By Colleen Quinn
STATE HOUSE NEWS SERVICE
STATE HOUSE, BOSTON, FEB. 21, 2012….The state’s network of transportation services that gives rides to elderly and disabled residents is “fragmented,” and “ripe for fraud, waste and abuse,” according to a new report from the Inspector General’s office.
Inspector General Gregory Sullivan sent a letter last week to state transportation officials and the MBTA board of directors with 12 recommendations to cut costs and consolidate services for the T’s RIDE program.
The IG’s office spent more than a year looking at RIDE services run by the T, as well as other paratransit services managed by the Executive Office of Health and Human Services, regional transportation authorities, local councils on aging and not-for-profit agencies. The IG’s report concluded there is little coordination between the different agencies that provide rides, no shared efficiencies, and a lack of oversight.
“The MBTA is in a financial crisis mode. The IG’s office thinks there is a potential $60 million or more in annual savings by improving the procurement and management of the RIDE without diminishing the high quality service,” Sullivan told the News Service Tuesday afternoon.
One factor driving up costs is the RIDE program’s door-to-door service for riders. The service exceeds federal curb-to-curb requirements, and goes beyond the service level mandated by the Americans with Disabilities Act.
“Although MBTA standards have created a nationally recognized program for its level of service and commitment to riders, these standards have come at a cost – a cost that the MBTA may no longer be able to afford,” the IG’s letter states.
The IG’s report also recommends more closely monitoring the eligibility of riders. In other parts of the country, a person’s eligibility is double-checked and their physician’s recommendation verified.
Sullivan pointed out that Boston’s utilization rate for RIDE services is 40 percent higher than a similar program in New York City, and nearly three times higher than Philadelphia.
“That is a potential indicator of an overly lax eligibility determination system,” Sullivan said.
Starting July 1, in-person assessments will be conducted to determine individual eligibility for the RIDE program, according to a statement from the Massachusetts Department of Transportation
The IG’s report comes at a time when the MBTA grabbles with potential fare hike and service cut scenarios to close a $161 million budget gap projected for next fiscal year. State transportation officials are weighing possible fare hikes between 35 percent and 43 percent, coupled with reductions in commuter rail, bus, and light rail service, as well as cuts to services for residents with disabilities such as the RIDE program.
The MBTA spends approximately $112 million each year on the RIDE program, with annual increases projected to top 16 percent, according to the IG’s report. MassDOT Secretary Richard Davey, during his tenure as MBTA general manager, referred to the ballooning costs of the RIDE program as a “budget buster” for the T.
In a statement to the News Service, Davey said the Massachusetts Department of Transportation is still reviewing the IG’s recommendations, but added several are already being implemented.
Fare increases for the RIDE were also included in the two scenarios proposed by MassDOT to close its budget gap, ranging from a 50 percent hike to $3 per trip to a 125 percent hike to $4.50 per trip. Residents requesting the RIDE service outside of legally required territory would also be charged premium fares of either $5 or $12.
Elizabeth Levin, a member of the MBTA board of directors, said she had not seen the letter or the report yet, but said, “I think there is no question about looking at how we can run it (RIDE program) in a different way in the future.”
Last year, Gov. Deval Patrick, in an executive order, created a paratransit services commission to look at the issue.
Catherine Mick, a member of the commission appointed by Secretary of Health and Human Services JudyAnn Bigby, said the commission is looking at ways for the different agencies to coordinate better.
“We appreciate and welcome the Inspector General’s thoughtful insights into transportation issues impacting people with disabilities, elders and veterans,” Mick said in a statement. “The Commission has afforded us the opportunity to discuss ways in which government can work together across agencies to provide cost-efficient, high-quality services that will enable people with disabilities, elders, and veterans to live full lives and contribute in meaningful ways to their communities.”
Sullivan said Tuesday there are plenty of places to cut costs and make the system more efficient. He projected the MBTA could save millions by implementing some of his findings, which include seeking more federal reimbursements for rides given to Medicaid recipients who are using the services for medical appointments.
The inspector general said the most frequent destination of riders is to a medical appointment. But the MBTA does not have the authority to ask a rider if they are headed to doctor’s office – losing millions of dollars in Medicaid reimbursement money, he said.
“If somebody is a Medicaid patient, and they are going to a medical appointment, the federal government pays for transportation costs,” Sullivan said. “In Massachusetts we don’t have a system that differentiates. It is paid 100 percent at a much higher rate by the state. We are trying to coordinate this.”
The report also points out that the state pays $47 for a one-way trip on the RIDE in the Greater Boston region, while the person using the service pays just $2. The same trip covered by Medicaid costs the federal government $12.
The inspector general said the state is paying more for RIDE services because only three large RIDE vendors cover large geographic areas in Greater Boston. The federal government allows multiple providers to give rides to Medicaid recipients, driving down the costs with more competition, Sullivan said. He predicted the MBTA could save $60 million annually by increasing the number of vendors who provide rides.
“The RIDE has won many national awards for excellent quality. We have no doubt about that. The problem is the method which they procure the ride. We are not getting it at a reasonable price. We are overpaying,” Sullivan said.
Some of the IG’s other recommendations include:
Improving coordination of services and looking at the practices of the Executive Office of Health and Human Services, which uses a “brokerage model” to obtain ride services from vendors. The brokerage model creates a perpetual open bid process that seeks the lowest cost per trip, according to the report. Any vendor that meets a set of minimum criteria may participate.
The MBTA should look at raising revenue by charging RIDE customers a fare up to twice the cost of other MBTA services, which is allowed under federal regulations. For example, if a subway ride is $2.00, the T could charge a ride client $4.
Take greater advantage of fixed routes by using a centralized scheduling process and purchase up-to-date software to schedule RIDE trips in conjunction with the fixed route system.
The MBTA should charge a fare to “no show” riders who schedule a trip, and do not take it. This increases costs and causes delays, the IG report states.
The MBTA should improve vendor oversight. Sullivan said the T may not have adequate assurances that unwarranted non-RIDE expenses are being routinely charged to the MBTA.