The Future of Rural Public Transportation

1 NEW YORK STATE FORUM 2 ----------------------------------------------------- 3

THE FUTURE OF RURAL PUBLIC TRANSPORTATION 4 5 ----------------------------------------------------- 6 7 Cooperstown Village Library

22 Main St 8 Cooperstown, New York 13326 9 July 22, 2015 10 11 12 PRESIDING: 13 SENATOR THOMAS F. O'MARA 14 SENATOR JAMES L. SEWARD 15 16 17 18 19 20 21 22 23 24 25 1

SPEAKERS:PAGE QUESTIONS 2

Jeanette Frank 10 14 3 Executive Director

Amber Simmons 4 Mobility Manager for Schuyler and

Chemung counties 5 ARC of Schuyler County, New York 6 Sean Yetter 19 23

Commissioner of Social Services 7 Tioga County, New York 8 Karen Sullivan 28 37

Director 48 9 Otsego County Planning and

Solid Waste Department 10

Peggy Bush (ph.) 28 37 11 Regional Manager 48

Birnie Bus Service 12

Paul Paterson 28 37 13 Representative 48

Oneonta Public Transit 14

James Fleming (ph.) 28 37 15 Regular Rider at OPT 48

Also, regular user of MAS system 16

Dan Dineen 49 59 17 Director of Planning

Cortland County, New York 18

Jan Dempsey 49 59 19 Mobility Management Coordinator

Cortland County, New York 20

Jackie Leaf 49 59 21 Executive Director

Seven Valleys Health Coalition 22 23 24 25 1

SPEAKERS (Continued): PAGE QUESTIONS 2

Greg Kilmer 62 68 3 Commissioner of Public Transportation

Broome County, New York 4

Dwight Mengel 71 5 Chief Transportation Planner for

Department of Social Services 6 Tompkins County, New York 7 Michael DeRaddo 78 87

Director of Regional Operations 8 Jamie Mott

Regional Manager for Genesee County 9 and Orleans County

Rochester-Genesee Regional 10 Transportation Authority 11 Jim (no last name given) 90 110

Company Representative 12 Jennifer Carlson

Albany Representative 13 First Transit 14 Bob Zerillo 90 110

Policy Director 15 New York Public Transit Association 16 Bob DiBella 114 116

Director of Transportation 121 17 Ulster County, New York 18 Shelley O'Reilly 114 116

Agency Representative 121 19 ARC of Ulster-Greene 20 Jim Arey 126

Director 21 Elmira-Chemung Transportation Council 22 Jim (no last name given) 126

