Legislative Democrats demand ‘Plan B’ for troubled MaineCare rides program

Rep. Peggy Rotundo, D-Lewiston, listens during a joint meeting of the Legislature's Appropriations and Financial Affairs and Health and Human Services committees on Oct. 9, 2013.
Scott Thistle | BDN
Rep. Peggy Rotundo, D-Lewiston, listens during a joint meeting of the Legislature's Appropriations and Financial Affairs and Health and Human Services committees on Oct. 9, 2013.
By Scott Thistle, Sun Journal
Posted Nov. 13, 2013, at 5:24 p.m.

AUGUSTA, Maine — Maine lawmakers Wednesday said they want to know what “Plan B” is for a $40 million nonemergency ride program that has foundered since it was transferred to the hands of third-party brokers in August.

“I know in my community there are still very, very significant problems,” said state Rep. Peggy Rotundo, D-Lewiston. Rotundo is the House chairwoman of the Legislature’s Appropriations and Financial Affairs Committee, which learned Wednesday that the system is not only still fraught with problems, it is also costing the state more money.

Information provided by the Legislature’s nonpartisan Office of Fiscal and Program Review showed the program, for the first fiscal quarter of 2013, cost $426,000 more than it did for the same period in 2012.

Rotundo said she was contacted Tuesday by a health care provider who said seven clients did not show up for appointments, all before 10 a.m., because they did not get the rides they needed.

“The people of Maine are paying $28 million for services that are not being delivered,” Rotundo said. “This is a critically serious issue that needs to be solved immediately.”

The brokering agencies have been operating under a state-sanctioned corrective action plan since problems first developed soon after they took over the system.

Under the corrective action plans, they have until Dec. 1 to meet contract requirements, including one that requires no rides be missed.

Of the three brokers, the largest is Consolidated Transportation Solutions, which operates from a Lewiston-based call center and holds a $28.3 million contract. The organization already has been paid $5.2 million, according to data provided to the committee from the Office of Program and Fiscal Review.

It also remains unclear how many rides have been missed even though CTS has reported missing more than 5,000 rides since August, including missing 505 rides the week of Oct. 5.

Because the data is self-reported, some lawmakers questioned its veracity.

Others said that many clients had simply given up on the system because it had become so unreliable. Others questioned whether people were still communicating their concerns to the state given the level of frustration with the new system.

Rep. Megan Rochelo, D-Biddeford, said she had heard the story of one woman, a single mother living in a homeless shelter, who was denied a ride because she needed to bring her children, a toddler and an infant, with her to a therapy appointment.

“When her ride arrived to take her to her medical appointment, she was told her children couldn’t come with her and needed to be left in the homeless shelter,” Rochelo said. “If I were to put myself in her shoes, my first thought after that experience would not be that I should go back into the homeless shelter and call the complaint line.”

Stefanie Nadeau, the director of the Office of MaineCare Services, told the committee the state has options, including terminating contracts with brokers, but is concerned doing so would mean the agencies providing the rides would be left without pay. She also expressed concern that pulling contracts would lead to even greater disruption to the rides program.

“We are at the point where we are trying to assess the risks as well as the benefits of moving in a different direction if that becomes necessary,” Nadeau said.

Nadeau also reiterated that officials in her agency and throughout the Maine Department of Health and Human Services agreed that brokers were not performing to the contract standards.

Earlier this year, the state changed the way the system — which provides rides to medical appointments for those on the state’s Medicaid program, MaineCare — operates based on concerns from the federal Centers for Medicaid and Medicare Services that ride providers had a conflict of interest if they were also scheduling the rides.

Rotundo asked if the department would be in a position to evaluate whether the brokers were making progress under the corrective action plans by Dec. 1.

Nadeau said the state was able to receive data on requests for rides and would then be able to correlate that with whether the ride-providing agencies, like Western Maine Transportation, had actually delivered the rides.

Rep. Mike Carey, D-Lewiston, said he saw a “glimmer of hope” in that the program may be moving in the right direction, but others, including an advocate for the agencies that deliver the rides, differed.

Mary Lou Dyer, managing director of the Maine Association for Community Service Providers, said the new system “was not working well for anyone at this time.”

In a seven-page letter, Dyer outlined many problems, details about rides that have been missed and the costs incurred by both the ride agencies and the medical providers. She also said the new system was burying those who provide the rides in paperwork.

“They estimate they spend at least three times as much time as they spent in the old system,” Dyer said.

“I hate to bring down your glimmer of hope,” Dyer said. “But I am not particularly optimistic.”

The committee will get another update on the status of the program in December.

http://bangordailynews.com/2013/11/13/politics/legislative-democrats-demand-plan-b-for-troubled-mainecare-rides-program/ printed on July 29, 2014