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Medicaid changes cut mental health transportation reimbursement


A change in how Medicaid transportation is handled has left at least one agency without reimbursement for driving mental health clients to services.

For now, St. Lawrence County Community Development Program will continue at its own expense to bus roughly 50 clients from across the county to programs at the St. Lawrence Psychiatric Center, Seaway House and Step-by-Step in Ogdensburg.

“We can’t continue to do it long-term because it costs us to transport people,” CDP Executive Director Norma S. Cary said. “You’re talking about a very vulnerable population. You’re leaving them out in the cold. It’s very disconcerting they’re being pushed to the side.”

Medicaid has for years paid for the shuttling of eligible people, often from family-style group homes, to day programs. The services generally help those with mental illness develop life skills.

The county Department of Social Services used to administer Medicaid transportation, but that changed Sept. 1. As part of the state’s shift toward managed care in Medicaid, the state Health Department contracted with Medical Answering Services, Syracuse, to administer transportation in 24 counties.

As of Jan. 1, MAS told CDP that it would no longer pay for it to drive individuals to the mental health programs.

Those eligible for transportation through the county’s Community Services department are not affected.

A spokesman for MAS referred questions to the state Health Department, which had no immediate response for the reimbursement change.

The rationale may be that the programs are not medical — some include work opportunities — or that the sites are not Medicaid-approved, Ms. Cary said.

“It is part of their treatment plan and signed by a doctor,” she said.

The decision to cut funding will leave some people sitting at home, said Seaway House Program Director Carol A. Whitcombe.

“How individuals are supposed to get to programs is up in the air,” she said. “I think this will hinder a person’s mental health. Everyone needs purpose.”

CDP has contacted state representatives for help.

“We’re trying to talk to people, raise some awareness and have people go to bat for us,” Ms. Cary said.

Judy A. Aldrich, a legislative coordinator in the office of Assemblywoman Addie J. Russell, D-Theresa, said she has started making calls on the issue.

“I don’t know what the answers are at this point,” she said.

Although the change in Medicaid reimbursement has become a headache for some, the transition from Department of Social Services coordination appears smoother for volunteer drivers.

Volunteers who drive people for non-emergency medical reasons are being organized and coordinated by Volunteer Transportation Center Inc., Watertown, which already handled the service in Jefferson and Lewis counties.

“We were asked to come up. We already had drivers in St. Lawrence County. It’s part of our mission,” Executive Director Samuel M. Purington said. “We are one transportation vendor.”

Volunteer Transportation Center Inc. opened a branch office Dec. 1 at 19 Hodskin St., Canton, with three full-time employees and one part-time employee. Individuals interested in becoming a volunteer driver can contact the center at 714-2034.

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