Company Representative 23 First Transit 24 25 1

SPEAKERS (Continued): PAGE QUESTIONS 2

Roberta Zaire 136 145 3 Lewis County Transportation

Representative 4 Sara Freida

Lewis County Transportation 5 Representative

Lewis County, New York 6

Nancy Dola 136 145 7 Director of Transportation

Essex County, New York 8

Sam Purington 136 145 9 Executive Director

Volunteer Transportation Center 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 1 SENATOR O'MARA: I want to thank you all for 2 coming out today to talk about this very important 3 issue of transportation in all of our more rural 4 counties across New York State, and the 5 non-emergency medical-transportation issues that 6 we've been having, and the growing pains that we've 7 been having with that, and look forward to you all 8 coming up here and giving us your personal accounts 9 of what's going on in your counties as regards to 10 the transportation services and how it's affecting 11 you locally. 12 The plan is to call, either, county by 13 county, or a couple counties up at the same time 14 to -- to sit and give your version of what's going 15 on, and how you're being impacted with all of this. 16 And just give you a heads-up of where we're 17 going: 18 First, we're going to start with, 19 Schuyler County, from my district, will be up number 20 one, so, Jeanette and Amber, be ready. 21 Number two is going to be Tioga County, and 22 then three is going to be Otsego. 23 Four will be Cortland, and then we'll play it 24 by ear from there. 25 But, don't be shy. We're here to listen to 1 you, to figure out exactly what the impacts are so 2 that Jim and I can go back to Albany and continue to 3 work to try to improve these things to -- to help 4 support our rural-transportation networks which are 5 vital to our communities. 6 I want to thank Jim Seward for hosting this 7 hearing in his district in Cooperstown. 8 And, I want to thank the Village of 9 Cooperstown for giving us this room, to be here 10 today. 11 And, I thank all of you for coming and 12 helping fill this room up. 13 Looks like we've got barely a big enough room 14 for everybody to come, so I think that shows the 15 importance of the issue that we're talking about, 16 and the interest you all have in what's going on in 17 your neck of the woods, so to speak. 18 So, we're here primarily to listen, so we can 19 take back information and deal with that. 20 And, Jim? 21 Thank you. 22 SENATOR SEWARD: Yes, thank you, 23 Senator O'Mara. 24 And I, too, want to thank everyone for being 25 here today. 1 The size of the group here, looks like the 2 buses arrived. 3 [Laughter.] 4 SENATOR SEWARD: And this is a critically 5 important issue that we're here to talk about today, 6 and to listen to your concerns. 7 You know, as a result of the Medicaid 8 Redesign Team, their efforts, through the Department 9 of Health, to take over -- have the State take over 10 the non-emergency medical transportation for 11 Medicaid recipients, this has caused some major 12 disruption in terms of the various public 13 transportation systems that exist in the rural 14 counties. 15 This has come about with an eye toward trying 16 to be cost-effective. 17 I, personally, you know, question how 18 cost-effective this move has been, or, effective, 19 when it comes to serving those patients in a quality 20 way. 21 The issue has certainly been one that -- 22 I know Senator O'Mara, and I know Senator Young's 23 office is represented here today -- many of us from 24 the rural parts of the state have been working on 25 this issue the last couple of years in the -- in the 1 budget. 2 In the last two years, we have primarily, at 3 our request, inserted some monies, another 4 million dollars this year, for a total of 5 $4 million, to provide some financial assistance to 6 those rural systems who have been negatively 7 impacted by this implementation of the Medicaid 8 Transportation-Manager System. 9 I know we've attempted to do some things 10 legislatively. 11 I know Senator O'Mara has passed a bill 12 unanimously in the Senate that would create the 13 interagency-coordinating committee on rural public 14 transportation, that -- to give voice to some of the 15 concerns of the rural counties. 16 I have sponsored legislation in the Senate 17 that would give, in effect, counties the right of 18 first refusal, so to speak, if they choose to 19 continue managing the non-emergency Medicaid 20 transportation within their own borders, where that 21 makes sense. 22 But, there's a lot more to be done on this 23 issue, and that's why we're here, to hear your 24 concerns, and recommendations, and I certainly look 25 forward to the discussion. 1 Thank you. 2 SENATOR O'MARA: Thank you, Jim. 3 And I want to give regards, as Jim mentioned, 4 to Senator Cathy Young, who's just west of us, 5 covering the western parts of the Southern Tier of 6 New York, who has been very active in this. 7 And there's also a couple of staff members 8 from here as well. 9 She wishes she could have been here today. 10 But, she's been at the forefront with us on 11 this as well, or maybe a year behind us, because 12 they were phased into this process a year later than 13 our central core of the state. 14 So, we were kind of the first ones to 15 confront these issues, and now it's spread further 16 across the state, so that we're certainly gaining 17 more interest across the state. And our voices are 18 getting louder, the more people we have to talk 19 about this. 20 So, let's get started, and I'll call 21 Jeanette Frank and Amber Simmons up, from 22 Schuyler County, to give us your perspective on 23 either side. 24 Sit together so we don't have to play tennis. 25 [Laughter.] 1 JEANETTE FRANK: Thank you, Senators, for 2 keeping this issue alive. 3 Rural public transit is really important 4 to a lot of people who are otherwise 5 transportation-disadvantaged, and I believe that the 6 need for coordinated transportation is only going to 7 grow as changes occur with trying to meet the 8 demands of Olmstead, which is pushing for people to 9 be more -- living in more community-based 10 environments. 11 I'm Jeannette Frank, the executive director 12 at the ARC of Schuyler. 13 We -- Schuyler County contracts with us to 14 provide the public transit system in our county. 15 We're celebrating our five-year anniversary 16 next month, and it has been an art to keep it alive. 17 The system was originally designed with a 18 coordination effort with our Department of 19 Social Services, providing non-emergency medical 20 transportation, and public transportation as the 21 basis. 22 As of this month, we have no non-emergency 23 medical-transportation referrals supporting the 24 system. 25 Again, thank you for the supplemental 1 funding, because it has allowed us to look at, How 2 do we redesign? 3 And, we are continuing to look for partners 4 to cost-share the basis of the system. 5 The ARC of Schuyler does cost-share some of 6 our runs with the public system, which has allowed 7 us to continue public transit, and even expand to 8 some degree, but it is all tenuous, as we go 9 forward. 10 Amber Simmons is the mobility manager for 11 both Schuyler and Chemung, as an employee of the ARC 12 of Schuyler, and she's on the ground, and can tell 13 you a little bit about how we're doing. 14 AMBER SIMMONS: Thank you. 15 This continues to be a huge issue for 16 ourselves and other counties. 17 Through our mobility-management program, when 18 we originally did the non-emergency Medicaid 19 transportation, we coordinated transportation. 20 We shared the ride with public riders, the 21 Dial-a-Ride, the fixed-group services, and, through 22 a volunteer-network driver program is how it was set 23 up prior. We provided most of those rides. 24 After the changes in the Department of 25 Health, and in the new environment that we are in, 1 the Dial-a-Ride service which served our more -- 2 most rural residents, providing them with essential 3 transportation, not just to their doctors' 4 appointments, but to get them to grocery stores, and 5 to get them to see friends and relatives, and 6 life-supporting services, those rural residents 7 really didn't have a way to get there. 8 The funding just wasn't there anymore from 9 the non-emergency Medicaid, and our Dial-a-Ride 10 service, basically, dwindled down to two days a 11 week, providing just enough time to get people in 12 to, basically, get their groceries and go home. 13 But that Dial-a-Ride service had been a 14 fairly robust system, running five days a week and 15 going through multiple counties. 16 Schuyler County doesn't have any -- we were 17 lucky enough to have a hospital, but we don't have 18 any major medical centers. So, in order for people 19 to get those services, they really had to travel out 20 of county. That service is no longer available to 21 them. 22 So, as we move forward, we were fortunate 23 enough to do some scrambling, and that Dial-a-Ride 24 service was pretty much maintained, simply because 25 the County really didn't want to completely 1 eliminate our rural residents' way to get in to get 2 some sort of service. 3 So as Jeannette mentioned, we scrambled to 4 look for new ways to maintain our service, which 5 turned out into the partnership with the ARC of 6 Schuyler, opening some of our existing routes for 7 the people that we provide supports to, to the 8 public, to open those seats. 9 So we've done our best to do that. 10 But, really, going forward, if that funding 11 is not there, there is nothing to support and 12 sustain, long-term, the needs of the public in that 13 area. 14 And quite -- you know, where the council -- 15 the coordinating council will come into effect, is 16 there really has to be somebody out there that's 17 looking at what's going to happen jurisdictionally. 18 You know, people don't -- they're not working 19 in county lines. They're working over the county 20 borders. They need services in other areas. And 21 there's a lot of hurdles for people to get through 22 in order to actually provide that transportation. 23 So that council could also help guide and 24 break down some of those barriers, and to also 25 ensure that the same -- the same structure doesn't 1 accidentally dismantle more pieces that are in place 2 and reliant on each other. 3 SENATOR O'MARA: You mentioned, Jeannette, 4 that you have no referrals right now. 5 Prior to the changes in the way these rides 6 were handled, what was your monthly ridership on the 7 system? 8 JEANETTE FRANK: The Medicaid riders, when -- 9 well, we were one of the first counties in the 10 upstate area to be subject to the regionalization. 11 And we were about -- 12 AMBER SIMMONS: Well, we were running 13 about -- we were running between 80 and 90 trips on 14 the Dial-a-Ride per month. That was all Medicaid. 15 We were providing close to that number in 16 volunteer trips that we were coordinating. So, if 17 we couldn't make that fit transit, it went to a 18 volunteer. That's a little harder to calculate 19 because that was done in another office. 20 And we had fixed route, which we're not 21 really sure, you know, of the number on that. 22 So they were all on those services. 23 That has -- that's just not there. 24 SENATOR O'MARA: And who is covering those 25 rides now? 1 AMBER SIMMONS: Taxis. 2 JEANETTE FRANK: Taxis. 3 SENATOR O'MARA: And they're referred by the 4 Medicaid Answering Service (MAS)? 5 AMBER SIMMONS: Yes. 6 SENATOR O'MARA: And you get calls from MAS 7 at all? 8 AMBER SIMMONS: Yes. Actually, I had a call 9 this morning. 10 They asked us to take somebody from Clinton 11 to Madison, in -- yes, the entire wrong part of the 12 state. 13 [Laughter.] 14 SENATOR O'MARA: From Clinton to Madison. 15 Okay. 16 [Laughter.] 17 AMBER SIMMONS: That was a call this morning. 18 SENATOR O'MARA: Yeah, that wasn't very 19 helpful. 