Going Away?

Thanks to a change in how rides are reimbursed by Medicaid, the county's public transit system may go the way of the horse and carriage.

Soon, the Ride Tioga bus system may go the way of the horse and carriage and the rotary phone; it may become a thing of the past. Until recently, the bus system had been funded primarily by Medicaid. When Medicaid patients had non-emergency medical appointments, they could arrange a ride and Medicaid would pay for Ride Tioga to transport them. Now, Medicaid patients will still be able to arrange rides, but instead those rides will be in taxis.

Shawn Yetter, the commissioner of the Tioga County Department of Social Services, explained, “The state has given the management of non-emergency Medicaid rides to Medical Answering Service from Syracuse and they assign a provider to every ride call that they get and they primarily utilize cab companies.” Previously, the management of ride scheduling was handled by individual counties, but over the course of the past year New York State has implemented the use of Medical Answering Service for transportation scheduling in the majority of upstate counties.

Legislature Chair Martha Sauerbrey said, “For the last 20 years we’ve been able to run a bus system in Tioga County because of how the Medicaid payments were coming down from the state, but in an effort to be more cost effective the state has pulled that process back and they’re doing those arrangements at the state level and they have decided that putting people in taxis is cheaper.”

Unfortunately, that switch in transportation management will have a huge impact on Tioga County’s ability to support a bus system. County Legislator Bill Standinger said, “In the past the bus service has been subsidized by the county’s Medicaid money that pays for transport of Medicaid patients and that’s a good portion of the money that funds the bus service.” The bus system costs around $440,000 to operate annually and, until the end of 2013, Medicaid reimbursements covered that cost.

In regard to Medical Answering Services, Yetter said, “Their contract is to provide transport in the cheapest way possible and their claim is that doing the bulk of the transports by cab is the most cost effective. I have data that shows otherwise.” He continued, “We’ve had a system that’s worked successfully for 20 years in the county and they pretty much took us 20 years backwards in a very quick fashion. Twenty years ago that was how it worked – people took cabs – but we came up with a more efficient and cost-effective alternative. Then the state switched gears on us.”

Yetter is trying to convince the state to reevaluate the matter: “We’re in the process of working with the state to see if they’re willing to make some adjustments because while the process may work in urban settings it just isn’t a good fit in rural districts.”

When Medical Answering Services was contacted about the data they have used to justify using cabs over buses, the owner stated that he was not allowed to answer any questions, saying that all inquiries were to be directed to Tim Perry-Coon at the New York State Department of Health. When contacted, Tim Perry-Coon said that he was not authorized to answer questions unless they were routed through Public Affairs first, and Public Affairs did not respond by the time this article went to press.

Sauerbrey spoke about the way in which these changes could affect county residents, saying, “We’re very pleased that the Medicaid people are getting taken care of but now there’s the issue with people traveling back and forth to Ithaca, to the colleges. I don’t know that we want to expend $440,000 a year to get people back and forth to work.” Currently it is costing the legislature $37,000 a month to keep the bus system running until they make a decision whether to close the bus system altogether or to close certain routes.

Aside from the bus driver jobs that the county would lose if the bus system were closed, many people who rely on the bus system to get to work could lose their jobs. A Candor resident who asked to remain anonymous said, “If there’s no bus then I have no job. I pay for a bus pass every month and it only costs 30 dollars. If I had to take a taxi cab to work every day it would cost me 20 bucks there and 20 back – and I only make a little over 40 bucks a day.”

The Candorite continued, “There’s lots of women that ride the bus in the morning go to Owego and Ithaca and they go to and from work every single day. They are not poor people by any means but it’s safer and cheaper than driving. It’s not like every bus only has two or three people on it.” However, unless the state decides to reconsider its Medicaid transportation arrangements, there won’t be anybody riding the buses.

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