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home : • politics : • government
January 26, 2020

5/1/2014 10:40:00 AM
Eye on Augusta: Waldo CAP to Take Over Complaint-Ridden MaineCare Ride Program
by Andy O’Brien

Last week the Maine Department of Health and Human Services (DHHS) announced that it has chosen non-profit Waldo County Community Action Partners to broker non-emergency transportation for Waldo, Knox and Lincoln counties, replacing problem-plagued ride broker Coordinated Transportation Solutions (CTS). According to Waldo CAP Executive Director Keith Small, the organization plans to take over scheduling rides for low-income, elderly and disabled MaineCare recipients in those three counties on July 1.

Under the broker system, DHHS pays a fixed, contracted rate to brokers to schedule and dispatch rides to each MaineCare member within the eight geographic service regions in the state. The program costs about $40 million a year and serves about 45,000 patients, but the federal government reimburses the state for the majority of the costs. Prior to switching to the broker system, the scheduling of rides was handled in-house by staff at the local agencies that also provide the rides. According to DHHS, the change was made to comply with rules created by the federal Centers for Medicare and Medicaid Services (CMS) that required a separation between agencies doing the dispatching and those providing the rides, in order to prevent conflicts of interest. CMS presented states with four options, including the brokerage model that was selected by DHHS.

"We've provided 30-plus years of good transportation customer service to a wide variety of folks primarily in Waldo County," said Small, who noted that his organization, Waldo CAP, also is familiar with the other three counties in its new service area. "We have a better sense of who our clients are and where they're located than some dispatcher out of Lewiston."

While Waldo CAP will provide the dispatching service, Coastal Trans will still provide the vehicles and service for Knox, Lincoln and Sagadahoc counties, as well as the towns of Harpswell and Brunswick.

Since last summer, after Connecticut-based CTS was awarded a contract to broker rides for the region, the local ride provider agencies were flooded with complaints of missed rides, wrong information provided to drivers, and patients unable to reach a dispatcher. According to Small, although some of the worst communication problems did get fixed, his organization continued to suffer problems with billing and multiple rides being dispatched to the same residences.

In January, after a probationary period and a partisan battle over the new broker system between Democrats and the LePage administration, DHHS announced its decision not to renew its contract with CTS. Although the organization submitted bids to continue its service in six regions in the state, the department has chosen not to renew any of the contracts. CTS has until May 8 to appeal the decision, after which DHHS will begin final negotiations with the new awardees. The organization's $23.8 million contract ends on June 30.

According to a press release from DHHS, the request for proposals drew 32 bids from 11 bidders for Maine's six regional contracts. Atlanta-based for-profit and LePage donor Logisticare, which currently provides brokering for York County, was chosen by DHHS to serve four of the regions, including Aroostook, Washington, Hancock, Cumberland, Androscoggin, Oxford and Franklin counties. Penquis CAP, which currently serves Penobscot and Piscataquis counties, was selected to serve Kennebec and Somerset counties.

DHHS stated that the brokers must all first produce performance bonds to protect the state from financial liability within two weeks of the contracts being signed. The department was heavily criticized after it was revealed last fall that CTS failed to secure performance bonds prior to beginning its service, despite it being a condition of their contract. And in March, critics blasted DHHS for paying CTS an additional $1.2 million for what the department said was to support the volunteer driver network despite the organization's failed performance.

"We remain committed to the brokerage model and will do all that we can to minimize any disruption of services of those who rely on these critical services,' said DHHS Commissioner Mary Mayhew in a written statement last week.

According to Small, Waldo CAP had previously considered putting out a bid to handle dispatch, but had concerns about the risk posed by potential financial penalties in the contract. He said the state had since rescinded the penalties and the risks were minimized.

"There is still some risk involved, but we think we can operate the program in such a way that those risks will be minimized," he said.

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