20 AMBER SIMMONS: No. 21 [Laughter.] 22 SENATOR O'MARA: Jim, do you have any 23 questions? 24 SENATOR SEWARD: No. 25 SENATOR O'MARA: Thank you for being here. 1 You guys -- you ladies have been at the 2 forefront of this with us, and we appreciate your 3 continued interest in letting us know what's going 4 on. 5 And, we continue to try to work to -- as 6 I see it, the transportation network is the wheel, 7 and we've taken a spoke out of that wheel and it's 8 way out of balance right now. 9 So -- 10 JEANETTE FRANK: And, definitely, the 11 coordinating council was something needed. And, 12 hopefully -- you know, I know you were at the 13 forefront of trying to get a coordinating council. 14 I think it's going to become more important 15 as these other changes occur. 16 I know Department of Health has a 17 transportation study. The Office of People with 18 Developmental Disabilities has a transportation 19 study. 20 And if they keep doing things in isolation, 21 it doesn't make sense not to coordinate those 22 efforts. 23 And there's a lot of regulatory barriers that 24 you really need someone on the state level to 25 understand those, and understand where those 1 regulations may have to be modified or relaxed to 2 allow for coordinated transportation. 3 SENATOR SEWARD: No, you are absolutely 4 right, because one of the issues here before us is 5 the fact that the Medicaid Redesign Team and the 6 Department of Health, they are looking at this issue 7 with tunnel vision, not realizing the impact of 8 their actions on others that depend on the public 9 transportation system that has been built up in 10 these rural counties. 11 AMBER SIMMONS: As you read, everything going 12 forward in the Olmstead plan, and in others, 13 everything is community-based. Everyone is 14 stressing community-based service, community-based 15 service. 16 Part of the DSRIP and Medicaid and redesign 17 is based on community-based. 18 Interestingly enough, the community-based 19 transportation development was pulled out of the 20 community and put into a regional system, which just 21 does not make any sense. 22 SENATOR O'MARA: Well, the inner agency 23 working together is what's not happening in 24 New York. And I understand the Department of 25 Health's interest in trying to save costs, and we 1 all should be trying to save costs in the state, and 2 we look to do that every day. 3 But, to just take it away without those -- 4 that part of the transportation structure, without 5 considering what the ramifications are for the 6 entire base, is (unintelligible). 7 So that's one of the reasons that I have 8 supported legislation that I have, and it's 9 really -- it's real earth-shattering legislation, 10 because the inner-agency coordinating committee 11 actually exists under law. And the legislation 12 I have would actually require them to meet. 13 So -- 14 [Laughter.] 15 SENATOR O'MARA: So I'm not sure what the big 16 hangup within that is, but, I've been at it for 17 several years now and not been able to get that to 18 happen. 19 And as you know, you've been involved, and 20 many people in the room have been involved, with 21 some of the working-group meetings we had in Albany, 22 and that really resulted in nothing. 23 So, we continue to work. 24 But, Jeannette and Amber, thank you for being 25 here today. 1 AMBER SIMMONS: Thank you. 2 JEANETTE FRANK: Thank you. 3 SENATOR O'MARA: Next up, we'll hear from 4 Tioga County, and we have, Sean? 5 SEAN YETTER: Yes. 6 SENATOR O'MARA: Anyone with you? 7 SEAN YETTER: No. 8 SENATOR O'MARA: You're all alone. 9 SEAN YETTER: I'm alone. 10 SENATOR O'MARA: Thanks for being here, Sean, 11 and giving us your background from Tioga County -- 12 SEAN YETTER: Yes. 13 SENATOR O'MARA: -- with that. 14 And, you're probably alone because you don't 15 have a transit system in Tioga County anymore. 16 SEAN YETTER: That's right. We all have to 17 travel alone now. 18 SENATOR O'MARA: Yeah. 19 [Laughter.] 20 SEAN YETTER: Thank you, Senators, for this 21 opportunity. 22 I'm Sean Yetter. I'm the commissioner of 23 social services in Tioga County. 24 And, prior to this past year, I was also the 25 director of public transportation, but, as you 1 referenced, that system no longer exists. 2 We were one of the first counties in the 3 state to create what was called a "coordinated 4 transit system," that was able to survive by doing 5 public transit and Medicaid transportation together. 6 And with the funding of those two sources, we 7 were able to build a -- what was a viable and 8 effective transit system in a rural county. 9 And when it was announced that medical 10 answering services would be implemented across the 11 state, we were given early assurances by the 12 Department of Health that that change would not 13 impact how we do business; that they would continue 14 to utilize public transit, and that we did not need 15 to be concerned. 16 Because that was our immediate -- our county 17 and other counties' immediate concern when that came 18 into being. 19 We went into effect with MAS in October of 20 2013, and, immediately, we went from doing 21 approximately 1200 -- 1200 Medicaid trips a month on 22 public transit, to zero. 23 The impact was immediate, and it was a 24 $500,000-a-year fiscal impact that would have had to 25 become local share on a $1.4 million system. 1 So what you had happening, and you have 2 happening, in other counties, is local legislators 3 are boxed into a decision of, Do we add that much 4 amount of local share to keep a transit system going 5 that is only now going to be doing public transit, 6 and not even going to be doing Medicaid 7 transportation, at a cost that would, right away, 8 put them above the tax cap that they're mandated to 9 be under? 10 So our local legislature voted to disband 11 that system in November of 2014. 12 We were given some hold-harmless money from 13 both DOH and DOT, which, of course, was appreciated, 14 to cover that year that we did try to keep it 15 running. But, our local legislature was not in any 16 way going to continue to absorb that cost because 17 there was no assurance that those hold-harmless 18 dollars would continue. 19 So what you had was a failure to recognize 20 the unintended consequences of the implementation of 21 coordinated service by medical answering services, 22 which, in essence, is not coordinated services. 23 Just like you heard from Schuyler, all those 24 trips are going to cabs. 25 Our trips have gone from, we used to do about 1 3,000 trips a month, total, Medicaid trips when we 2 were coordinating locally with our contractor. And, 3 the last month I looked at, which was June of this 4 year, we had -- they had 5200 trips. 5 So not only are they not adequately placing 6 trips where they need to be placed; that being, on 7 public transit when it's available, they're, in my 8 opinion, not even screening as effectively as local 9 districts could do when we had it in our own hands. 10 They're just allowing trips to occur that may not 11 need to occur, and it's created -- there is no cost 12 savings in rural areas to this change. 13 There truly is no cost savings. 14 Also gone, of course, is because of the lack 15 of public transit, commuter service for employment. 16 Consumers of our ARC service were a big user 17 of our system, and they are significantly impacted, 18 elderly and low-income, for everything from shopping 19 to medical to other services, and, of course, the 20 Medicaid population. 21 I see two viable solutions, and the answer is 22 probably somewhere in between, and one you've 23 already referenced, Senator, and that is to allow 24 counties who wish to do opt out of having to be a 25 player with medical answering services, or, hold MAS 1 accountable for those early assurances. 2 And when I say "MAS," I mean the Department 3 of Health; hold them accountable for those early 4 assurances that public transportation should and 5 will be utilized for Medicaid transportation. 6 I'm not necessarily here for Tioga, although 7 I am, because I think that we've had irreparable 8 damage. 9 Politicians are in a very different place at 10 the local level than they were 20 years ago when we 11 created the system. 12 It's all about, How do we get rid of services 13 at the local level and not have any impact on local 14 tax dollars? 15 I just don't see us ever being able to get a 16 system back. 17 But, it's not too late to make the changes 18 that you need to make to fix this and save systems 19 throughout the state. 20 SENATOR O'MARA: Thank you very much, Sean. 21 It's a devastating story, and it really 22 impacts everyone that needs transportation, as you 23 stated, in areas other than just getting to the 24 doctor, to the hospital, back and forth, on a 25 non-emergency basis. 1 So, I appreciate you coming here and sharing 2 all of that with us. 3 When you said you got some hold-harmless 4 money from the State in that first year before the 5 county shut down the whole transit system, how much 6 hold-harmless money did they come through with for 7 Tioga? Do you recall? 8 SEAN YETTER: It was, I believe, 9 approximately $240,000. 10 SENATOR O'MARA: And the overall loss to the 11 County was 500,000? 12 SEAN YETTER: Yes. 13 Because of the shifts that we made as those 14 months passed, it -- it didn't totally add up to the 15 $500,000. It would have if we hadn't changed and 16 reduced routes, and did some gradual things, until 17 we shut the system down. 18 SENATOR O'MARA: All right. 19 Well, thank you very much. 20 Do you have anything? 21 SENATOR SEWARD: I just wanted to clarify, 22 Sean, one point you made. 23 SEAN YETTER: Sure. 24 SENATOR SEWARD: Did I understand you 25 correctly when you said you were -- your research 1 indicates that the number of rides or trips has 2 greatly increased -- 3 SENATOR O'MARA: Yes. 4 SENATOR SEWARD: -- under the new system? 5 SEAN YETTER: Yes. 6 SENATOR SEWARD: From approximately 3,000 a 7 month to...? 8 SEAN YETTER: ...June of this year, it was 9 5200. 10 SENATOR SEWARD: 5200. 11 You know, as a commissioner, and one that, 12 you know, involved with the Medicaid program over 13 the years, would you -- are you suggesting that, 14 perhaps, that some are taking advantage of the 15 system, and there's really no checks and balances in 16 terms of, Is this ride really necessary? 17 Is that -- 18 SENATOR O'MARA: Yeah, I hesitate to use the 19 term "take advantage of," but, when we managed the 20 system locally, and it was our contractor who 21 managed the system and screened the calls, you 22 become familiar with the population you're serving, 23 and you create, basically, a repertoire of who these 24 folks are, and you're able to assess better what 25 those trip needs truly are, and you ask more -- you 1 dig a little bit deeper to see -- you know, we're 2 obligated to ask somebody, Well, if you get to the 3 grocery store, do you have that same transportation 4 to get to medical services? 5 And I just don't think that that kind of 6 screening is happening. 7 The folks at MAS who are answering the phones 8 have not taken the time to learn local systems at 9 all. They don't know our service deliveries. 10 We have cabs coming into the county from all 11 over the place to transport people, because they 12 just don't -- they just don't understand the 13 geography of each county to any degree whatsoever. 14 And a county like Tioga is negatively 15 impacted because we don't have -- we don't have a 16 hospital in the county, we don't have services, you 17 know, to that degree, so everybody is going out of 18 county. And it's just -- it's -- it's escalated the 19 number of trips. 20 SENATOR SEWARD: That's an interesting point, 21 because we heard from Schuyler County, where people 22 who were administering, making decisions on these 23 rides, are in some far-off place, not on the ground 24 and familiar with the local people, or, certainly, 25 local geography. 