October 10, 2013

Our View: Troubled MaineCare ride broker has had its chance

A more local system would appeal to clients and still meet federal regulations.

It’s been a little over two months since the state debuted a revamped system for getting low-income Mainers to medical appointments, contracting with two private companies to coordinate MaineCare rides.

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Sheena Patel, 27, has Down syndrome and relies on the MaineCare rides program for transportation from her South Portland home to a sheltered work environment in Portland, her father says. Coordinated Transportation Solutions – which coordinates MaineCare transportation in the Portland area and most of the rest of Maine – could lose its state contract for failing to provide adequate service.

2013 File Photo/John Ewing

And it’s been almost that long since complaints started flooding in from MaineCare patients about the system, including no-show rides, late rides and long hold times for setting up rides.

Now the state has put one of the ride service brokers on what amounts to probation. Coordinated Transportation Solutions, which serves most of Maine, could lose its $28.3 million contract if it doesn’t address riders’ concerns by Dec. 1.

It’s questionable that giving CTS more time to improve will do anything but prolong a sorry situation. Instead, Department of Health and Human Services officials should plan to revive the old, locally based system and cut ties with CTS as soon as that network is in place.

The state has offered mixed messages about CTS’ progress toward resolving rider complaints. DHHS Commissioner Mary Mayhew recently praised the company’s September performance in an official memo, citing a decline in the number of missed trips.

But a separate memo by another DHHS official – Stefanie Nadeau, the head of MaineCare services – tells a different story. Putting CTS on notice that the future of its contract is inthe balance, Nadeau told the company’s president that patients are still spending too long on hold and that up to 58 percent of all callers hang up in frustration before reaching a live person.

Nadeau’s memo also notes that CTS has received more than 3,300 complaints, not counting the unspecified number of concerns “received separately by the department.”

Now CTS has until the beginning of December to straighten out its problems. But given what we know of CTS’ record so far, it’s hard to envision a turnaround sufficient to ensure that those who need dependable transportation to medical appointments get it.

A much more viable alternative would be for the state to bring back the old system, in which local nonprofits both arranged and provided rides. Indeed, ride providers based in Portland, Aroostook County and central Maine have said they could be ready to jump in within a matter of weeks should the CTS contract be canceled.

Though patients liked the old setup, the state, citing a federal mandate, scrapped the arrangement in favor of having regional brokers connect patients with the local providers. But Vermont has retained a locally controlled ride system for its Medicaid recipients while still managing to meet federal standards.

CTS’ inability to fulfill the terms of its contract means that many low-income Mainers can’t count on being able to access critically needed care. With local agencies prepared to step up – and a nearby state presenting an example of a functioning, federally compliant ride system – there’s no reason for Maine to stick with a system that’s not working.

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