Wednesday, April 23, 2014
The troubled transportation system that’s kept thousands of low-income Maine patients from accessing needed medical services could face some sweeping changes under two measures that will undergo legislative review starting today.
The spotlight has been largely on the failings of Coordinated Transportation Solutions, the larger of the two companies hired last year to arrange rides for MaineCare recipients in a system that has provided poor service since it started about six months ago.
But while most of the complaints have centered on Connecticut-based CTS, which has been serving most of Maine, that doesn’t mean that the other private broker, Atlanta’s LogistiCare, has been doing a good job in York County.
Lawmakers should press for rules that would give a York County-based nonprofit a chance to win the contract, ensuring that that area’s low-income and disabled residents aren’t left at the curb.
Until last August, Maine had a locally controlled system for giving MaineCare recipients transportation to non-emergency appointments, such as doctor’s office visits, dialysis and laboratory tests. Then the state, citing a federal mandate, scrapped the arrangement in favor of having regional brokers connect patients with the local providers.
Outsourcing the ride system, however, was not necessary to meet federal regulations. Vermont has retained a locally controlled system for its Medicaid recipients while still managing to meet federal standards.
One measure up for discussion by the Health and Human Services Committee — L.D. 1663 — would cancel the state’s six contracts with CTS. L.D. 1636, also to be weighed today, would allow Maine to follow the lead of Vermont, keeping the local nonprofits in charge of the ride system.
We agree that CTS’ performance has been abysmal — and we have called for the contracts to be canceled — but L.D. 1663, as written, isn’t the right way to go about it. Ending the arrangement with CTS won’t help MaineCare patients unless a new non-emergency transportation system is in place. Although L.D. 1636 is a viable option for a different setup, if it doesn’t pass and CTS’ contracts were canceled, it is unclear how services then would be provided.
To help low-income and disabled Mainers right away, a good first step would be to change the way transportation contracts are awarded, giving preference to local transportation providers. The Department of Health and Human Services has said it could implement this rule change without getting federal approval. The shift, however, should apply for York County as well as for the regions served by CTS (the rest of the state, with the exception of Penobscot and Piscataquis counties).
Regardless where they live, the most vulnerable among us should be able to access medical services without having to worry that they’ll be forgotten or stranded along the way.