1 If they're calling Schuyler County to go from 2 Clinton to Madison, which is, you know, in Oneida in 3 Madison County, not Schuyler County or anywhere near 4 it. 5 And in your case, you suggested they are not 6 asking questions in terms of, "Is this ride really 7 necessary?" and they're just -- just calling the 8 taxi. 9 SEAN YETTER: Right. 10 You know, the Medicaid population is not 11 unhappy about this change because they're getting 12 door-to-door cab service, as opposed to being asked 13 to be on a public transit system. 14 We, in the beginning, had a lot of people 15 calling, saying, But I want to take the bus. 16 So it's not, across the board, that everybody 17 wants to be getting in a cab and doing this. 18 But, overall, it's had it's -- it's -- what 19 we created and built over 20 years in counties like 20 Tioga and several other counties, to both educate 21 consumers of Medicaid and the providers of services 22 to those consumers, was undone overnight by this 23 change. And now it's going to take a long time to 24 get it back. 25 SENATOR SEWARD: Well, the point's 1 well-taken, though. You're suggesting it is more 2 efficient with a local administration of these -- 3 SEAN YETTER: Yes. 4 SENATOR SEWARD: -- non-emergency rides. 5 SEAN YETTER: Yes. 6 SENATOR O'MARA: Thank you, Sean. 7 SEAN YETTER: Thank you. 8 SENATOR O'MARA: Next up, Otsego County we're 9 going to hear from. We have Karen Sullivan, and -- 10 SENATOR SEWARD: Do you have your team with 11 you, Karen? 12 SENATOR O'MARA: -- Peggy, who's on my list, 13 or, whoever you have with you, bring them up. 14 KAREN SULLIVAN: Okay. 15 SENATOR SEWARD: Whoever you would like to 16 bring along. 17 This is Otsego County's opportunity, so 18 anyone from Otsego. 19 KAREN SULLIVAN: Okay. Thank you, 20 Senator O'Mara and Senator Seward, for this 21 opportunity. 22 I believe we were in Albany almost two years 23 ago at this -- a similar conference center. 24 Otsego County has moved ahead. 25 We are -- we all were impacted. I don't 1 think I need to repeat what everyone has already 2 said. 3 You know, fortunately, we're not as severely 4 impacted as Tioga, and I can sympathize with them. 5 It is unfortunate that, as I'm sitting at a 6 meeting this morning and transportation comes up as 7 an issue with our region, that now we're in a 8 position where the coordinated efforts that all 9 these counties have taken has dissipated. 10 When I use the word "coordination," and 11 "shared service," I look at the opportunity where 12 agencies can pool their resources. 13 This change in 2013, which -- Otsego County 14 was initially considered as optional. 15 It became mandated without any discussion, 16 but we then were mandated, and we had to act 17 accordingly, which meant we eliminated all of our 18 Dial-a-Ride service and we eliminated routes because 19 of the situation. 20 And then we seek to find more partnerships 21 with OPT, with ARC, with the village trolley, which 22 you see running, which is now part of our county 23 system, to increase our ridership, because, as 24 everyone knows, our revenue is generated by miles 25 and passengers. 1 So the more that we can coordinate systems 2 and not take on the full burden of purchasing 3 equipment and providing riders and transportation 4 and marketing, we look for those opportunities. 5 So we are -- you know, we're functioning, 6 we're keeping close tabs of our cost. 7 Just for an example, our last full statistics 8 in 2012, we had Dial-a-Ride Medicaid, which was 9 100 percent. We had over 7,000 passengers a year, 10 at a cost of, roughly, $172,000; or $23 a person. 11 On our public fixed routes, which we were 12 working with DSS, they were underwriter of our 13 system, we had total passengers from Medicaid, just 14 over 1700, at a, roughly, cost of $6.50 a ride, not 15 including the fares. 16 So, we work closely with our provider, which 17 currently is Birnie Bus, to try to coordinate rides. 18 If there were four dialysis patients coming 19 from the northern part of the county into 20 Bassett Hospital, Peggy, I know made great efforts 21 to try to get more than one person on a bus, or more 22 than one person in taxi. 23 Unfortunately, that's not happening anymore. 24 My personal observation with the change that 25 I saw was, the positives, and I'll go with positives 1 first, is that it definitely was an economic 2 opportunity for our individual taxi services in 3 Otsego County. All of a sudden, I saw these new 4 "medi-vehicles" traveling around that I had never 5 seen before. 6 And so, obviously, that was a positive for 7 them. 8 Also was a positive for the individual taking 9 a ride. They got door-to-door service, so they can 10 come and go as they please. They didn't have to 11 wait for the bus. They didn't have to go to a bus 12 stop. 13 But, those are the two positives. 14 And, also, our DSS staff no longer has to 15 coordinate the rides. 16 So those are some positives. 17 The negatives, is that we lost riders that 18 were taking some of our NEMT bus routes. These lost 19 jobs because the service was discontinued. 20 The coordination of the services was lost 21 between us and DSS, where we were able to coordinate 22 more than one person at a time. That was totally 23 lost. 24 And, the county residents no longer have a 25 stake in the part of it. 1 You -- as Sean said before, the dispatching, 2 as Peggy can speak to, they become very familiar 3 with the people calling for services, and they know 4 the people that are calling for services, and they 5 can coordinate, and they can say, Can you can please 6 try to get your doctor to make a different 7 appointment so we can get you on this public system? 8 That effort's not being made anymore. 9 So, when we talk about coordination, and we 10 talk about green ventures, this is, obviously, not a 11 green venture because this is putting more vehicles 12 on the road now for more transportation. 13 The hold-harmless definitely helped, 14 I appreciate that, and the efforts that are still 15 continuing. 16 We've -- like I said, we've moved on. 17 And I -- you know, we tried to work with the 18 Department of Health to get a cost-share analysis. 19 We felt that we could provide the service, 20 but we wanted to be compensated for the additional 21 part of that; meaning, you take on a Medicaid 22 ridership, there's a certain part of the 23 administration cost. 24 They wanted nothing do with that. They said 25 it's based on fare, that's it. 1 So, obviously, we weren't interested in 2 picking up Medicaid ridership anymore because it 3 just didn't help us in any way. 4 I know Paul distributed out quite a few bus 5 passes to MAS, but I don't know if you want to add 6 to that, what your results were? 7 SENATOR O'MARA: Also, could you please, 8 before, if you could just give us your name and 9 title for the record. 10 KAREN SULLIVAN: Oh, I'm sorry. 11 I'm Karen Sullivan. I'm the planner -- 12 director of planning and solid waste for 13 Otsego County. 14 PEGGY BUSH (ph.): Peggy Bush (ph.), regional 15 manager, Birnie Bus Service. 16 We were the contractor for the County, and 17 did all the coordination of services, and also 18 operate their transit system. 19 I don't have a lot to add to what Karen has 20 already spoke about. 21 I think I just want to emphasize the impact 22 to the actual consumer, because, obviously, we don't 23 have a lot of consumers here to speak for 24 themselves. 25 As Karen mentioned, when I had to announce to 1 our regular riders that services were going to be 2 reduced because of loss of revenue, I had several 3 people that lost their jobs because they didn't have 4 transportation to their employment, because they 5 live in rural areas of Otsego County, and they 6 worked in Oneonta or Cooperstown, and their 7 particular routes were eliminated, so they had to 8 lose their job. 9 To our disabled community, several people 10 that are wheelchair clients, again, because we had 11 to reduce our routes, their rides were eliminated. 12 They are unable to afford private transportation for 13 a wheelchair. 14 So, right now, I don't know how some of those 15 folks even get to where they need to go, because 16 they can't afford, you know, private services, and 17 the bus doesn't go there anymore. 18 So I don't even know. Unless they have 19 friends or family that can help them, I'm not really 20 sure what they're doing. 21 I want to also touch on the fact that -- 22 I know the State's biggest reason for this was to 23 save costs. However, as one example, in our county, 24 the northern-most community is Richfield Springs. 25 We used to coordinate many rides from there to 1 Cooperstown, where their, obviously, Bassett Medical 2 Center is. 3 That ride for them, to Bassett and home, 4 was $2. 5 I can tell you now for a fact, that that same 6 ride is costing the state $50, because all those 7 people are riding in taxis to that facility now, 8 because they're the -- they're regular riders, they 9 were regular clients, that used the system at least 10 once a week. They're now using -- they're using 11 taxis because, they're given the choice. 12 When they contact MAS, MAS doesn't tell them, 13 There is a bus, you need to ride the bus. 14 They don't do that. 15 They give them the choice of how they want 16 their transportation, and, of course, they're going 17 to pick a taxi. It's door-to-door. Taxis also will 18 take them to other shopping venues or other places 19 to do other things. 20 The taxi is getting paid per mile for it, so 21 of course they'll do it. They don't -- they have no 22 stake in it. 23 And to piggyback on that "has no stake in 24 it," when the coordination is being done at a local 25 level, those people are local employees, they're 1 local residents. They have a stake in that 2 coordination too. They know what it's costing the 3 State, and them as the ultimate taxpayer. 4 This coordination is now done in Syracuse. 5 Those people don't care. They don't have a stake in 6 our county, they don't have a stake in their taxes 7 out of this county; so they don't care. 8 And what I found, and what I have been told, 9 is that, when a client calls MAS, MAS, under 10 contract, only has five minutes to assign that ride. 11 <Snaps fingers> They assign it, they're done 12 with it. 13 That's all they care. 14 They don't care about the consumer, and they 15 don't care about coordination of services. 16 They have no stake in it. 17 On that same side, several of our clients 18 have requested us -- or, requested the County, or 19 Birnie Bus, as the transporter, and we still don't 20 get those rides, because they're going to a taxi 21 service. 22 So MAS isn't helping any of us in the rural 23 area at all. 24 SENATOR O'MARA: How many calls a month do 25 you get from MAS? 1 PEGGY BUSH (ph.): Right now, we, as a 2 private transporter, Birnie Bus, we're still getting 3 some, more for wheelchair clients, or people that 4 are requesting us. We get nothing for the county 5 side, for the county, through public transit or 6 Dial-a-Ride. We get none of that. 7 They -- the first month we dealt with MAS, 8 they gave us a couple. There was somebody there 9 that was trying, but they don't understand the bus 10 routes. They don't understand that, in our county, 11 there's, you know, three different bus systems that 12 all coordinate together. They didn't understand 13 Otsego Express from OPT. They didn't understand how 14 we met and how we can coordinate people to get from 15 Richfield to Oneonta. 16 They didn't understand it. 17 We had representatives from their 18 organization into our facility, to try to explain 19 the bus routes to them. 20 Couldn't get it, and have made no attempt 21 since then to try to understand it. 22 Initially, when they -- when they took over 23 our county, they purchased 1,000 bus passes from us, 24 and assured us that they would be calling us back 25 for more passes. 