Thursday, April 24, 2014
Lawmakers will get a progress report Tuesday on the troubled MaineCare rides program, a briefing that may determine whether legislative leaders will press for the state to cancel contracts that have led to thousands of complaints and missed rides.
Other than committee briefings, the Legislature has remained mostly in the background as reports have shown a deeply flawed system that costs Maine taxpayers more than $40 million and, in its first three months, has left thousands of poor or disabled people without rides to and from medical appointments.
The company that was hired to arrange rides in most of the state, Coordinated Transportation Solutions of Connecticut, vastly underreported the number of complaints it received in the first month of its $28.3 million, one-year contract with the Department of Health and Human Services.
Limiting service complaints is a key requirement of the three ride brokers’ contracts, but the agreement leaves a low bar for compliance. The contracts say that complaints must be below 1 percent of the number of patients who are eligible to receive MaineCare rides, rather than 1 percent of those who actually use the system.
About 279,000 people statewide, including 205,000 in Coordinated Transportation Solutions’ service area, are eligible for MaineCare rides, but only about 45,000 use the service. That means the broker could report 2,000 complaints per month and still meet that performance standard.
According to the DHHS, the company received 3,662 complaints by phone in August, nearly 23 times the number it reported in a written log. Company President David White said his staff was overwhelmed in August so it could not keep track of the complaints.
Nonetheless, some lawmakers are questioning a performance standard that allows the company and other brokers to fail repeatedly.
Rep. Richard Farnsworth, D-Portland, said the performance metric is “worthless.”
“I mean, how big a hole do you need to have in a wall in order to walk through it?” he said Monday.
John Martins, spokesman for the DHHS, said the agency drafted the performance standards for the contracts. In the old system, he said, the transportation providers only billed for their services and there was no metric for missed rides.
The agency switched to the regional program run by ride brokers on Aug. 1. The change addressed federal concerns that the previous system, in which local agencies arranged and provided rides, lacked accountability and transparency.
Despite those concerns, complaints about missed rides were relatively few. That hasn’t been the case with Coordinated Transportation Solutions or LogistiCare, the Atlanta-based broker that has a $5.1 million contract to cover the York County region.
Marylou Dyer, managing director for the Maine Association for Community Service Providers, told lawmakers this month that complaint data provided to the state will never “show what’s happening on the ground.” She said the brokers were 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 told the Legislature’s budget-writing committee.
Maine officials have given Coordinated Transportation Solutions until December to show significant improvement. But the state doesn’t have a backup plan if the contracts are canceled.
Representatives for local nonprofits that had been coordinating rides, such as the Portland-based Regional Transportation Program and the Kennebec Valley Community Action Program, have said they could revive that system.
The pressure on the brokers to improve performance has come mostly from state officials. Farnsworth, co-chairman of the Legislature’s Health and Human Services Committee, said Monday that legislative leaders have relied on his committee to lead the scrutiny.
“Leadership has left it in the committee’s hands,” he said. “That’s why it’s coming up on a consistent basis (during meetings). At some point, if we get to a drop-dead date in December and there still hasn’t been any progress made, that’s the point where leadership might get involved.”
Rep. Deborah Sanderson, R-Chelsea, the ranking Republican on the committee, said she is awaiting Tuesday’s progress report. She said missed rides should be the exception, not the norm.
“There’s always going to be some transitional hiccups, but this certainly has been a nightmare for many folks who have been relying on these rides to either get to appointments or day programs,” she said. “Some who get to their day programs are not sure how they’re going to get home.”
Sanderson said she isn’t sure if the compliance barrier is too low for the brokers, but she said complaints shouldn’t be underreported.
“Personally, my tolerance threshold is that none of these folks should miss a ride, ever,” she said. “As far as holding the (DHHS) accountable, I don’t know until we hear back from the department (Tuesday).”
She added, “I am very anxious to hear the report-back to see if there’s any improvement. If there’s not, then I want to know what the department is going to do to make sure these folks get their rides.”
Farnsworth said the brokers and DHHS officials have been asked to attend the meeting. The department has been asked to provide copies of the contracts and steps it has taken to “make things right” for patients and their families who have not been served properly.
Martins, the DHHS spokesman, said the department was drafting its response Monday.
This story has been clarified to note that DHHS drafted the performance standards for the broker contracts.Steve Mistler can be contacted at 620-7016 or at:firstname.lastname@example.orgTwitter: @stevemistler