February 19

Our View: Start small to address MaineCare rides issues

Scrapping CTS’ contracts won’t help patients if a new system isn’t in place. A better idea: Offer bidding preferences to Maine agencies.

The troubled transportation system that’s kept thousands of low-income Maine patients from accessing needed medical services could face some sweeping changes under two measures that will undergo legislative review starting Wednesday.

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A bus arranged by Coordinated Transportation Solutions drops off Sheena Patel, who has Down syndrome, at her South Portland home last fall after her day at a sheltered work environment. CTS has done an abysmal job at setting up transportation for low-income and disabled Mainers, but immediately canceling CTS’ contracts won’t help patients unless a new system is in place.

2013 File Photo/John Ewing

The spotlight has largely been on the failings of Coordinated Transportation Solutions, the larger of the two companies hired last year to arrange rides for MaineCare recipients in a system that has provided poor service since it started about six months ago.

But while most of the complaints have centered on Connecticut-based CTS, which has been serving most of Maine, that doesn’t mean that the other private broker, Atlanta’s LogistiCare, has been doing a good job in York County. Lawmakers should press for rules that would give a Maine-based nonprofit a chance to win the York County contract, ensuring that that area’s low-income and disabled residents aren’t left at the curb.

Until last August, Maine had a locally controlled system for giving MaineCare recipients transportation to non-emergency appointments, such as doctor’s office visits and trips for lab tests. Then the state, citing a federal mandate, scrapped the arrangement in favor of having regional brokers connect patients with the local providers.

But outsourcing the ride system was not necessary to meet federal regulations. Vermont has retained a locally controlled system for its Medicaid recipients while still managing to meet federal standards.

One measure up for discussion by the Health and Human Services Committee – L.D. 1663 – would cancel the state’s six contracts with CTS, which are set to expire June 30 without being renewed. L.D. 1636, also to be weighed Wednesday, would allow Maine to follow the lead of Vermont, keeping the local nonprofits in charge of the ride system.

We agree that CTS’ performance has been abysmal – and we have called for the contracts to be canceled – but L.D. 1663, as written, isn’t the right way to go about it. Ending the arrangement with CTS won’t help MaineCare patients unless a new non-emergency transportation system is in place. Although L.D. 1636 is a viable option for a different setup, if it doesn’t pass and CTS’ contracts were canceled, how services then would be provided is unclear.

To help low-income and disabled Mainers right away, a good first step would be to change the way transportation contracts are awarded, giving preference to local transportation providers. The Department of Health and Human Services has said it could implement this rule change without getting federal approval. But the shift should apply to York County as well as to the regions served by CTS (the rest of the state, with the exception of Penobscot and Piscataquis counties).

Regardless where they live, the most vulnerable among us should be able to access medical services without having to worry that they’ll be forgotten or stranded along the way.

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