1 I have yet to hear from them. 2 And I don't know if you experienced the same 3 thing, Paul. I know that you sold them tickets 4 initially, too. 5 SENATOR SEWARD: Well, once again, these -- 6 the dispatchers for the medical answering service, 7 they're handling a number of counties. And I guess 8 it's just, they're not taking the time to become 9 familiar with the system in each county or how that 10 could be coordinated. 11 Unlike, if it was done locally, you would be 12 dealing with people who have a real knowledge of how 13 things are working in that county. 14 PEGGY BUSH (ph.): Absolutely. We all have a 15 vested interested in this county. 16 SENATOR SEWARD: A vested interest, right. 17 PEGGY BUSH (ph.): The people at the end of 18 the phone, and MAS, have no vested interest in what 19 goes on outside of their office. 20 SENATOR SEWARD: Uh-huh. It's a real 21 problem. 22 KAREN SULLIVAN: Paul? 23 SENATOR O'MARA: Well, Peggy, for not having 24 much to add -- 25 [Laughter.] 1 SENATOR O'MARA: -- you did a pretty good 2 job. 3 SENATOR SEWARD: It was all valuable, by the 4 way. 5 PAUL PATERSON: And she does do a great job, 6 day to day. 7 I'm Paul Paterson from Oneonta Public Transit 8 in Oneonta, New York. 9 We're a public transit that works in 10 coordination with the county bus system and ARC. 11 And Jim related, "the buses has arrived." 12 Well, this morning, even though I'm the 13 transit director for the city of Oneonta, I was also 14 driving the bus. 15 And many people in this room will understand 16 that. In the small rural systems you wear a lot of 17 hats. Okay? There's not a big overhead. There are 18 not all kinds of folks. 19 These are lean organizations, struggling to 20 get by. And every little hit on their financial end 21 not only hurts service, but it hurts the people that 22 the services was meant to provide. 23 The State of New York provides hundreds of 24 thousands, if not millions of dollars annually, for 25 the capital, for portion of the equipment that's 1 used. 2 And, now, you've put the capital out there 3 and it's being underutilized because we thought that 4 we would be more efficient by coordination. 5 Every person in this room, as have we, have 6 coordinated transportation for years, have worked 7 together. 8 We used to, every night, get a fax from 9 Peggy: These are the clients that need be picked up 10 the next day. 11 It was done discreetly, and, the next day, 12 the people got to where they needed to go. 13 We didn't know why they were going, but we 14 knew there was a central coordination. 15 Just like in our office, very often, you get 16 to know the local people. 17 Mary calls up and says, Hi, Kelly. I need to 18 go to the -- get a hairdresser appointment tomorrow 19 afternoon. Can the bus come by? 20 And you said, Well, Mary, Helen's got a 21 doctor's appointment at the same time. Could you go 22 15 minutes earlier? 23 "Yes." 24 And it happens, and both people get to where 25 they need to go. 1 But if you're calling someone in Syracuse, 2 our experience is that it's for the convenience of 3 the alleged dispatcher up there, but basic as an 4 assigner. 5 And I'll give you the specific example. 6 We had a person who lived on State Street in 7 Oneonta who loved to ride the public transportation. 8 It was existed, it made sense, it was 9 convenient. He got to see other people. 10 Didn't want to ride in the cab. 11 Mr. Jim Fleming (ph.) will relay a -- 12 similar stories as a user of the system. 13 But, anyway, the person was in my office, and 14 I said, "I've got a person here" -- I called MAS, 15 "I've got a person here who has changed their 16 address to 104 Main Street in Oneonta." 17 That's where OPT is. Okay? Buses leave 18 every hour on the hour in Cooperstown. 19 "They want to go to Fox Hospital in 20 Cooperstown, One Atwell Street." 21 Okay? 22 So, the bus starts from OPT, it goes there. 23 He says, He needs to go change his address 24 from State Street. 25 "But how does he go about doing that?" 1 "Well, send in the form, and then I'll give 2 you the phone number for the cab company." 3 So, for a $6 round-trip fare, there was going 4 be, I've heard different things, 20,30, 40 dollars, 5 one way, to Cooperstown. 6 So they didn't even take the time to put that 7 on a map or on an address. There was no attempt at 8 all to try to see, what is the best alternative? 9 It doesn't cost hardly anything to put a 10 passenger in a seat that already exists on the 11 existing bus. 12 And by taking those passengers away, you've 13 denied people who need that transportation, for a 14 variety of reasons, the opportunity to fully 15 partake. 16 And, we want everybody, Well, why don't they 17 go and get a job? 18 Well, if you can't get there because there's 19 no public transportation. 20 So you're hurting the people that can least 21 afford it by this change. 22 We're all for coordination. We understand 23 that, we've worked with it, we do it on a daily 24 basis. 25 But, let the local people, who can do it most 1 effectively, and have proven to do it most 2 effectively, do that. 3 Thank you. 4 SENATOR SEWARD: Thank you. 5 Do you want to introduce your -- 6 PAUL PATERSON: Yes, this is James Fleming. 7 He's one of our regular riders at OPT, and also uses 8 the MAS system on a regular basis. 9 JAMES FLEMING: Your MAS system is a 10 nightmare. 11 It is -- 12 SENATOR SEWARD: It's not ours, it's not 13 ours. 14 [Laughter.] 15 JAMES FLEMING: The MAS system is a 16 nightmare. 17 [Laughter.] 18 JAMES FLEMING: Well, it's yours, you're the 19 legislators, so, therefore, you've got to own up to 20 it. 21 SENATOR O'MARA: Yep. 22 JAMES FLEMING: If you call them to set up 23 transportation, you receive a number of prompts. 24 Okay. You go through the prompts, and the 25 first thing you get is a lady who wants to put you 1 on a taxicab. 2 I don't want a taxi. I'm perfectly willing 3 to take OPT. I've been doing it for years. 4 When they worked in conjunction with 5 Birnie Bus, Birnie sent them a fax every evening, 6 there was a list of names of people who were going 7 to various doctors' appointments. You got on the 8 bus, you said, "DSS transportation," bus driver 9 pushed the button, bingo, bango, you were there. 10 Now if you want a bus pass, I've been on hold 11 for over 20 minutes, waiting to get through to 12 someone to get a bus pass. 13 If it has been an appointment that OPT could 14 not take me to, I have specifically asked for 15 Birnie Bus to transport me because they had 16 transported me in the past. 17 I end up with some other cab company. 18 Now, I was in a taxi one day, and it took 19 me -- and I spoke to Paul about it. It took me 20 about six weeks before I could finally get someone 21 who would issue a bus pass. 22 They kept sending cabs when I didn't want a 23 cab. I just wanted a bus pass. 24 I'm in a cab, and the driver calls for fare 25 information, from Oneonta to Cooperstown. 1 $40; 20 for the cab company, 20 for the 2 driver. 3 Had they given me an OPT bus pass at that 4 time, it was $5. 5 This is supposed to be cost-effective 6 measure. 7 It's not working out to be that way, that 8 I can see. 9 If I have to sit on the telephone, waiting -- 10 and one day I waited 58 minutes before I finally got 11 through to someone to get a bus pass -- I can see 12 why people are like opting for cabs, because that is 13 extremely frustrating. 14 I won't give in. I'm thick. 15 But, if it's cost-effective, make it 16 cost-effective. 17 If these people are offering you 18 transportation alternatives, don't have the cab 19 dispatcher answering the phone on the first ring. 20 Have someone who knows all about the various 21 transportation options in that county answering the 22 phone. 23 I should not have to wait that long. 24 I had an incident, where I go to Albany once 25 every six months to see an endocrinologist. And 1 I have someone who drives me up, and they receive a 2 small stipend for their mileage. 3 Now, I saw them in July, and I had had an 4 appointment in May, and they hadn't received their 5 check. So I called MAS to find out what was going 6 on with their check. 7 They had no record of my appointment. 8 Don't know why. They'd given me an invoice 9 number prior to that, that I had to bring to my 10 doctor and have her fill out, because every time you 11 go to the doctor, he has to fill out a form, stating 12 you've been there, what time, what procedure, phone 13 number, et cetera. 14 Then you have to get that back to MAS. 15 Well, I called up. They had no record of the 16 transaction. 17 They contacted my physician, found out I had 18 been there on the day I said I had been there, and, 19 that they were mailing out a check on Friday. 20 On Monday I called -- this was a Wednesday. 21 The following Monday I called to see if the 22 check had been mailed. 23 All MAS could tell me was, "It's pending." 24 I said, "Pending, how? Pending verification? 25 Pending being mailed?" 1 "It's pending." 2 No training. I mean, absolutely no training. 3 I asked to speak to a supervisor. 4 I get the operator back on the phone. "She's 5 busy. It's pending." 6 "Pending, how?" 7 I think they should be able to answer those 8 questions. 9 If I request Birnie Bus, I should be able to 10 get Birnie Bus. 11 If I want to take OPT and save you $35, 12 I should be able to get to OPT without sitting on 13 the telephone for 20 minutes and hoping somebody 14 will, you know, get it in the mail. 15 Now, the first prompt tells you, if you're 16 calling for medical transportation, you need to call 17 three days in advance. 18 But it's not three days if you want a bus 19 pass. 20 If you want a bus pass, it's actually 21 six days, because the day you count -- call doesn't 22 count, and they need five days to process, they 23 claim, a bus pass and get it mailed out. 24 But they tell you when you call, you just 25 have to call three days in advance. 1 So people aren't aware of the fact that it 2 takes that much longer to process a bus pass, and 3 they're not making them aware. 4 You want to save money? You know, somebody's 5 got to do some better training or something. 6 SENATOR SEWARD: Did you use the system prior 7 to this change? 8 JAMES FLEMING: Excuse me? 9 SENATOR SEWARD: Were you using the system 10 prior to this change? 11 JAMES FLEMING: Yes, I was. 12 I got on the bus, and I told the driver I was 13 a DSS transport. He punched number "7," and that's 14 how it went into the system. 15 SENATOR SEWARD: So from your point of view, 16 it's much more user-friendly and cost-effective, 17 both? 18 JAMES FLEMING: Much more user-friendly. 19 And, if it's a cost-effective measure, a 20 30-some-odd-dollar fare difference. 21 SENATOR SEWARD: Hardly cost-effective. 22 JAMES FLEMING: It doesn't make sense. 23 PAUL PATERSON: I do have to interject, that 24 there's a bus stop right in front -- it just happens 25 to be right in front of Jim's house. And they send 1 cabs to where the bus comes every 15 minutes. 2 So... 3 SENATOR SEWARD: Interesting. 4 SENATOR O'MARA: All right. 5 Well, thank you all very much. 6 KAREN SULLIVAN: Thank you. 7 JAMES FLEMING: Thank you. 8 SENATOR SEWARD: Thanks. 9 SENATOR O'MARA: I know it's a little bit 10 warm in here. 11 We do have some bottles of water over here, 12 to the side, if anyone would like. 13 (Pause in the proceeding.) 14 SENATOR O'MARA: No, we're not taking a 15 break. 16 Next up is going to be Cortland County, with, 17 on my list here, whoever is here from Cortland, 18 Jan Dempsey, Jackie Leaf, Dan Dineen. 19 Good afternoon. 20 Well, thanks for being here. 21 Who wants to lead off? 22 DAN DINEEN: I will lead off. 23 My name is Dan Dineen. I'm the director of 24 planning for Cortland County. 