Call it a test, or call it a pilot project.
Sometimes it’s better to dip your foot in the water rather than diving right in.
Which is what the State of Maine did Aug. 1 when it switched local coordination of rides for poor people to a Connecticut company.
The switch away from local control has resulted in a flood of complaints from Medicaid patients who depend upon the rides for doctor and hospital appointments, counseling sessions and classes.
On Monday, Tracy Bennett of Bethel told the Sun Journal she had been stood up for rides 10 times in the past week.
Similar complaints have been pouring in to the Department of Human Services, to lawmakers and media since Aug. 1 when the new statewide system went into effect.
The rides were formerly coordinated, at least in this area, by Community Concepts and Western Maine Transportation.
They handled the requests for rides and then brokered them out to drivers who were paid for their services.
State officials say they were forced to change that system when the federal government found the arrangement “non compliant” with federal regulations.
They considered one agency handling the requests and brokering the rides a conflict of interest, and threatened to reduce the rate at which Maine is reimbursed for the service.
So, local agencies laid off the workers providing the service, and awarded two contracts, one of which was to Coordinated Transportation Solutions of Connecticut for $28.3 million.
CTS now brokers rides for the state’s most rural counties, including Androscoggin, Franklin and Oxford, as well as Aroostook, Washington, Hancock, Waldo, Knox, Lincoln, Sagadahoc, Cumberland, Kennebec and Somerset.
At the same time, CTS began applying federal guidelines which apparently do not allow payment to drivers for the miles spent getting to and from a client’s home.
Since then, drivers have been quitting in “droves,” according to a Maine Senate staffer.
“The launch of this new system has not gone as planned and the performance has been both frustrating and unacceptable,” Sarah Cairns, a spokeswoman for MaineCare, told the Sun Journal by email.
“As we move into the second full week of this new system, we will remain vigilant in holding the brokers accountable for the provision of rides to Medicaid recipients.”
Perhaps CTS and MaineCare will hit on the right combination of higher driver payments and better coordination to get the system back on track.
Meanwhile, a Washington expert on Medicaid recently told the Press Herald that the state may not have been forced to adopt this system at all.
“The states have flexibility,” Kathleen Nolan with the National Association of Medicaid Directors, told the Press Herald. “There are a lot of different ways the states provide this service.”
But chaos and poor performance are often the result when any large organization suddenly makes large, complicated changes.
Perhaps the state could have run a pilot program in one or two counties. CTS would have had time to establish a workable compensation system for drivers and iron out any other logistical wrinkles.
Then the program could have absorbed a few more counties at a time until the contract was fulfilled.
Suddenly taking over a critical system involving all 16 Maine counties at once was a predictable prescription for trouble.
rrhoades@sunjournal.com
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