August 10, 2013

MaineCare contractors must follow strict rules

Those who provide rides have to track complaints and limit them to one percent of their clients or less.

By Joe Lawlor jlawlor@pressherald.com
Staff Writer

The new contractors that arrange non-emergency rides for MaineCare recipients must meet a stringent performance standard, limiting complaints to 1 percent of their clients or less, according to state contracts released to the Portland Press Herald on Friday.

click image to enlarge

Rebecca Lee gets a ride home from her father from the Goodwill Neurorehab Services at Bayside after her regular MaineCare-funded ride failed to show because of a "medical emergency" on Wednesday, Aug. 7.

Gordon Chibroski / Staff Photographer

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But since the companies started serving MaineCare recipients on Aug. 1, hundreds have contacted the state with complaints. Many have said they have missed rides to doctor's appointments, therapy and classes.

"They've already blown right by that 1 percent," said Pam Lee of Kennebunkport, whose daughter is a MaineCare recipient who needs rides to neurological appointments in Portland.

The complaint system spelled out in the contracts relies primarily on the companies to report problems.

Complaints are to be tracked by the companies, which must report them to the state monthly. Complaint logs must be detailed and each complaint must be resolved, according to the contracts.

The contractors must keep complaints each month at or below 1 percent of the clients in each of the program's eights regions.

Rita George-Roux, a volunteer driver in York County, said she has heard horror stories from other drivers and is skeptical of any system that relies on self-reporting.

"I think they'll edit the complaints and only send the ones that aren't as bad," she said.

But state officials said they have ways of knowing whether complaints are becoming numerous, including through the media, and a phone number that people can call.

A letter sent to MaineCare patients in July to let them know about the new system encourages patients to call the ride brokers with complaints, and provides a state Maine-Care number to call.

The new system separates tasks by having brokers arrange rides while separate agencies provide them. Previously, the local agencies that gave the rides also coordinated them.

State officials have said the change was made to eliminate conflict-of-interest concerns by the U.S. Centers for Medicare and Medicaid that local agencies would steer rides to themselves.

The contracts -- totaling $28.3 million to Coordinated Transportation Solutions of Connecticut to cover most of the state and $5.1 million to Atlanta-based LogistiCare for the York County area -- were released to the Press Herald on Friday in response to a Freedom of Access Act request.

State officials and representatives of the companies have said they're working to solve any startup problems.

Robert Baskin, a spokesman for LogistiCare, said Friday that the company takes complaints seriously and uses them as a tool to improve.

"We take the complaints, and in real-time, use them to correct deficiencies in the system," Baskin said.

State Sen. Dawn Hill, D-York, suggested that a system could be set up to notify the state of complaints automatically, as an added check on the companies.

That way, she said, the company officials will realize that the state can keep constant tabs of complaints while not burdening the Department of Health and Human Services with additional duties.

"If the state sees a lot of complaints coming in, that can be a red flag and they can ask about it," Hill said.

Baskin said that while LogistiCare wouldn't discuss a "hypothetical" change in the contract, he noted that the companies compete for the contracts and comply with all state requirements.

"The leverage is always on the side of the state, and not the company," he said.

The state can terminate its contract with a company at any time if the company is not meeting its needs, according to the contract.

Pam Lee, who has distributed her phone number to MaineCare patients to report problems with the transportation system, said Friday that the complaints haven't let up.

"I've been getting lots of calls," Lee said. "It's just as bad as it was (earlier this week)."

Martha Smith of Hollis said her adult daughter has missed half of her rides this week to a camp in Windham, including one on Friday.

"They'll call and cancel at the last minute and strand her out there," Smith said.

Alicia Hallock of Shapleigh said she hasn't missed a ride but she fears that she will.

She's on dialysis for renal failure, so "I can't miss," Hallock said. "This is my life. If I miss, I die." 

Joe Lawlor can be contacted at 791-6376 or at: jlawlor@pressherald.com

Twitter: @joelawlorph

 

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