25 And, first, I would like to say thank you to 1 you Senators for allowing us to speak about this 2 very important issue today. 3 Cortland County has had public transportation 4 since 1993, and the number one reason why it was 5 initially implemented in the county was because 6 medical trips were being provided by taxis, 7 uncoordinated, at a great price. 8 So, we thought that we would start operating 9 a public transportation system to coordinate these 10 services at a lesser cost. 11 And, that has worked great for the past 12 22 years. And, now, with those trips being provided 13 through medical answering services, we're back to 14 the way it was 22 years ago, with trips being 15 provided on taxis at a higher cost than they were 16 when they were coordinated through the public 17 transportation system. 18 Our public transportation system has grown 19 over the past 22 years as a result of our 20 coordinated efforts. And, we provide services for 21 not only medical transportation, but for folks to 22 get to work, for educational opportunities. 23 We've actually expanded our service to 24 Tompkins Cortland Community College in our 25 neighboring county, to provide service for 1 educational purposes to that institution, as well as 2 commuter bus system to Cornell University for 3 employment needs. 4 So we have -- over the years we've 5 coordinated our system, and a lot of that 6 coordination is being lost through the loss of the 7 non-emergency medical transportation as a result of 8 MAS scheduling those on taxis. 9 But, I have Jan Dempsey here from 10 Seven Valleys Health Coalition who can talk more 11 about the impacts of MAS. 12 JAN DEMPSEY: Thank you, Senators, for this 13 opportunity. 14 Again, my name is Jan Dempsey. I am the 15 mobility management coordinator in Cortland County, 16 and I work under Seven Valleys Health Coalition. 17 And I want to address some very specific 18 concerns that I see on a daily basis with the people 19 who contact me as a mobility manager. 20 First of all, I want to talk about MAS, and, 21 I don't believe the system is working quite as -- 22 quite as well as they tell us. 23 At our last meeting, I believe in February or 24 March, you know, everything was fine, and they had 25 worked through, you know, all of the issues. 1 But, we're still hearing about a lot of 2 missed appointments, especially the out-of-county 3 trips. 4 We're hearing that people need to confirm 5 their trips ahead of time, even though Department of 6 Health and MAS say they do not need to do that. 7 But, we've been told that if they don't, those trips 8 are not in the system. 9 So, there seem -- there seems to be some type 10 of a lack of scheduling. I'm not sure if they're as 11 automated as they -- they say they are. 12 We've heard differing things about that. 13 I think they are struggling to schedule 14 rides. 15 We had an incident, one person was told to 16 take the Greyhound bus from Cortland to the regional 17 transportation center in Syracuse, where they were 18 told then they had to pick up a taxi to get to their 19 medical appointment in Syracuse. 20 That -- that's pushing it for -- and we have 21 four taxi companies providing the majority of the 22 rides in Cortland, three of which are not county -- 23 Cortland County-based. Even last month, there is 24 another taxi coming in from Oneonta. 25 So they're bringing them in from all over 1 because they cannot -- they cannot do those trips. 2 On another issue, we had a local agency that, 3 due to problems with MAS, they purchased two 4 vehicles in December. And, just last week, they got 5 their approval to be a transportation -- Medicaid 6 transportation vendor. 7 Well, this all came about because, in 8 November of last year, they had 24 no-shows of their 9 clients not showing up, which, obviously, causes 10 problems for their clients, but also had a huge 11 financial impact on that agency. 12 So they decided to go out and purchase 13 vehicles and to do their own transport. 14 Now, the funding for those vehicles came from 15 the OASAS program (the Office of Alcoholism and 16 Substance Abuse). 17 So what you're doing is, you're just 18 transferring the cost from one agency to some other 19 agency. 20 MAS is delighted because they're going have 21 another option for transport, but, that is still 22 costing taxpayers money, it's just coming out of a 23 different -- different program. 24 Another issue for us are the taxis 25 themselves. 1 There's no oversight of these taxis. 2 And, I've also been hearing less and less of 3 what's going on because, back in January, the 4 Medicaid field liaison from MAS for Cortland County, 5 she started telling all of her clients, the 6 organizations and agencies that she works for, that 7 if they had any issues or problems, don't contact 8 the mobility manager. 9 And so their explanation was that, Well, it 10 will save a step, and it will give, quote, their 11 direct access to grievances for quick resolution. 12 But, I think the real reason was because, 13 when they would contact me, I would contact MAS to 14 advocate for them, but I would also let the 15 Department of Health know what was going on. 16 That, I think is the real reason. 17 So now there's very little independent 18 oversight. 19 And then when you start talking about the 20 taxis, they're private entities. They can deny 21 service to anybody they want if it's not 22 discriminatory. 23 So, I recently heard from someone who is 24 being denied service by a local taxi company because 25 she complained about their service in the past. 1 So when they see her address pop up, they 2 refuse the ride. 3 Well, then that got me thinking, well, that 4 could happen with the Medicaid taxis as well. They 5 accept or deny rides all the time. 6 So, if people start complaining, they may, 7 you know, suffer some consequences of that 8 complaining. 9 So now I'm thinking that people are just 10 keeping quiet about what's going on. 11 So it is -- it's harder for us to find out 12 exactly what's -- what's happening. 13 The other thing with the taxis is the 14 Department of Health doesn't want to oversee the 15 taxi services. They want to leave it up to the 16 local authorities. 17 This came up at one of our previous meetings, 18 there were issues with the taxis. 19 But, MAS is scheduling most of the people in 20 taxis. 21 And based on last month's data, 88 percent of 22 all ambulatory trips are scheduled -- in 23 Cortland County have been scheduled in taxis. 24 So we have in Cortland, the way it works, is 25 the city police in Cortland actually oversee license 1 and regulate taxis within the city limits, but they 2 don't have any oversight in the rest of the county. 3 And only one of the four taxi companies 4 operating under Medicaid is licensed by the City, 5 because those other ones are coming from out of 6 county. 7 So, I've tried -- it's a complicated issue. 8 I've tried to get an answer from the City of 9 Cortland attorney, regarding whether taxis that are 10 contracted by Medicaid are subject to the same 11 licensing and registration requirements. 12 But I haven't heard back because -- I'm not 13 sure. There's an answer there. 14 There are loopholes in the state law that 15 allow taxi drivers to smoke in their vehicle as long 16 as there are no passengers. 17 This is a huge problem. 18 Medicaid policy states that there should be a 19 clean, non-smoking vehicle, but they don't enforce 20 it, and they say, It's up to the local authorities. 21 But we don't have any oversight of the taxis. 22 So the fact that they're putting these people 23 in taxis, that have no oversight, I think is a big 24 problem. 25 Also, like I said before, public transit 1 versus the taxi ridership, last month alone, 2 1,090 taxi rides to 147 transit rides. 3 The impact on the system, as of April 1st, we 4 had to eliminate -- or, Cortland Transit had to 5 eliminate Dial-a-Ride in the rural areas of our 6 county. 7 So that means there's -- you know, unless you 8 live near a fixed route in the rural areas, and 9 that's very limited, there are people who have no 10 options. 11 Especially for those who are in wheelchairs, 12 they call me, I don't have any real option to give 13 them. There are no accessible taxis. 14 There's really, unless they have somebody, 15 you know, that can provide that transportation for 16 them, they're pretty much out of luck. 17 A lot of them will end up being forced to 18 move into the city; move out of their homes in the 19 rural areas of the county. 20 That's about what I wanted to say. 21 SENATOR O'MARA: Thank you. 22 JACKIE LEAF: Thank you very much, Senators, 23 for putting this together today. 24 My name is Jackie Leaf. I'm the executive 25 director of Seven Valleys Health Coalition. 1 And I don't have a lot to add to what Dan and 2 Jan have said. 3 And as well as even else, I think it's very 4 clear, in rural communities, the cost-sharing and 5 the coordination is so very important, and having 6 that taken away from us is really having a lot of 7 huge negative impacts. 8 The infrastructure is not there in the rural 9 communities like it is in an urban area for the 10 oversight of the taxis, like we're talking -- you 11 know, talking about that in particular. 12 Also, the cost-sharing helps, because the 13 health and well-being is beyond just going to the 14 doctors' appointments. 15 The low-income wage earners that rely on the 16 buses to get to work, now without the cost-sharing 17 of the public transportation system, we're losing, 18 you know, a lot of public transportation. 19 So, it's affecting people. 20 Even the people on Medicaid who are happy to 21 take the taxis, don't realize that those taxis 22 aren't going to get you to the grocery store, and 23 they're not going to get you to the drug store to 24 get your prescriptions filled, or the chronic 25 disease self-management classes that might be 1 offered in the community. 2 DSRIP is going be hugely affected, negatively 3 affected, with the loss of the public transportation 4 as the things they're trying to do through DSRIP, 5 because you need that cost-sharing to keep the buses 6 going so people can get to those other things. 7 And, I don't think the people on Medicaid 8 that opt for the taxis realize that it's taking away 9 from the bus system, and, eventually, they're not 10 going be able to get their prescriptions filled, 11 they're not going be able to get to the grocery 12 store, they're not going to be able to get to their 13 jobs. 14 So, it's very important that we look at this, 15 so, we really appreciate you taking the time. 16 SENATOR O'MARA: Now, you said your 17 ridership -- or, the current ridership is about 18 200 on transit and 1,000 in taxis, or something like 19 that you said. 20 Were those rides that the transit system was 21 getting prior to the changes? 22 JAN DEMPSEY: They're getting -- I don't have 23 that exact figure. 24 Do you remember, Dan, what Dial-a-Ride 25 numbers they had before? 1 The thing was, too, there were a lot of folks 2 that were taking the fixed routes. And now we don't 3 really have a good indicator of the numbers there, 4 of how many people that MAS is putting on the fixed 5 routes. 6 We think that's very, very small, because 7 they don't know our system, like other people have 8 said. 9 They don't know our system. 10 JACKIE LEAF: There is a significant -- was a 11 significant drop in the number of the Dial-a-Ride. 12 But, in the previous system, with the fixed 13 routes, when people on Medicaid used the fixed 14 routes, they were given a token. 15 So there was no way to identify them as being 16 somebody on Medicaid, going to a doctor's 17 appointment. So, we don't have really good numbers 18 about how many people were riding the bus, because 19 they would pay the dollar -- if they didn't have a 20 monthly pass that paid for them, they would pay 21 their dollar fee, just like everybody else did, to 22 ride the bus. So you had no way of knowing it was a 23 Medicaid person. 24 They didn't mind paying their dollar to ride 25 the bus, which I think is what the gentleman 1 testified previously. He liked taking the bus. No 2 problem paying his dollar to take the bus. 3 So, you have no way of actually counting 4 that. 5 So, in the previous system, they didn't have 6 specific numbers like they do now. 7 But we do know the numbers in the Dial-a-Ride 8 have significantly decreased. 9 SENATOR O'MARA: You have now eliminated 10 Dial-a-Ride completely? 11 JAN DEMPSEY: Just in the rural areas. 12 There is Dial-a-Ride within the city of 13 Cortland and the village of Homer. 14 But, in the rural areas, no. 15 SENATOR O'MARA: Thank you. 16 SENATOR SEWARD: It's A great loss. 17 Thank you. 18 SENATOR O'MARA: Let's see. 19 We have, Monroe County? Is someone here from 20 Monroe? 21 Elizabeth Murphy? 22 No? 23 Okay. 24 All right. 25 1 Broome County? 2 Broome? 3 There are a couple of people on the list from 4 Broome. I'm not exactly sure who's here and who 5 isn't. 6 But, anybody with you? 7 GREG KILMER: I came alone. 8 SENATOR O'MARA: Okay. 9 Good afternoon. 10 GREG KILMER: Good afternoon. 11 Greg Kilmer. I'm the commissioner of public 12 transportation for Broome County. 13 And, again, I would like thank both of you 14 for coordinating this event, and it really is an 15 important issue. 16 I actually didn't have any prepared remarks, 17 but I kind of want to look at this from almost a 18 scholarly perspective of: How did we get here? How 19 is it working right now? A couple of the possible 20 solutions we might have. 21 I think this is a classic case of intent 22 versus impact. 23 I think the intent from Department of Health 24 was noble. I think that they were trying to seek 25 efficiencies by having a centralized agency 1 coordinate transportation. 2 But that effectiveness, though, has been 3 extremely negative, particularly on the rural pieces 4 of the transportation. 5 Now, in Broome County, I represent the larger 6 form of public transportation, which is our 7 fixed-route urban core that coordinates with the 8 rural system, as well as with our paratransit 9 system. 10 And, it's had a very negative impact on us. 11 Probably the most simple metric that we can 12 look at is the proliferation of cabs in 13 Broome County. 14 We have a population that's basically flat or 15 declining; yet, we're having a relatively large 16 increase in cabs. 17 We've had a very, very negative impact on our 18 rural system. 19 So, you know, in this case, I think we're 20 looking at examples of our government and silos. 21 There was lack of coordination in the sense 22 that you have one of the largest consumers of public 23 transportation in Medicaid spending. 24 People need medical care, they need various 25 forms of health care, rehabilitation, job 1 reeducation; that type of thing. All of it requires 2 transportation. 3 And, so, it's not necessarily Department of 4 Health's fault that public transportation is, I'll 5 use "brittle" as a description. 6 You know, we operate on a very, very thin 7 razor's-edge margin. And when you take away one of 8 the largest consumer groups and spread it out over a 9 new form of spending, you know, realize, public 10 transportation has been heavily invested by the 11 taxpayer -- federal dollars to build capital, state 12 dollars to operate and do capital, as well as local 13 county and municipal dollars to build those 14 systems -- and as such, we operate to a high 15 standard. 16 We have drivers that operate under a very 17 stringent program called "19A," where these people 18 have to be healthy, clear-headed, and they're 19 checked regularly. 20 We've got buses that are inspected, front to 21 back, every 6,000 miles and maintained to a very 22 high standard. 23 So on and so forth. 24 Yet, we've shifted a sizable portion of the 25 transportation that we're providing to cabs, which, 1 obviously, operate at a much lower standard. Their 2 vehicles are much less expensive and subject to a 3 lot less overview. 4 And it's not to say that those folks can't 5 provide a safe trip. 6 But, the truth of the matter is, we've asked 7 the taxpayers to invest in serving the public by 8 building an infrastructure of buses, both rural and 9 urban. 10 And now we've, basically, taken away a large 11 chunk of the funding that came via transactions, and 12 we've taken away from public transportation to the 13 point, where our neighbors in Tioga County have gone 14 under, where we're seriously contemplating what our 15 next efficiencies are in Broome County. 16 And so, at the end of the day, this is a case 17 where this isn't irrepairable. It can be fixed. 18 And part of it is that, the State tried 19 something new from the Department of Health 20 perspective. But, unfortunately, there's not a lot 21 of robust third-party providers out there that have 22 plug-and-play systems that can provide ride 23 scheduling at a highly coordinated level. 24 Subsequently, you've an organization, and 25 this isn't necessarily a slap at MAS, you know, they 1 made a lot of promises, and some of which they 2 delivered, and some of which they haven't, to be 3 fair to them. 4 The problem is, there's not a robust, 5 competitive third-party provider network out there. 6 And, at the end of the day, you're talking 7 about very intricate transit systems, geographic 8 layouts, the intricacies of the people that are 9 using the services. 10 Those all point best to going back to a model 11 where the local service providers have the most 12 oversight, the most intelligence that can let them 13 make the most informed decisions. 14 And, oh, by the way, they can actually hold 15 people's feet to the fire when they're not 16 necessarily complying. 17 So, you know, we really can't blame the end 18 user, because who wouldn't want a door-to-door, 19 convenient schedule, single-ride system, when you're 20 looking at coordinating and sharing a ride that's 21 maybe, in some cases, a little bit less convenient; 22 yes, you may have to alter 15 or 20 minutes to one 23 side of your schedule. 24 So, you know, the solution is, really, I have 25 a couple of things I might recommend. 1 One is, simply, to ask that the policy, as 2 written, is adhered to. 3 And one of the components in that, was that 4 people, prior to MAS coming on board, prior to using 5 a third-party coordinator, that, basically, they 6 were to give people like-kind transportation; 7 meaning, if they took a bus, then they were to get a 8 bus pass. If they took a cab, then they would get a 9 cab ride. If they use their own car, they would get 10 a reimbursement. 11 Well, the metrics don't bear that out. 12 They're simply not honoring the intention of 13 the policy as written, because, as a matter of 14 convenience, to try and grow this massive 15 organization that has taken on a tremendous amount 16 of transactions statewide, as you can imagine, the 17 amount of trips are very numerous. 18 So, they're taking the path of least 19 resistance. 20 And, in doing so, it's much easier for them 21 to simply call a cab. Even if that cab costs more, 22 from a transactional standpoint, it's easier for 23 them. 24 So, the first option, is simply to have them 25 perform as the policy is written. 1 But I would suggest that probably the better 2 option would be the second, which is what you've 3 already suggested, Senator, is that we simply allow 4 the counties to carve out, to opt out, of the system 5 as it's designed. 6 SENATOR O'MARA: Has Broome County shifted 7 over to take up any of the business in Tioga since 8 they shut down their transit system? 9 GREG KILMER: We have not. 10 We took a good hard look at it, and at the 11 end of the day, I think there was a lot of 12 skepticism, when we were having our own financial 13 problems, to adopt a business model that already 14 resulted in failure in a neighboring county. 15 And we saw the merits of it. 16 I mean, these are people that come and they 17 get education and health care and they shop and they 18 procure services and goods in Broome County. 19 But at the end of the day, there were no 20 assurances that this wouldn't just accelerate the 21 losses that we were experiencing with public 22 transportation. 23 SENATOR O'MARA: Is there a difference in 24 what you're seeing from -- because you've got 25 Binghamton, a more urban area. 1 GREG KILMER: Correct. 2 SENATOR O'MARA: You've got some outlying 3 areas as well. 4 Is there less of an impact in Binghamton than 5 there is on the more outlying areas of the county? 6 GREG KILMER: Yeah, that's an accurate 7 assessment. 8 I mean, we are robust enough in a sense that 9 we have a strong urban core. We've got a very 10 prosperous university and college system in the 11 area, so we could buffer this to a certain extent. 12 And if you look at Tioga County, where 13 I believe almost half of their ridership was related 14 to Medicaid spending, they simply couldn't. 15 And, quite frankly, we are contemplating 16 efficiencies. 17 We have consultants that we're hiring right 18 now to look at our overall picture, to improve our 19 financial position. 20 And, this is one of the areas that has had a 21 significant impact on our solvency. 22 SENATOR O'MARA: To what extent? 23 Can you quantify that as far as dollars or 24 percentages in loss of ridership? 25 GREG KILMER: We have recovered from the 1 peaks in 2011 before this policy was enacted. 2 We are seeing a return to urban-core 3 ridership that is, roughly, the same as it was back 4 then. 5 We've seen a tremendous dropoff, in the 6 neighborhood of close to $300,000, affected by the 7 rural system. 8 SENATOR O'MARA: And what type of 9 hold-harmless dollars has Broome gotten in the past 10 year or two? 11 GREG KILMER: I believe we received about 12 172,000, which was about 47 percent of our loss due 13 to this. 14 And we appreciate it. 15 Obviously, more would be helpful. 16 SENATOR O'MARA: Yeah, but, obviously, it's 17 not covering that whole loss -- 18 GREG KILMER: That's correct. 19 SENATOR O'MARA: -- to support the whole 20 system. 21 GREG KILMER: That's correct. 22 SENATOR O'MARA: So you're looking at ways to 23 cut back, I would say, in the rural areas, on the 24 routes and things? 25 GREG KILMER: Yeah, as a holistic approach, 1 we're trying to find the greatest efficiencies that 2 we can, and it could very well result in cutbacks in 3 the rural service. 4 SENATOR O'MARA: All right. 5 Thank you very much. 6 GREG KILMER: Thank you. 7 SENATOR O'MARA: Next, we've got a few from 8 Tompkins County that are here? 9 One? 10 DWIGHT MENGEL: Thankfully. 11 SENATOR SEWARD: Well, the others are 12 well-represented. 13 DWIGHT MENGEL: My name is Dwight Mengel. 14 I'm the chief transportation planner for the 15 Department of Social Services. 16 And I would like to -- first, I want to thank 17 you very much for calling this meeting. 18 Frankly, without you doing so, it is not 19 clear that there was any process to solicit input 20 from affected counties. 21 So thank you very much. 22 From the point of view of Tompkins County, we 23 have a different situation than what you've heard of 24 so far. 25 First, our fixed-route transit service is the 1 largest of the small urban systems in the -- in the 2 state. It's very robust. 3 We assume that MAS is assigning and sending 4 passes to people using the fixed-route service. 5 But, our fixed-route numbers are 4.2 million 6 per year, and it would just be susumed (sic). 7 So, on the fixed -- fixed-route side, we 8 don't necessarily see, one way or another, a 9 measurable impact. 10 We do have a demand-response service called 11 "Gadabout" that's been operating since 1978. 12 And, up until the month that MAS took over as 13 the broker, had very steady ridership increases. 