What’s happening with public transit in Cortland County?

The news is out about what is happening with public bus service in Cortland County. Unfortunately much of what you hear and read is inaccurate. It’s a very complicated issue. I will try to set the record straight with this FAQ. If you have any other questions, let me know and I can address them in future blog posts.

Q. So, what’s going on?
A. Cortland County is in danger of losing their public transit system because of a New York State directed initiative, which has hired a private broker (MAS) to schedule Medicaid transportation.

Q. What is Medicaid?
A. Medicaid is a national health insurance program that is fueled by federal and state funds. The program, which began in 1965, is designed to help the needy have better access to health care.

Q. What is Non-Emergency Medicaid Transportation (NEMT)?
A. People who are on Medicaid are provided transportation to their medical appointments when they have no other means and seek prior approval. Some are reimbursed mileage for taking their own car, some are given tokens to ride a fixed route bus, and others are provided transportation in a Dial-a-Ride bus, in a taxi, or in an ambulette/ambulance, based upon their need. Transportation is provided because it doesn’t help to offer people medical care if they can’t get to that medical care.

Q. Who is MAS?
A. Medical Answering Services (MAS), out of Syracuse, is a private brokerage company contracted by the New York State Department of Health to handle the scheduling of Medicaid transportation in many counties throughout the state.

Q. Why did the State hire a private broker and how was Medicaid transportation handled before?
A. The State, through their Medicaid Redesign Team, created the broker system in the hopes of saving money on Medicaid transportation. Before the implementation of the broker system in Cortland County on October 1, 2013 the State Department of Health (DOH) reimbursed Cortland County’s Department of Social Services (DSS) to make this service available. This money was then used to contract with First Transit to handle all scheduling of and transportation to medical appointments for all Medicaid recipients. This funding, together with State Transportation Operating Assistance (STOA), provided the major portion of funding necessary to make a public transportation system that allowed Cortland County to serve Medicaid recipients needing to travel to medical appointments in a more cost effective manner.

Q. How long had that system been in place in Cortland County?
A. The reason why the transit system was created in this county in 1993 was due to the prohibitive cost of transporting Medicaid recipients in taxis and by county employees. It was less expensive to contract with a transit provider to provide transportation for Medicaid recipients and the county was able to provide transportation for many others in the community as well with the public transit system.

Q. So why is First Transit losing money?
A. MAS has been directed by the State DOH to find the least expensive mode of travel for Medicaid recipients. The rate that was negotiated by First Transit and DOH is higher than the taxi rate. (Remember the fare that you pay to ride the bus is not the true cost of that ride.) So MAS is scheduling many of these Medicaid recipients in taxis. First Transit is losing out on this revenue.

Q. Can a Medicaid recipient choose what mode of transport that he/she prefers?
A. When calling the MAS call center, you can request a certain mode but there is no guarantee that they will schedule you in that preferred mode. MAS has been instructed to use the cheapest mode of transportation and to the extent there is more than one provider in that mode, then people can choose.

Q. So how many people ride Cortland Transit buses?
A. Cortland Transit buses provide transportation, not only for Medicaid recipients to medical appointments, but for many others. Elderly people who can no longer drive depend on the bus system. Those who can’t afford a car, want to lower their commuting costs, or be environmentally more responsible use the bus to get to work. High school and community college students use the bus to get to school. People with disabilities are heavily dependent on the system. There are no wheelchair accessible taxis in this county. Many need the bus to get to the grocery store. There’s even a commuter bus that goes to Cornell University. In 2012, more than 181,000 rides were provided on Cortland County’s public transit buses.

Q. Will Cortland County lose their public transit system?
A. It is a possibility that First Transit could decide that they can no longer provide bus service based upon the amount of revenue coming in. There is also a possibility that they will remain but there might be a reduction in services.

Q. If the county loses transit, how will people get around?
A. Medicaid transportation is mandated, so Medicaid recipients would be placed in taxis if ambulatory. If someone is in a wheelchair, they would need to be transported by TLC or some other medical transport company. Many of these taxis and medical transport companies are being brought in by MAS from neighboring counties because Cortland County has so few companies that are certified to transport Medicaid recipients.
Remember that Medicaid transportation only provides transport to medical appointments for those on Medicaid. Anyone else who uses the bus to get to their medical appointments, to pick up their prescriptions, to go to work, to go to the grocery store, etc. would have to find another way to get there. And most likely it would be a much more expensive taxi service or medical transport company.

Q. What is being done about this situation?
A. The Transportation Advisory Committee (TAC) in Cortland County is a group of representatives from various community agencies and governmental departments who are committed to improving transportation options for all residents in our communities. We are under the direction of the Cortland County Planning Department and report to the Cortland County legislature. We are exploring alternative funding streams to make up for the lost revenue. We are contacting our elected officials to make sure they are aware of the situation and to ask for their help in finding a solution.

Q. Why should I care if I don’t use the bus?
A. “Public transit’s broad reach extends to all of America’s communities, large and small, as it helps revitalize business districts, allows employers to tap into larger workforces, builds economic revenues and increases property values. On the national level, public transportation supports our nation’s goals and policies, including reducing our dependence on foreign oil, and providing critical response in emergencies. On an individual level, public transportation saves money, and provides people with choices, freedom and opportunities.” – American Public Transportation Association

Q. What can I do?
A. If you are currently on Medicaid, it is important to call MAS to schedule transportation for your medical appointment. Even if you currently pay your own fare or use a monthly pass from an agency, MAS and DOH need to have accurate numbers of all those who are using the bus for their Medicaid transportation.

A. If you have any specific complaints about MAS or the mode of transport they assigned you, please contact MAS but let me know as well. I will make sure that complaints are passed on to DOH.

A. Also, contact your elected officials (city, county, state) and let them know how much you depend on public transit. Or if you don’t personally use the bus, how important public transit is to the community.

For more information give me a call at 607-756-4198 or email me at jdempsey@sevenvalleyshealth.org

Jan Dempsey

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2 responses to this post.

  1. Posted by anonymous on November 12, 2013 at 10:21 am

    Since MAS is contracting with the lowest bidder, they are also contracting with what appears to be the worst service providers. They are contracting with transportation companies out of the county that often arrive over an hour late to pick up their clients, young kids who drive carelessly, and companies that will cancel their pick up’s with little or no notice. This presents a challenge for Medicaid Service Providers that are licensed to provide under Waivered programs and serve individuals that require 24 hour support and supervisio. Agencies are losing money for late clients as providers have to pay for staff to wait for transportation companies to pick up clients and will never recieve reimbursement for this. Please advocate for Cortland Transit as they are one of the few available wheelchair transports in this county! Additionally, they are willing to commute out of county and long distances when necessary when Medicaid recipients must seek Specialized Medical Doctor’s that are not aviable in this county.

    Reply

  2. I read a version of this in the Access to Independence Newsletter that put an emphasis on getting people to ride the busses. It is important to get this message to all the organizations and employers in the county. If people are concerned about maintaining a public transportation system that arguably is the mark of a triving and forward looking city/county. If people do not support the bus system, it will disappear and with it the ability for people with disabilities, the young, the elders and, those without their own cars to participate in jobs, social activities, and business appointments. We need to join the rest of the world in participating in public transportation to save money and this community asset. We could even petition our elected officials to prioritize public transportation in funding. Mary Beilby

    Reply

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