Sunday, December 08, 2013

Squeaky Wheel Versus Grease Source

(C) 2013 Luke T. Bush



Some problems have arisen with recent changes with Medicaid client transportation services to medical appointments in the Clinton-Essex-Franklin region.  To address these and other issues an advocate for the disabled, Debra Buell, organized and moderated a meeting held Wednesday morning, December 4th, at the Clinton County Government Center. 

Attendees from the region included Medicaid clients, community service agency representatives, transport vendors, and local governmental officials.   Also in attendance were representatives from Medical Answering Services (MAS), the private company now handling the scheduling of Medicaid client rides for medical appointments, and representatives from the New York State Department of Health (NYSDOH) based in Albany.

The following is part of a series covering different aspects of that meeting.

*  *  *

Communication can lead to conflict resolution - or continued unresolution.

Towards the end of the meeting James Bosley, Clinton County Public Transport (CCPT) Planning Technician, challenged moderator Debra Buell on including issues outside of the scope of what he thought the forum was intended to discuss.

As an advocate for the disabled Debra has described herself sometimes as acting as a "bad cop."  This role, she says, is the only way in certain situations to bring about changes needed with problems faced by the disabled.

During the meeting Debra didn't get into her bad cop role.  Well, she did have to ask someone to stop talking in the background when another person was speaking to the group but she did that diplomatically.

The extraneous talker had to be corrected.  I was having enough trouble keeping track of the dialogue that I didn't need any noise in the primary channel.  Besides taking notes I was making an audio recording – statements enclosed by quotation marks in an article should be direct, not paraphrased – and I knew from previous experience that my digital voice recorder could pick up more than the main speaker.

Debra did well as a moderator.  She made sure that everyone had a chance to speak.  I was aware of how difficult that role can be, keeping people on topic, trying to maintain the flow of the meeting.  Years ago I had attended meetings in the same conference room as coordinator of a social group.  Occasionally it wasn't easy getting business done.  For example, the person who didn't pay attention, chatting with friends in the background, and then wanting statements repeated.  Or someone going off on time-consuming tangents, prolonging the process, inducing boredom.

My involvement ended one night when three people in the singles club didn't like my efficiency, each one attacking me from a different angle.  They succeeded in getting me upset to the point where I walked out and never came back.  It's impossible to keep your emotions in check in a public setting under those circumstances.

(Please note that social group fell apart after I left.  I wasn't perfect but apparently better than those who took over.)

Moderator Debra Buell (center) speaks with attendees before the meeting.

So when James Bosley became upset with issues Debra was mentioning I could understand that kind of frustration, the feeling that you're being attacked.  But I also could identify with Debra in her moderator role.

Caught in the middle.  On friendly terms with both people.  Trying to be fair with my coverage.

One topic that led to the exchange was Debra raising the issue of trip denials with CCPT's paratransit bus.  The demand for the service exceeded capacity.  Also, due to advance booking, trips were being taken up for two week periods.

Sometimes the non-medical paratransit eligible riders could negotiate, explained Debra, getting a ride later in the day.  But that didn't help anyone, she continued, if the person had an appointment at 11 AM and the ride couldn't be provided until 3 PM.

James Bosley responded: "There has been a portrayal that CCPT is constantly denying trips, that people can't get to where they need to go, that people can't get anywhere.  And that is not an accurate portrayal.  CCPT does have trip denials.  I've recorded zero trip denials some months, some months I've recorded ten, but to say that we're constantly denying trips I think is a bad picture."

"Clinton County paratransit covers the entire county," he explained.  "We could make it a lot easier on the trip denials if by cutting back.  But the county is doing it because we want to provide that service for the people.  Public transit is for the public, public transit isn't required to take care of all of the transportation needs out there in the world.  We try to provide as much as we can."

CCPT Planning Technician James Bosley (standing) shares information during a less intense part of the meeting.

James said that some of the points Debra raised were outside the topics that were supposed to be addressed during the meeting, i.e., Medicaid transportation and issues clients have with Medicaid transportation.

He continued: "I think it is disrespectful to sort of ambush CCPT in a meeting like this, and bring everyone together and say 'We're going to talk about this, but while we're here let's put CCPT on the spot and let them make their case about something entirely separate.'"  

Debra Buell replied that she wasn't trying to ambush James but meant to raise an issue that affects public transportation overall.  She did admit that she and the North Country Center for Independence (NCCI) didn't provide him with enough documentation about trip denials.  She and NCCI were working to have disabled riders to be courageous enough to document problems by stating their names and detailing what happened but most clients thought it wouldn't make a difference.

She said: "If I, a squeaky wheel, has gotten to the point where I don't want to try anymore, imagine what all the shy, scared folks are doing. This is the point I'm trying to make, I'm not trying to ambush you. What I'm trying to bring up is a systems issue, it is part of the whole system, and if you weren't a Medicaid vendor, this wouldn't even have come up today but you are a Medicaid vendor and it does impact us [disabled people] in ways that are far more than medical."

"Everything that has been raised has been addressed," replied James, explaining why such outside issues didn't need inclusion.  With the issue of the two week advance booking policy CCPT is looking into it, he had spoken with his supervisor.

"It takes longer than people want it to," he added, "what I wanted it to."

He continued: "I think a pattern of bringing these issues in big forums like this, takes everyone single one of these people, everyone single one of these professionals, away from their daily jobs, and they could get more done to help the public if we took the issues to the appropriate people and left it at that.  The issues are being addressed and it doesn't require taking up everybody's day to do something like this."

Debra replied: "We didn't take up everybody's day, James."

She raised the point that a local group moderated by James, Coordinated Transportation Human Services Committee, hadn't met in a while.

The committee is an ad hoc group looking into ways to improve transportation in Clinton County.  I wrote about its last meeting back in May, Platypus Might Be Growing Wings.

James explained that the meeting was delayed primarily because it needs structure. "It needs structure because it has been hijacked and taken off into tangents and other topics, we've gotten away from coordination."

As the disagreement continued, Debra stated: "I just going to say that the disabled people in this community do not feel that we're having the communication with human service relation departments or from CCPT that we like to have."

"I don't know who you are speaking for," replied James, "because when I deal with NCCI I have great communication, but when I deal with you and these different tactics that you use that don't work well with others, communication does break down."

"OK, if you think that, that's your opinion," said Debra.  "Some of the things that I do work well for others, work very well for NCCI to get things they need done. I'm going to let that end there."

I've never been a completely objective reporter, just writing down facts and quotes.  I do make observations.

Debra and James know each other only through their professional paths crossing.  Sometimes their methods in reaching a mutual goal don't mesh.  It's unfortunate that such disagreements can impede progress, jam up communications.

And also this observation must be made in a general context:

"Mom, Dad!  Don't fight!"

[ Article edited and revised, 12/08/13, 4:20 PM.  Edited for clarity again at 9:40 PM.  ]

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