A contractor that the state hired to arrange rides to medical appointments for MaineCare patients dramatically underreported the number of complaints it got in its first month on the job, which made it appear that the company was meeting the state’s job performance standards.
Coordinated Transportation Solutions of Connecticut gave the Maine Department of Health and Human Services a log book detailing 160 complaints in August. In reality, 3,662 calls poured into the company’s “complaint line” during the month, the DHHS said.
The Portland Press Herald obtained the figures from the state under a Freedom of Access Act request.
John Martins, spokesman for the DHHS, said Tuesday that the actual number of complaints exceeded standards outlined in the state’s one-year, $28.3 million contract with Coordinated Transportation Solutions.
A key critic said the chasm between the contractor’s written report and the actual complaint numbers reveals flaws in the system.
“This is like the fox counting how many hens there are in the hen house,” said state Rep. Richard Farnsworth, D-Portland, House chair of the Legislature’s Health and Human Services Committee.
But David White, president of Coordinated Transportation Solutions, said the company was overwhelmed in August, and not deliberately trying to deceive the state.
White apologized, saying his staff was beset with a myriad of problems when the company launched its service on Aug. 1, and failed to keep up with the task of logging all complaints. He said the company’s performance has since improved.
“We were trying to get rides to people,” White said. “We were not capable of documenting all the complaints. We are by no means saying that there were only 160 complaints in August.”
The other two contractors, Atlanta-based LogistiCare and Penquis, in the Bangor area, did not have the level of discrepancies in their complaint numbers that Coordinated Transportation Solutions had, according to state records.
On Aug. 1, the DHHS switched from a decentralized transportation program operated by local nonprofit agencies to a regional system run by ride brokers, to meet federal incentives designed to protect against abuse of the Medicaid rides system.
Coordinated Transportation Solutions won its taxpayer-funded contract to arrange rides in most of the state. LogistiCare won a $5.1 million contract for the York County region. Penquis was hired to cover the Bangor region.
Since the contractors took over, thousands of patients have missed rides to various medical appointments, and numerous stories have surfaced of elderly patients being left at the curb or people missing needed treatments.
DHHS records show that calls to Coordinated Transportation Solutions’ complaint line decreased from 3,662 in August to 1,299 in September. The log of complaints that the contractor submitted to the DHHS for September is not yet publicly available.
Martins, the department’s spokesman, said the state noticed the discrepancy between the log filed by the contractor and calls on the complaint line, and demanded reporting changes. He said the DHHS asked the contractors to provide weekly counts of complaint line calls.
Martins said the two numbers – complaint line calls and written logs of complaints – will never match exactly because of dropped calls and instances in which one person complains numerous times about the same event, but they should be closer together than what Coordinated Transportation Solutions submitted for August.
“It needs to be in the general ballpark,” he said, and the state expects the numbers to better reflect reality in subsequent reports.
State officials are using calls to the complaint lines to determine whether the brokers are meeting the performance standards in their contracts, Martins said.
However, the contracts spell out that the written logs – not calls to the complaint lines – determine whether the companies meet the standards. That means Coordinated Transportation Solutions’ logbook count of 160 complaints shows that the company complied with its contract.
The contracts also say that total complaints must be below 1 percent of patients who are eligible to receive MaineCare rides – not 1 percent of those who are using the system.
About 279,000 people statewide – 205,000 in Coordinated Transportation Solutions’ service area – are eligible for MaineCare rides. But only about 45,000 people use the service.
That means, according to the contract, that Coordinated Transportation Solutions could have about 2,000 complaints per month and still meet performance standards, at least as defined in the contract.
Farnsworth, the legislator from Portland, said the performance standards are turning out to be far too generous to the companies.
“What good is setting up a metric that doesn’t mean anything?” he said. “It’s easy to get a touchdown when there’s no one within 50 yards of you.”
While the contracts specify performance standards for complaints, they also give the state authority to fire the contractors at any time for any reason. The DHHS has put Coordinated Transportation Solutions on the equivalent of probation for its poor performance, requiring substantial improvements by Dec. 1.
White said his company has made “significant progress” in all areas, and when the numbers catch up to what’s happening, they will show improved service.
But two patients said they haven’t noticed any improvement.
Joe St. Pierre, 33, of Pittston, said he can’t rely on Coordinated Transportation Solutions. He said he has missed almost all of his appointments since August for mental health services and treatment for continuing complications from a back injury he suffered in a car accident.
He said he takes 90 pills per month, and he’s worried that MaineCare won’t cover his prescriptions anymore because he has missed so many appointments. St. Pierre said he also believes he’s on the verge of losing doctors and counselors because he can’t show up for appointments.
St. Pierre said Coordinated Transportation Solutions has made filing a complaint difficult.
“It’s getting to the point I’m sick of trying. I don’t even want to call anymore,” he said.
Cynthia Dow of Augusta, who has severe back problems, said she has called and written numerous complaints, but nothing worked until she figured out a way to mostly circumvent the contractor. Now she calls the Kennebec Valley Community Action Program to arrange a ride, and copies the information to Coordinated Transportation Solutions.
Joe Lawlor can be contacted at 791-6376 or at: