Thursday, April 17, 2014
The Connecticut company under fire for its work as a contractor for MaineCare’s medical transportation program failed to obtain a performance bond, as required by its contract with the Maine Department of Health and Human Services.
Mary Mayhew, commissioner of the Maine Department of Health and Human Services, would not return calls seeking an explanation for why MaineCare rides contractor CTS never bought a performance bond, which could cost the state significant money.
Joe Phelan/Staff File Photo
Coordinated Transportation Solutions has prompted complaints from thousands of MaineCare patients, who have missed appointments or been stranded because the company has failed to schedule rides for them to doctors’ offices, therapists and other health care providers. The DHHS threatened in October to cancel the company’s $28.3 million, one-year contract. State officials also said the company’s performance bond could be revoked, which would cost the contractor money and help Maine recover funds to improve the program.
But there is no bond to revoke, because Coordinated Transportation Solutions failed to purchase one, a DHHS spokesman said Wednesday.
Democratic legislators accused the DHHS of managerial incompetence and called for reforms in the $40 million program, which is supposed to provide non-emergency transportation and is used by about 40,000 low-income patients.
“This was gross mismanagement,” said Rep. Peggy Rotundo, D-Lewiston. “The state never should have flipped the switch to start the contract without a performance bond being in place.”
The program has been plagued with problems since it started Aug. 1, when the DHHS ended a largely trouble-free system in which nonprofit agencies arranged and provided the rides. The new regional system employs brokers who field requests for rides and book them with transportation providers.
The federal government has pushed for more accountability and transparency in Medicaid programs in recent years, and Maine switched to the regional broker system in response. Medicaid, called MaineCare in this state, is funded with a blend of federal and state money.
A performance bond would help cover the state’s cost to transition to a new broker if it canceled Coordinated Transportation Solutions’ contract. The state is now evaluating CTS, which is on the equivalent of probation for its subpar performance, and officials have said they will decide by December whether to cancel the contract.
It isn’t clear who was responsible for ensuring that CTS obtained the required bond, although Stefanie Nadeau is the director of all MaineCare services for the DHHS.
State officials would say little about the issue Wednesday.
“We acknowledge that Coordinated Transportation Solutions has not secured a performance bond to date,” DHHS spokesman John Martins wrote in an emailed response to questions. “The Executive Branch continues to analyze and evaluate information regarding this situation. We have no further comment at this time.”
Mary Mayhew, health and human services commissioner, did not return calls seeking comment.
CTS President David White declined to comment. “You’ll have to talk to the state about that,” he said in a brief interview.
White has said previously that his company, which was hired to serve most of the state, excluding the Bangor and York County regions, has improved its performance since its troubled August start.
But the company’s credibility has been damaged by discrepancies between the number of complaints it has received and the number it has reported to the DHHS. It gave the department its logs from August showing 160 complaints about missed rides, but a later count revealed the number of complaints was 3,662.
Legislators said the system must be fixed immediately. Some are advocating for the entire system to be scrapped. States have wide discretion in meeting federal standards for accountability in their Medicaid rides programs. Some states, such as Vermont and Pennsylvania, have retained more local systems.
Rep. Drew Gattine, D-Westbrook, said that without a performance bond, the state will have a difficult time recovering money.
“It should have been on everyone’s radar, everyone’s checklist,” said Gattine, who questioned whether any bonding company would issue a bond for CTS now.
“It would be like trying to buy fire insurance after your house has burned down,” he said.
Because the state and the company would not answer detailed questions, it’s unknown how much money the state could have recovered by revoking the bond required by the contract.
Based on another contractor’s performance bond, and assuming administrative costs are similar among contractors, the state could have recovered $600,000 to $700,000. A bond is worth 10 percent of the administrative costs of the contract.
Obtaining a performance bond is a new experience for Penquis, the local agency that is arranging rides in the Bangor region and has had the fewest problems in the new system.
Brian Thibeau, chief administrative officer for Penquis, said the state verbally checked in once to make sure Penquis had its performance bond, but there was no apparent written follow-up.
Jack DeBerardinis, president of the Portland-based Regional Transportation Program, which works with Coordinated Transportation Solutions, said there have been only incremental improvements in the past month. He said his staffers still spend many hours on the phone with the company every day, trying to solve problems.
DeBerardinis said the root of the problem is an inefficient system. “I don’t feel a brokerage system is something that really works all that well in the state of Maine,” he said.
Some lawmakers said that even if the contract is terminated, the system must change.
Sen. Colleen Lachowicz, D-Waterville, proposed a bill that could be taken up in January to compel the state to switch to a different system. “We’ve given this system a chance and it’s not working,” she said. “The time for waiting is over.”
Rep. Rotundo said that every day the state waits to fix the system is a day that people miss rides to crucial appointments. “We need to come together and find a solution,” she said.
Rep. Carol McElwee, R-Caribou, said she didn’t know about the performance bond, but she agrees that CTS has not made enough improvements.
“As far as I’m concerned, representing the residents of Aroostook County, I have not seen the improvement that’s necessary,” she said.
Joe Lawlor can be contacted at 791-6376 or at: