medical Center in Rockport coming up soon. He also has a Tracfone with limited minutes to wait on hold with the new brokerage company.
“I called them 53 times and I’ve never gotten through,” he said this week. “Prior, it ran like a top. I just finished 37 radiation treatments at the Alfond Cancer Center in Augusta. Now, I don’t know what to do.”
Burns said he’s wondering if he needs to cancel his operation.
“I don’t have any confidence in this company — I can’t find a human being,” he said.
Stefanie Nadeau of the Maine Department of Health and Human Services said that Coordinated Transportation Solutions, which is serving six of the eight regions around the state, is trying hard to make improvements.
“We’re working to make sure we are overcoming these implementation hurdles,” she said. “Every day, we see progress … We absolutely understand that this has not gone as smoothly as any of us would have liked.”
She said that the switch happened because Maine needed to be in compliance with regulations issued by the federal Centers for Medicare and Medicaid Services. The government was concerned that if brokers of transportation services were also providers of those services, there could be potential conflicts of interest, she said.
“This was always about compliance,” she said.
The state awarded contracts for brokerage services around the state to three different companies or organizations: Penquis in the Bangor area, Logisticare in York County, and Coordinated Transportation Solutions. The statewide agency has received complaints since the changeover in each region around the state, though fewer about Penquis, which already had been acting as the transportation broker.
Ideally, the division of transportation broker from service provider will allow the state more oversight, John Martins of DHHS said.
“It puts us in a position where we can hold the broker accountable long-term,” he said. “That’s something we didn’t have in the past. In the long-term, it will put us in a position where we’ll really be driven by data and accountability. In the short-term, the problems that exist today may have existed two weeks ago.”
However, the chorus of frustrated, angry voices from MaineCare recipients who are suddenly worried about their ability to get to medical appointments, work and more is loud and clear.
“I tried getting through the new broker people. It’s been totally horrendous,” Rose McAdams, a retired firefighter from Palermo, said. “I have a husband living in a hospital bed in the living room. I’ve missed doctor’s appointments because of this. It’s totally unacceptable.”