Thursday, December 5, 2013
The state is on the brink of canceling its contract with a company it hired for $28.3 million in taxpayer funds to arrange rides to medical appointments for thousands of MaineCare patients, according to a memo released Wednesday by the Department of Health and Human Services.
Sheena Patel, 27, is dropped off at her South Portland home by an RTP bus after her day at “Affinity,” an outpatient rehabilitation facility in Portland.
John Ewing / Staff Photographer
Connecticut-based Coordinated Transportation Solutions, which has been the ride broker for six of eight transportation regions statewide since Aug. 1, has been put on the equivalent of probation for failing to provide adequate service, according to a memo dated Monday and signed by Stephanie Nadeau, director of MaineCare services in the DHHS.
The department is giving the company two more months to fix the problems, and some state lawmakers say that’s too much time.
The rides program for low-income Mainers has been in turmoil since the state switched from a system in which local nonprofits arranged and provided the rides, to a system in which regional brokers connect patients with the transportation providers. The DHHS said it made the change to comply with federal rules requiring more accountability and transparency.
In the program’s first two months, thousands of patients have missed rides to doctor’s appointments, therapy sessions, counseling and other medical services.
Now, Coordinated Transportation Solutions must submit a “corrective action” report to the state by Monday and make “significant measurable” improvement by Dec. 1 or it could lose its contract, according to Nadeau. The state could also recover money set aside by the company in a performance bond, the memo says.
“CTS has failed in its service to MaineCare members by: failing to secure an adequate transportation network, failing to provide prompt and competent service at its call center. As a result, thousands of MaineCare members have missed, or been late, for appointments and, in some instances, gone without necessary medical services, among other things,” the memo says. “CTS’s performance failures also have a ripple effect throughout the state, causing caretakers to miss work and causing medical providers to lose revenue.”
Nadeau also wrote to the two other ride brokers the state has hired, LogistiCare for the York County region and Penquis Community Action for Bangor. She mentioned issues that need improvement, but the contractors were not put on probation or threatened with losing their contracts.
The service, required by the federal government, gives rides to MaineCare recipients who don’t have other access to transportation.
The DHHS has refused multiple requests by the Portland Press Herald to release the numbers of complaints that the contractors have received and reported to the state. But Nadeau’s memo says that, since Aug. 1, Coordinated Transportation Solutions “has received over 3,300 complaints from members, and this does not include the numerous complaints received separately by the department.”
The memo contrasts with the largely upbeat, official memo that the DHHS submitted Wednesday to the Legislature’s Appropriations Committee. In that memo, released by the office of Commissioner Mary Mayhew, the company was lauded for its performance in September, “demonstrating improvement in problem areas they saw in August.”
The weekly average of missed trips for patients covered by Coordinated Transportation Solutions declined from 824 in August to 394 in September, according to Mayhew’s memo. The contractor failed to provide rides for more than 4,000 patients through mid-September, out of about 160,000 trips scheduled, the memo says.
“We have made significant progress,” company President David White told the Press Herald on Wednesday. “It’s been a very significant improvement. We are in a very different place than we were in August.”
White noted that Nadeau’s memo says the average time that callers spend on hold has decreased from more than 7 minutes to about 3½ minutes.
But Nadeau wrote that wait times still are too long, and that the contract requires an average of less than a minute.
Nadeau also wrote that the number of people who hang up in frustration should be 5 percent or less, while callers have been giving up on Coordinated Transportation Solutions 15 percent to 58 percent of the time.
Overall, the service has not improved enough, Nadeau’s memo says.
“While there has been some improvement over the last few weeks, information provided to the department demonstrates that CTS has not responded quickly enough to identified deficiencies, and has not provided sufficient resources to remedy the deficiencies,” Nadeau wrote.
Others criticized the contractor Wednesday.
Marylou Dyer, managing director for the Maine Association for Community Service Providers, said the data the DHHS is using will never “show what’s happening on the ground.” She described the two-month experience as a disaster and said any hint of improvement has “flat-lined.”
Dyer said the companies also are making it difficult for people to log complaints for missed or delayed rides. “You have to be very pushy to get an official complaint number with the broker,” she said. “It’s ludicrous.”
A memo signed by Paul Murphy, president of the Maine Transit Association, which represents the ride providers, casts doubt on the system adopted by the state, and suggests an overhaul.
“I would like to report that things are improving and that we have faith in the brokers and DHHS to make this system work. Unfortunately, I cannot,” Murphy wrote. “The number and the significance of the problems we are encountering lead us to question whether this system will ever work.”
State Sen. Patrick Flood, R-Winthrop, a member of the Appropriations Committee, said he was encouraged that the DHHS had indicated that “one ride missed was one too many.” But he said the Dec. 1 deadline to correct the problems seems “weak.”
Rep. Richard Farnsworth, D-Portland, chairman of the Health and Human Services Committee, said in a phone interview that he wouldn’t give CTS another two months to fix problems, when many of the logistical issues should have been resolved by now.
“We should have given them two weeks, not two months. Now we’re going to give them another two months?” Farnsworth said.
Jack DeBeradinis, who heads the Portland-based Regional Transportation Program, a nonprofit that provides rides, said the system is cumbersome and hasn’t improved much since August. He said his agency often doesn’t receive its list of upcoming rides until the afternoon before the rides are needed, rather than a week in advance, which would allow for better planning.
And he said Coordinated Transportation Solutions’ computer software still doesn’t interface with the Regional Transportation Program’s software, bogging down the system.
“We have to work with this ponderous system,” he said. “Our riders have had 40 to 50 percent less efficient service compared to before Aug. 1.”
DeBeradinis said the state inserted a “middle man” that’s bogging down the system and he doesn’t believe it will ever be as efficient as it was.
Glen Herbert of South Portland said his 27-year-old daughter, Sheena Patel, who has Down syndrome, relies on the MaineCare rides program for transportation to a sheltered work environment, and he’s still leery of Coordinated Transportation Solutions, despite some improvements. He said he circumvents the contractor as much as possible.
“I’m not supposed to call (Regional Transportation Program) for a ride, but I’ve been calling RTP on the day of the ride to make sure that Sheena is getting her rides,” Herbert said. “We’re still not confident in CTS.”
The state is threatening to recover funds put up by Coordinated Transportation Solutions in a performance bond for failure to provide adequate service, although the amount available for the state to claim was not available Wednesday, and the company would not reveal the amount.
“Upon issuance of this notice, the department shall also put CTS’s bond holder on notice of its performance failures,” Nadeau’s memo says.
State House Writer Steve Mistler contributed to this report.
Joe Lawlor can be contacted at 791-6376 or at:firstname.lastname@example.orgTwitter: @joelawlorph