Waiting and hoping for an uncertain ride
JANESVILLE—Lynn Gehri said she had to pay for a missed doctor's appointment because her ride didn't show up.
Jeremy Smith said his medical appointment was held hostage for gas money.
Melissa Sennett said she's lost track of the number times she's had to cancel appointments because her driver didn't show.
Across Rock County, Medicaid and BadgerCare Plus recipients are struggling with the state-contracted, taxpayer-funded ride service hired to get them to their medical appointments.
All of the people have limited means. They cannot drive themselves.
Many have given up complaining saying, “It just doesn't do any good.”
HOW IT WORKS
Medicaid and BadgerCare Plus will pay for non-emergency medical transportation for patients who have no other ways to get to appointments.
“These are people that have exhausted their own resources,” said Justin Svingen, mobility manager for Rock County.
Starting in 2011, the state switched from locally run programs to a statewide system.
“The idea was to leverage more federal funding, and save the state of Wisconsin money,” Svingen said.
It's an idea that has worked in other states, he said. Having one contractor overseeing the whole state could mean efficiencies, and that might lead to better services.
Under such a system, the state takes bids from private companies. The companies don't operate the buses, cars and vans needed to get people to appointments. Rather, the companies subcontract with a network of providers ranging from taxis to non-emergency transport providers such as K-Town, Access Medical and D.R. Medical Rides.
In turn, some of the subcontractors contract with private individuals, who use their own cars to transport patients.
In 2011, the Georgia-based company Logisticare won the bid. But by mid-2013, the department of health services was overwhelmed by complaints about the service from many parts of the state.
At the time, Logisticare told the Milwaukee Journal Sentinel that the state had underestimated the numbers of rides needed.
Toward the end of the year, the Missouri-based company MTM won the bid. Since that time, the state has been paying the company $4.5 million a month.
CARS AND DRIVERS
Many people interviewed for this story didn't want their names used because they were afraid complaining would make services worse.
Jeremy Smith was angry enough to talk.
During Logisticare's brief tenure, he didn't have problems getting rides. One of the providers, K-Town, was “practically located across the street from him.”
His experiences with MTM include being asked for gas money.
“I had to get to Madison for my appointment,” Smith said. “What was I going to do?
When he complained, he was told someone would look into the matter.
Another time, a driver came from Milwaukee to pick him up.
“She was driving on the doughnut, the spare tire,” Smith said. “Then we went up the Interstate on that tire.”
Another driver told him she didn't have proof of insurance. Smith isn't sure if that meant that she didn't have her insurance card with her or if she didn't have insurance.
“When I called them up to complain, they said I didn't have any business asking her about her insurance,” Smith said. “But I didn't ask, she told me.”
Smith said he isn't fussy: “Just send me a car that can make it around the block, and a driver that has insurance.”
-- Gehri requested a vehicle that could accommodate a wheelchair. The driver showed up in a Chevrolet Blazer. Bystanders at the clinic helped her into the vehicle.
-- Smokey Combs has had several no-shows. Drivers have arrived as much as an hour late.
She's was told the company “doesn't have anything available.”
-- One woman, who did not want to be identified, was told that she could ride her electric wheelchair to the clinic, even though the charge of the chair's battery wouldn't carry her home. However, the woman's aide could travel in a vehicle. The aide confirmed the story.
-- Smith once rode to Madison with a driver who made several stops at private homes.
The bulk of patients' complaints revolve around rides that didn't show up or showed up late, and drivers with unreliable or inappropriate vehicles for their physical needs. Perhaps the most difficult, however, is the feeling that they have no recourse.
RESPONDING TO COMPLAINTS
In a written statement, MTM spokeswoman Michele Lucas said: “It is never acceptable for transportation providers to ask members for gas money.”
In addition, clients are encouraged to report problems, “following our complaint guidelines.”
MTM has a “We Care” hotline separate from the dispatch number. It also has an online complaint form.
Company statistics show the number of substantiated complaints are miniscule when considered in proportion to the number of rides it provides.
Rock County's Svingen isn't convinced complaints are reaching the company.
“It just seems like people got so exhausted from complaining in the past, they just don't bother anymore,” he said.
Many clients echoed his sentiments.
Complaints must be registered properly or they don't count.
Melissa Sennett has had a number of no-shows or late pickups.
“I called MTM and let them know,” Sennett said. “But I found out later they weren't even making a note of them.”
In order to be “official,” the complaints must go to the quality control hotline. Sennett didn't know that until a dispatcher told her.
Gehri feels the same way. She called the complaint line about no-shows and late pickups.
“They just said they'd take down the information,” Gehri said.
Did anything change?
“Not on iota,” she said.
Combs has had to deal with no-shows and drivers who made her late to appointments.
“I've tried complaining,” Combs said.
Svingen is now encouraging passengers to call the state Legislative Audit Bureau Fraud, Waste and Mismanagement Hotline and share their stories. Several state legislators have called for an audit of the program.
ON THE RECEIVING END
At the other end of those rides are medical providers.
Svingen told of a patient with muscular dystrophy who needed to see a Madison specialist. After three no-shows by the transportation provider, the specialist's staff refused to make an appointment for her.
Elizabeth Shadel works for Associates in Psychotherapy and treats a number of patients who need the ride service.
“I've had complaints from all of them,” Shadel said.
The patients struggle with serious mental health issues, including post-traumatic stress disorder, depression and anxiety, and therapy is a crucial part of treatment.
One of her patients has a physical disability and had to climb into the back of a two-door car.
When a patient doesn't show up, Shadel cannot charge Medicaid or BadgerCare for a missed appointment. Her patients don't have the wherewithal to pay those fees.
“We're just out the money,” Shadel said.
Shadel is more concerned about her patients' health.
The structure of the appointments adds to the benefits of treatment, she said. For patients with anxiety and depression, the question, “Will my ride show up?” is another stress.
BETWEEN PATIENTS AND PROVIDERS
Also part of the puzzle are the companies subcontracted to provide the rides.
A Feb. 14 story in the Milwaukee Journal Sentinel reported that “veteran transporters say MTM is trying to force them to cut their rates” by 15 to 30 percent.
“Meanwhile, providers say, MTM uses cheaper but less reliable companies who often leave patients without a ride to or from their appointments,” the story said.
Jayne Phillips, owner of K-Town, the medical transportation provider that works in Rock and Walworth counties, picked her words carefully when speaking about MTM.
“The new broker is a challenge,” she said.
The company started in Kenosha and Racine, and has offices in Janesville—for now.
The company's trip volume in the Janesville area has fallen by one-third.
“I just don't know if we can continue to function in Janesville,” Phillips said.