AUGUSTA — After a 2½-hour presentation of data and bureaucratic jargon Tuesday, Daniel Donovan gave lawmakers the statistic that he believes matters most about MaineCare’s new rides program.
Donovan, executive director of the Aroostook Regional Transportation System, said his organization provided 9,762 rides to low-income patients in September.
In September of last year, the number was 16,192.
Donovan asked where more than 6,400 rides went, and what happened to the people who needed them.
In the hearing before the Legislature’s Health and Human Services Committee, state officials acknowledged for the first time that they are exploring contingency plans to use if they cancel contracts with the companies the state hired to run the program, which has left thousands of poor and disabled Mainers without rides to and from medical appointments.
Still, as the third month of the new system ends, many questions about the widespread, chronic problems have yet to be answered by lawmakers or the Department of Health and Human Services, which awarded contracts worth more than $40 million to three brokers that arrange rides statewide.
The contractors told the committee that there has been marked improvement since they started on Aug. 1. Stefanie Nadeau, director of MaineCare Services for the DHHS, acknowledged progress but said the agency is also looking into alternative plans.
“There are significant number of missed rides that continue to occur,” Nadeau told the committee, saying the failure rate is between 0.5 percent and 1.5 percent.
Transportation providers and health care advocates said that rate doesn’t tell the complete story.
Donovan’s 6,400-ride drop-off in September wasn’t unique among his colleagues, several of whom testified Tuesday.
Rick McCarthy, a lobbyist representing the Maine Transportation Association, the trade group for ride providers, said there has been little improvement, and the state should move to cancel contracts.
That may happen if the three contractors – Atlanta-based LogistiCare, Connecticut-based Coordinated Transportation Services and the Maine nonprofit Penquis – don’t improve service by Dec. 1.
Some lawmakers are growing impatient.
Rep. Carol McElwee, R-Caribou, was visibly exasperated during the hearing. She told Nadeau that she’s still getting 10 to 15 calls about missed rides every week. “My constituents are giving up,” she said.
Donovan said he believes that his organization’s clients are frustrated and resigned. While the state is promising accountability and the brokers are promising improvement, he indicated that both are forgetting about the patients.
“I look at stuff a little different than most,” he said. “The department that devised the plan. You have the brokers that won the bids. It was a fair process. But this whole MaineCare piece is … about the people we serve. When this whole process started, I told my staff, ‘It’s not about me, it’s not about you, it’s about the people we serve.’ And that is still the case today.”
David White, president of Coordinated Transportation Services, provided lawmakers with charts and statistics showing declining rates of abandoned calls, decreased hold times and more rides. He said the company got 3,662 complaints in August, 1,299 in September and 824 so far in October.
“We think we have made more than significant progress since August,” White said.
An official from LogistiCare, which covers the York County region, said there were eight missed rides out of 6,000 trip requests last week.
Despite those assurances, committee members said they are concerned. Rep. Deborah Sanderson, R-Chelsea, asked Nadeau what the department is willing to do to repair the system. Nadeau’s response didn’t satisfy Rep. Peter Stuckey, D-Portland.
“Can I get you to share my anxiety?” he asked Nadeau.
She replied, “Can I get you to share mine?”
Multiple reports have shown a flawed system and accountability failures. Last week, the Portland Press Herald reported that Coordinated Transportation Solutions vastly underreported the number of complaints it received in the first month of its $28.3 million, one-year contract.
Limiting service complaints is a key requirement of the contracts, but the agreements leave a low bar for compliance. The contracts say complaints must be below 1 percent of the number of patients who are eligible to receive MaineCare rides, rather than 1 percent of those who actually use the system.
About 279,000 people statewide, including 205,000 in Coordinated Transportation Solutions’ service area, are eligible for MaineCare rides, but only about 45,000 use the service. That means the broker could report 2,000 complaints per month and still meet that performance standard.
John Martins, spokesman for the DHHS, said Tuesday that the department drafted the performance standards. In the previous system, he said, the transportation providers billed only for their services and there was no standard for missed rides.
The DHHS switched to the regional program run by ride brokers on Aug. 1. The change addressed federal concerns that the previous system, in which local agencies arranged and provided rides, lacked accountability and transparency.
Despite those concerns, complaints about missed rides under the old system were relatively few. That hasn’t been the case with Coordinated Transportation Solutions or LogistiCare, which has a $5.1 million contract.
While the brokers report progress, health care advocates and ride providers said Tuesday that the data provided doesn’t reflect the reality.
Jessica Maurer, director of the Maine Association of Area Agencies on Aging, provided more than two pages of complaints from patients, including people who got rides to medical appointments but no rides home. Some were taken home by taxi. In other cases, hospital employees paid for patients’ rides home.
It’s unclear how Maine will proceed if it does end up canceling contracts. DHHS officials have said they plan to maintain a broker system, in part because of the increased federal contribution the state receives.
Representatives for local nonprofits that were coordinating rides, such as the Portland-based Regional Transportation Program and the Kennebec Valley Community Action Program, have said they could revive that system.
Lawmakers may consider another alternative in their next session. Rep. Richard Farnsworth, D-Portland, has submitted a bill that would provide “alternative solutions” for MaineCare rides, but the details of the legislation haven’t been made public.
The Legislative Council will vote Wednesday on whether to hear the bill in the session that begins Jan. 7.
Steve Mistler can be contacted at 791-6345 or at:firstname.lastname@example.orgTwitter: @stevemistler