AUGUSTA — Maine lawmakers Wednesday said they want a "Plan B" for a $40 million non-emergency ride program that's foundered since it was transferred to the hands of third-party brokers in August.
"I know in my community there are still very, very significant problems," state Rep. Peggy Rotundo, D-Lewiston, said Wednesday. Rotundo is House chairwoman of the Legislature's Appropriations and Financial Affairs Committee, which learned Wednesday that the system was not only still fraught with problems but was also costing the state more money.
Information provided by the Legislature's nonpartisan Office of Fiscal and Program Review, showed that the program, for the first fiscal quarter of 2013, cost $426,000 more than it did in 2012 for the same period.
Rotundo said she was contacted Tuesday by a health-care provider who said seven clients did not show up for appointments, all before 10 a.m., because they did not get the rides they needed.
“The people of Maine are paying $28 million for services that are not being delivered,” Rotundo said. “This is a critically serious issue that needs to be solved immediately.”
The brokering agencies have been operating under a state-sanctioned, corrective-action plan since problems developed soon after they took over the system Aug. 1.
Under the corrective-action plan, they have until Dec. 1 to meet contract requirements, including one that requires no rides be missed.
Of the three brokers, the largest is Consolidated Transportation Solutions, which operates from a Lewiston-based call center and holds a $28.3 million contract. The organization has already been paid $5.2 million, according to data provided to the committee from the Office of Program and Fiscal Review.
CTS has reported missing more than 5,000 rides since August, including 505 during the week of Oct. 5. Because the data is self-reported, some lawmakers were questioning the veracity of that reporting.
Others said many clients had simply given up on the system because it had become so unreliable. Others questioned why people were still communicating their concerns to the state, given the level of frustration with the new system.
Rep. Megan Rochelo, D-Biddeford, said she heard of one woman, a single mother living in a homeless shelter, who was denied a ride because she had to bring her children, a toddler and an infant, with her to a therapy appointment.
“When her ride arrived to take her to her medical appointment, she was told her children couldn’t come with her and needed to be left in the homeless shelter,” Rochelo said. “If I were to put myself in her shoes, my first thought after that experience would not be that I should go back into the homeless shelter and call the complaint line.”
Stefanie Nadeau, director of the Office of MaineCare Services, told the committee the state has options, including terminating the contracts with the brokers. But she was concerned that doing so would mean the agencies providing the rides would be left without pay. She said state officials also were concerned that pulling the contracts could lead to even greater disruption to the rides program.
"We are at the point where we are trying to assess the risks as well as the benefits of moving in a different direction, if that becomes necessary," Nadeau said.
She reiterated that officials in her agency and throughout the Maine Department of Health and Human Services agree that the brokers are not performing to the contract standards.
The state earlier this year changed the way the ride system operates, based on concerns from the federal Centers for Medicaid and Medicare Services that those who provided rides had a conflict of interest if they were also scheduling the rides. The system provides rides to medical appointments for people on MaineCare, the state's Medicaid program.
Rotundo asked whether DHHS would be in a position to evaluate by Dec. 1 whether the brokers were making progress under the corrective-action plan.
Nadeau said the state could receive the data on requests for rides and would be able to correlate that with whether the ride-providing agencies, including Western Maine Transportation, had actually delivered the rides.
State Rep. Mike Carey, D-Lewiston, said he saw a "glimmer of hope that DHHS, the brokers and transporters are using the same data to analyze and fix what is a big problem."
But Mary Lou Dyer, managing director of the Maine Association for Community Service Providers, said the new system was "not working well for anyone at this time."
In a seven-page letter, Dyer outlined the many problems and details about rides that have been missed and the costs incurred by the ride agencies and the medical providers. She said the new system was burying those who provide the rides in a whole new regime of paperwork if they hoped to be paid for the services they delivered.
"They estimate they spend at least three times as much time as they spent in the old system," Dyer said.
"I hate to bring down your glimmer of hope," she told Carey, "but I am not particularly optimistic."
The committee will get another update on the status of the program in December.