AUGUSTA — The executives in charge of a new brokerage system for delivering non-emergency rides, under a program offered through MaineCare, the state’s Medicaid system, say they have largely corrected many of the problems that led to confusion, frustration and missed medical appointments earlier this fall.

But advocates for those who receive the rides and the nonprofit agencies that often deliver them said little has changed since the state switched to the new system. The system, based on guidance from the federal government, depends on brokers to book rides and pay for their delivery.

Lawmakers also learned that health-care providers had been affected by missed appointments and that some of those who previously received rides under the program had simply given up trying.

All sides, as well as officials from the Maine Department of Health and Human Services, were before the Legislature’s Health and Human Services Committee on Tuesday to discuss what’s gone wrong with the $40 million ride program and what’s being done to fix it.

“We believe that consistently rides are being delivered more accurately, effectively and efficiently,” Stefanie Nadeau, director of the Office of MaineCare Services, told the committee. “We do know that there are still issues that we are trying to resolve through the system and we do know that there are individuals not getting rides to their medical appointments, their MaineCare-approved appointments.”

At stake are the contracts held by those brokering the rides, including the largest broker, Coordinated Transportation Solutions, a Connecticut-based nonprofit that does similar work in other states.  

CTS opened a Lewiston call center with 45 workers to help coordinate MaineCare rides, and holds a $28.3 million, one-year contract with the state. Two other brokers hold smaller contracts to deliver rides

CTS President David White told lawmakers Tuesday his organization has made vast improvements since it was before the committee in September.

He said the nonprofit was not in the practice of trying to deny rides to people but was committed to providing rides to those who needed them.

White said the ride volume expected for October in Maine for the area his agency is responsible for is about 25 percent higher than expected, based on the data provided by the state when they bid on the work.

White said wait times were down and the number of rides being delivered had increased from about 173,000 in August to about 200,000 in October.

But earlier this month the state learned CTS had missed more than 4,000 rides and half of its callers were hanging up over long waits.

Nadeau previously said wait times for calls to CTS were between 3 and 24 minutes but White said Tuesday that calls were being answered within 17 seconds.

He said that because those calling for rides had become more familiar with the program, the average “talk time” for a call was down, as well.

White vowed to get to the bottom of any problem members of the committee were hearing from their constituents.

“Anyone who has individual concerns, please reach out to us,” White told the lawmakers. “We have a very experienced — now — staff in Lewiston. You can also reach out directly to me and I would be happy to discuss. CTS will be responsive to your concerns. You can reach me and I would be happy to discuss them.” 

Those delivering the rides, however, said problems with double-booked rides and no-shows were persistent, and volunteer drivers who are reimbursed for mileage continued to be frustrated by the new system.

Koriene Low, director of transportation and corporate technology for the Lewiston-based Community Concepts, which provides volunteer drivers and previously help coordinated rides in Androscoggin, Oxford and Franklin counties, said fewer rides were being provided.

She said the rides Community Concepts provides were down 50 percent from 2011. She also said the numbers reported by CTS didn’t match previous trip numbers based on Community Concepts’ data for 2012 and 2011.

“We had transported 1,288 members in 2013 in the month of September and more than 1,800 in the prior September,” Low said. “So the concern is, for our agency, with our mission: What’s happening to those folks who aren’t being served? Where have they gone?”

She said the messages Community Concepts had received about the impact the change has had on lives was concerning. “I have a dialysis patient who has given up and is saying, ‘I won’t participate any longer because I just cannot handle the stress any longer. The stress of trying to book my ride and get there is more stressful than going to dialysis,'” Low said.

Computer and software upgrades the agency needs so it will be better aligned with the new brokerage system will cost $50,000, Low said.

Nadeau, director of MaineCare services, said she believed all three of the brokers involved in the program were making progress, but the state intends to keep the pressure on the brokers.

She said the state was in the process of finalizing a corrective action plan with CTS later this week.

“We hope to have a final version of that by the end of the week or early next week,” Nadeau said. “What we’ve asked for is, ‘What measures have you taken and what measures to you anticipate to take, what actions to you anticipate take to come into compliance with the performance metrics of the contract?'” Nadeau said.

She said the contract had a performance metric of “zero missed rides.” 

“No broker is meeting that contractual metric,” Nadeau said. “We are now having to revisit what is an appropriate number of missed rides based on the infrastructure within the state of Maine or circumstances outside of the brokers’ control.”

Still, Nadeau said, the state’s options remained clear.

“There are penalties and sanctions and we also have the option of terminating the contract,” she said. “Those are all being considered at this point in time.”

Lawmakers likely will be updated on the status of the ride system again in November.

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