And Crash Goes The System

Caption This Cartoon by Drew Sheneman: http://bit.ly/1tKb9ko . Word balloon dialogue by LTB.

(C) 2014 Luke T. Bush

PLATTSBURGH, NY — 06/5/14

Funding shortfall?  If that was the only problem Clinton County faces with its public bus service.  The Big Picture suggests a potential system failure far greater than just one local program.

Recently Clinton County Public Transportation (CCPT) was hit with a funding shortfall from New York State and also a drop in ridership, meaning less money coming in for the service.  (Previous blog article: “Shortfall Means Rough Ride For County Bus Service”)

But there's more to the story.  Like most local agencies across the nation CCPT depends upon on budgetary assistance from higher up, state and federal sources.  To receive this money there are strings attached, rules and laws to be followed to maintain eligibility, such as compliance to the Americans with Disabilities Act (ADA). 

As an activist for disabled citizens Debra Buell has been raising the issue of CCPT being ADA non-compliant for years.  In a Press-Republican article published on 1/6/13 — "Noncompliance puts funding at risk" [1] — she explained at a public meeting that agencies must provide equal access to all citizens, including the disabled.

Debra has been vocal regarding the problems faced by disabled Clinton County citizens including the lack of adequate transportation.  While the county has added another vehicle to its paratransit bus service, Debra says the service is still underserving the disabled community overall. 

Unlike the fixed route buses the paratransit vehicles provide door to door services and the driver can assist any riders who need help.  Also, the fixed route buses can only accommodate one wheelchair at a time and that spot can't be reserved.

The problem with the parantransit service, says Debra, is that too many Medicaid enrollees are being booked for medical appointments while there are other transportation options for them.  This means that disabled citizens who want to commute to a job, attend classes, or go shopping find themselves being excluded.

CCPT Planning Technician James Bosley has stated the bus program is working on the ADA compliance issue but it takes time to effect change.

Obviously it usually costs more to fix problems when something is broken right out of the gate.   If ADA non-compliance becomes a prominent issue then changes will have to be made, maybe costly ones.  If they can’t be made funds could be cut.

Besides non-compliance there is the bigger picture of fraud and waste: the Federal Government is looking into how Medicaid dollars are being spent in New York State.  According to a report issued by the U.S. House of Representatives Committee on Oversight and Government Reform — "Billions of Federal Tax Dollars Misspent on New York’s Medicaid Program" [2] — the authors state:  "As Table 1 shows, New York’s per resident Medicaid spending is nearly double that of Pennsylvania and more than double that of California and the entire country." (Page 7)

In the report's Executive Summary this point is made on page 4:

"Reforming Medicaid in New York faces several significant challenges. For one, many powerful special interest groups in New York benefit from the State’s large Medicaid expenditures and lobby strongly against changes that would reform the State’s program. Another challenge is the long-standing New York practice of increasing Medicaid as a way to leverage extra Federal money into the State."

The summary also refers to "waste, fraud, and abuse within New York’s Medicaid program."

Loosely translated: The Powers That Be are gaming and milking the system which has become a huge gravy train.  (Now if you're looking for the real welfare cheats...)

FBI probes [3] and other ongoing investigations [4] targeting fraud at the higher levels that could quickly thin out that gravy for all sorts of services, including those at the lower levels like CCPT.

Sources:

[1]  "Noncompliance puts funding at risk" - Press-Republican - January 6, 2013 - http://www.pressrepublican.com/0100_news/
x730424949/Noncompliance-puts-funding-at-risk

[2] "Billions of Federal Tax Dollars Misspent on New York’s Medicaid Program" — March 5, 2013 - http://oversight.house.gov/wp-content/uploads/2013/03/Bipartisan-Medicaid-Oversight-Report-Final.pdf

[3]  "New York City Employee Charged in Manhattan Federal Court with Medicaid Fraud" - April 24, 2014 - http://www.fbi.gov/newyork/press-releases/2014/new-york-city-employee-charged-in-manhattan-federal-court-with-medicaid-fraud

[4]  "Report finds $60.8 million in fraudulent New York Medicaid reimbursements" —

May 7, 2014- http://riponadvance.com/news/report-finds-60-8-million-fraudulent-new-york-medicaid-reimbursements/7599