State to Lewiston company: Answer calls, show up or else

After missing more than 4,000 rides and having as many as half of callers hang up over long wait times, the state has put a Lewiston company that arranges rides for MaineCare patients on notice.

It has until Monday to spell out what's wrong and why, and was given two months to turn its performance around.

Coordinated Transportation Solutions, headquartered in Connecticut, took over the non-emergency transportation services contracts for six regions of Maine on Aug. 1.

Since then, CTS in-house data show that from Aug. 1 to Sept. 14, between 15 percent and 58 percent of callers — people needing rides to doctors' appointments and other services — hung up before they reached a live person, according to a memo from Stefanie Nadeau, director of the Office of MaineCare Services.

During those same six weeks, the average wait time to answer a call was between 3 and 24 minutes.

The contract with the state stipulates a less than 5 percent abandonment rate (people hanging up because of long waits), and that 90 percent of calls be answered within a minute.

The ride program has been plagued with complaints since the state awarded the contract to CTS and shifted the scheduling from agencies such as Community Concepts and Western Maine Transportation Services, which used to schedule and provide the rides.

"We've given them chance after chance and are just listening to them time after time with great frustration," state Sen. Margaret Craven, D-Lewiston, Senate chairwoman of the Legislature's Health and Human Services Committee, said Thursday. "When somebody signs a contract and says, 'I can do the work,' we expect them to do the work."

Nadeau's Sept. 30 memo to CTS President David White said patients have missed necessary medical appointments, caretakers have missed work and medical providers are losing revenue.

She gave the company until Monday, Oct. 7, to deliver corrective action plans addressing each issue and until Dec. 1 to show "significant measurable improvement" or risk having the $28 million contract pulled. Nadeau also left open the possibility of the state recouping some of its money from a performance bond held by CTS.

"I definitely agree with it and support and feel like it was really past time," Craven said. "Two months from the department is very generous, but at least it's a start. It's the people and the customers who are at risk and are the big losers here; the taxpayers as well, of course."

In a separate report to the Legislature's Appropriations Committee on Tuesday, Maine Department of Health and Human Services Commissioner Mary Mayhew said CTS had improved from an average 824 missed rides per week in August to 394 missed rides per week in September. She said the company had hired 27 more agents in the past month.

A message left for White on Thursday wasn't returned.

Letter from Maine DHHS to CTS

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 's picture

Re: hi

why did they have to change a good thing when it was working just fine. I use western Maine transportation for rides to medical appointments and it had worked just fine for me. People count on them to pick you up on time and get you there on time.. What is the point of change if it is not going to work out? Put it back the way it was. Thank you

FRANK EARLEY's picture

I can relate to this in a way.................

As a truck driver in the "Dedicated Logistics part of the industry, it was essential to have shipments to the proper locations on time EVERY time. With the Auto industry, one missed appointment might have shut down a plant for a day, costing millions. It was always a struggle. Having knowledgeable people directing the schedules made the job a little easier. The dispatchers in turn needed smart professional drivers who knew they could do the job. There was very little turnover in that industry because you were paid relative to your performance. If you were good the pay was great.
The down side of this operation was that you had to be on time. If it meant leaving earlier than normal to compensate for a blizzard, that's what you did. Excuses were rare. The other problem was the contract for these services were offered for renewal every three years. If a new company came in, they either hired the drivers that knew the routs, or they soon found themselves answering a lot of questions.
One time a new company came in and thought they could do the job a lot better for a lot less. First mistake they made was try to get us drivers to train their new drivers, (just out of truck driving school), the routs. They were there to make our job easier. When they started laying off some of the more senior drivers, we all walked out. they tried doing it themselves and within six months all their brand new trucks were piled up in their abandoned lot, looking more like a junk yard. I mean very new tractors and trailers, just wrecked. It just goes to show you, new isn't always better, and you get what you pay for.............

 's picture

if it works, dont fix it

well state, why did you award a contract to this company in the first place? dont fix what isnt broken, and return to the former way of doing things. it doesnt take a genius to figure this out.


Tragedy waiting to happen

It was broken in a lot of ways. Even before these changes, my nonverbal adult son was being transported by volunteers in the Augusta area with no training. When volunteers weren't available, they'd stick him with random cabbies. Drivers refused to walk him in to his day program even after multiple promises that they would do it. Well, one day a few months ago, the nightmare happened - dumped at program on a day they were closed, and sat there alone in the dark. Of course the residential care provider should not have forgotten it was closed, but that driver would have been the last line of defense and he failed. I pulled my son from the residence and retired from my job so that I could move him back home with me. Too bad I had to leave gainful employment and will no longer be paying taxes, but as long as I'm alive, he will never be at the mercy of those unreliable, dangerous transportation services.

Randall Pond's picture

This was

The Dumbest Thing MaineCare Ever Did. Things were always perfect Western Maine and Community Concepts but, at Least You Got a LIVE Person who most often was Friendly, Polite and got you the ride you needed and if there was a problem they resolved it. This New Company is a Joke and a Half. I have heard from Local Cab Companies that have been subcontracted to provide some of the rides that CTS will call them and ask them to be in Bangor in 30 minutes to pick someone up at an appointment or their home. Seriously? CTS Clearly has no idea where things are in Maine and what the actual distances are between cities and towns in Maine like Mainers do.

Give the Contract Back to the Maine Companies, PLEASE and Let them Properly DO Their Jobs! Give them the money they need to hire Appropriate staff to man the phones and let's get Maine Medicaid Ride Program Back on The Right Track!

It was a Nice Try using this other company. However, Clearly this is not working for Maine Medicaid persons.

JOHN PAINTER's picture

I understand your sentiment,

I understand your sentiment, and think you're looking at this like most Mainers, pragmatically, though there's al larger issue. This problem with transportation is actually more serious than a "nice try" by the state to save since it's a violation of federal law to restrict a Mediaid beneficiary access to medically necessary services, let alone thousands of people as is occurring. The "why" of any restriction is actually immaterial in terms of our states approved Medicaid plan with the Ceners for Medicare and Medicad (CMS).

The state could have, and should have had contingency transportation plans in place. Much like it should have had contingency Medicaid billing processes in place when it deployed MIHMS and its predecessor MECMS, both were multi million dollar fiascos which were still paying for despite the MIHMS still not fully functional.

My point is, CMS pays attention to things like this, and if they suspect serious systemic problems, or systemic fraud, waste and abuse can and do suspend their portion of Medicaid payments to a state until shown the problems are fixed. When you look at the range of problems we have, Maine is at risk for a more widespread audit by the OIG of our state Medicaid system. There are a number of things we're at risk for for example Maine has for a number of years under both Democratic and Republican leadership utilized a tax and match scheme to essentially artificially inflate the cost of Medicaid services allowing the state to draw down more federal dollars. I had hoped under Governor LePage he would have addressed that as waste and fraud since it requires Maine tax payers to pony more money upfront in order to get the federal match. None of this improves the quality of services, or expands services to under served parts of the state. I have never heard let alone seen a cogent explanation of where the tax and match money goes.

I think Maine is playing with fire every day we do not implement an immediate fix to the transportation system.


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