14 At their height, Gadabout would serve 15 66,000 trips per year. 16 They use both volunteer drivers and paid 17 drivers. They are a regulated transportation 18 corporation, and they comply with all of the 19 standards and safety and regulatory 20 reacquirements (sic) that any of the public transit 21 services do. 22 Since MAS began to schedule rides, and 23 Gadabout was only charging 3 to 4 dollars, the 24 regular fare, Gadabout has had a sustained 5 percent 25 decline in their ridership, and so we can only 1 imagine that people have been switched off, similar 2 to what you have heard today. 3 The other thing, too, is they've had people 4 who have called up MAS and said, I want to use 5 Gadabout. And, they kept being referred back to the 6 taxis. 7 So it's a very similar story that you have 8 heard today. 9 But one thing that I don't think you have 10 heard today, is that we're becoming aware of certain 11 types of trip failures that are happening, relative 12 to taxi providers, that did not happen when people 13 used the demand-response service, Gadabout. 14 And it's something that we want to take an 15 initiative to resolve. 16 And when I mean "trip failure," is where a 17 taxi operator takes a person to the doctor's office, 18 and then does not come to pick -- pick them up, 19 although they have assured the person 5 times, every 20 30 minutes, that they are on the way, on the way, on 21 the way. 22 And when the doctor's office closes, the last 23 call is, We're not coming. 24 And, it just so happened that this was a -- 25 a client who came outside of Tompkins County, into 1 Tompkins County for medical service. And because of 2 a -- the kindness of another patient, the person was 3 able to get home. 4 Now, there were -- there were two failures 5 here. 6 One was, that the taxi operator was supposed 7 to assess and determine after the first hour that 8 they could not make that trip, and they were 9 supposed to call MAS to report that. 10 Okay? 11 Also, from the point of view of MAS, the 12 client ought to have called MAS. 13 And when we talked with the client, why you 14 did not call, it's just that, she was upset, she was 15 upset, for everything. 16 I mean, you're talking about people in all 17 types of states. 18 And, she was afraid that if she complained, 19 there would be retribution, and et cetera, 20 et cetera. 21 But just people who are frail; emotionally, 22 they are ill; they're at the doctor's; they're, just 23 from a real human-level perspective, to say, Well, 24 it's the person's fault that they weren't 25 complaining to the right people to get their trip 1 resolved. 2 So, I'm -- I'm determined that we find some 3 resources to create what I am -- am -- what I've 4 called an "SOS" app. 5 But, we need to be able to have available for 6 people in medical staffs, and so forth, and we would 7 promote it, that these are the procedures to use if 8 somebody is having a problem and their taxi is not 9 coming. 10 And, I think that we need to back that up 11 with a guaranteed-ride program that would serve 12 anybody coming into Tompkins County. If they have a 13 complete trip failure and they can't get home, that 14 there is a service that would backstop this. 15 And -- and, frankly, it's something that we 16 would -- we would never allow this to happen with 17 our demand-response service. We don't abandon 18 people. 19 So that was one -- that was one thing. 20 The -- a second issue is a basic 21 public-safety issue, and it is one that, when 22 Jan Dempsey talked about this from Cortland, but, 23 I want to bring a situation that I heard completely 24 by circumstance while on vacation up in the 25 North Country. 1 And, I was in the library. A woman asked me 2 for some technical assistance to get rid of this 3 pop-up on her laptop, and that resulted, that she 4 found out that I worked for the Department of Social 5 Services, when she had a very serious issue that she 6 wanted to talk about relating to Medicaid service. 7 She said there was a cab company from 8 Ticonderoga which is servicing their area. There's 9 a driver there who solicits women for sex, that 10 solicits patients for their prescription drugs, and 11 has committed sexual assault. 12 That was her allegation. 13 She asked me what should she do. 14 She went to the police department. She's 15 gone to the state police. She's called MAS. 16 She's going around to the doctors' offices 17 saying, You don't want any of your patients being 18 brought by this taxi provider. 19 She said there's a 30-mile area between 20 Tupper Lake and Saranac Lake where 911 does not 21 cover, and these conversations happen then. 22 And so she said, "Well, what more can I do?" 23 And the only thing I could think of was, 24 you -- you could try to be recording audio. 25 You need -- anytime anybody gets in a cab, 1 you need to have some verification of, like, what is 2 happening. 3 The -- but the basic systemic issue here is 4 that, you have the public-transit side, with 5 background checks, with drug and alcohol, with 6 system safety plans; and you have the taxi side, 7 which in the North Country is, any licensed driver 8 with $50 becomes a taxi driver, and it is with, 9 apparently, no background checks, or no any -- and 10 there's no system anything. 11 Drivers are working 12-hour consecutive 12 shifts. 13 Those are things that are not allowed on the 14 public side, but that is who's conveying everybody 15 on the taxi side. 16 Now, there's some great taxi services out 17 there. There's people who are very vigilant. 18 We have them in Tompkins County. 19 But our largest taxi operator has told me 20 that he's concerned because, now, Medicaid is 21 30 percent of his business, and growing, and he's 22 concerned that now he is -- he's really locked into 23 this system. 24 That his concern is that, if this growth 25 keeps happening, that he will -- he'll end up having 1 to ration the service that's available to the rest 2 of the public, because it's -- how do you juggle all 3 of this, like, growth and still have a service? 4 So those are some perspectives I wanted to 5 relate to you. 6 And, thank you very much. 7 SENATOR O'MARA: Thanks for coming. 8 SENATOR SEWARD: Thank you. 9 SENATOR O'MARA: Next up, let's go with 10 Genesee County, Livingston and Wyoming counties, and 11 Ontario County; we have some representatives from 12 them? 13 Do you want to come up together. 14 Good afternoon. 15 MICHAEL DERADDO: Good afternoon, gentlemen. 16 My name is Michael DeRaddo. I'm the director 17 of regional operations for the Rochester-Genesee 18 Regional Transportation Authority, commonly known as 19 "RTS" now. 20 And, this is Jamie Mott, who's one of my 21 regional managers, who oversees Genesee and Orleans 22 county. 23 Basically, we have the -- of the eight 24 counties that our authority has oversight on, seven 25 of them are rural. We have Genesee, Livingston, 1 Ontario, Orleans, Seneca, Wayne, and Wyoming. 2 So those are the seven counties that we have 3 general oversight and provide services for. 4 I myself, I joined the authority last year. 5 Prior to that, I was Ontario County transportation 6 director, when they were an independent, 7 self-coordinated county. 8 As the county reps, we ran the call center 9 and the transportation, and we did eligibility, and 10 we did the trip assignments to our public transit 11 company at the time, which was run by 12 MV Transportation Company at that time. 13 Ontario -- I'll speak specifically with 14 numbers in Ontario County. I have their -- their 15 data, if you will, generally. 16 Prior to MAS, on average, they were running 17 about 2,000 Medicaid trips per month. 18 Just -- I just called the regional manager 19 earlier this morning. Last month, they had 20 586 trips. 21 I think, on average, annually, it was about 22 $840,000 in revenue. Now we're hoping to get about 23 a quarter of a million, and continually declining. 24 That's about a 70 percent drop. 25 The last time we -- and I do thank you for 1 this opportunity, because I did participate last 2 time as well. 3 By the time -- this happened last time, and 4 by time we joined the authority, they were hovering 5 around -- Ontario was hovering around 47 to 6 50 percent drop in ridership, and, we continually 7 decline now. 8 So we're at a 70 percent drop. 9 That's, obviously, impacting jobs, not only 10 for them, but, for us, as the authority, we're also 11 in the process. We have an RFP out now for us -- 12 regional-operation service-efficiency plan, and 13 Medicaid is going to be a huge part of it. 14 We're look for efficiencies. 15 We're going through internally as well, but 16 we're going to go through this consultant, get the 17 feedback, and see, as the authority, our way ahead, 18 because we cannot -- in some counties it's 19 negligible. Other counties are impacted a lot more 20 significantly. 21 And, Jamie will talk about Orleans and 22 Wyoming that are more impacted than others. 23 Seneca is impacted as well. 24 So those are the three counties that -- out 25 of us, that are impacted the most. 1 Ontario, since August 1st, will be the 2 one-year mark. 3 We've made an agreement with Ontario County 4 not to change any services for the first year. 5 So, we are going through the analysis and 6 we're looking at service efficiencies, service 7 changes. 8 I'm not going use "reductions" or "cuts." 9 We're looking at options, and we have not made a 10 decision on where we're going. 11 We're still reviewing our courses of action, 12 and then we're going to compile with the consultant. 13 Similar stories that you've heard, nothing 14 really above and beyond that that we have. 15 So, I mean, they've already mentioned all of 16 the horror stories, the issues. 17 Some of it's good. 18 Some of our regionals, like Genesee, I think, 19 has actually had an increase in trips. 20 Livingston County actually had a slight 21 increase in trips; however, the significant -- the 22 cost was significant to conduct those trips, based 23 on the rates, and stuff like that, and changes of 24 rates and the mandatory rates forced on us without 25 us requesting changes. 1 However, overall, it's a negative impact on 2 us. 3 And the second, third order of effects is the 4 public transportation available for the general 5 public, to include other medical transportation, if 6 not Medicaid, that is declining. 7 So I'll turn it over to Jamie with other 8 concerns. 9 JAMIE MOTT: Thank you, gentlemen, for 10 letting us be here today. 11 I think I can give you some specific, very 12 similar to what everybody has already said. 13 In Genesee County and Orleans County, we went 14 through the process of actually applying and 15 becoming taxi vendors so we -- we can service the 16 community with the same exact taxi rates. 17 Wyoming County was very similar already. 18 They had those similar taxi rates. 19 But, interestingly enough, your -- 20 Orleans County, since the -- that was done in 21 2007 -- the MAS takeover was 2007. 22 Orleans County has always had very few rides 23 on public transportation. And, within the last few 24 months, since applying and being approved for 25 taxi-rate-vendor level, we've dropped down to zero. 1 So there are no rides. 2 Not only are there no taxi rides -- or, 3 rather public transportation rides, there's not even 4 taxi-level-service rides being assigned to public 5 transportation in Orleans County. 6 Seeing some very similar drops in 7 Wyoming County. 8 Genesee County, although we've been 9 successful, and we've seen some moderate increases, 10 one of the biggest changes that we've also seen is 11 the administrative burdens place upon the billing 12 side and the management side and the communications 13 side, in dealing with rates, and rides assigned to 14 us that are incorrect, incorrect addresses, having 15 to go back and request transportation changes 16 through MAS. 17 There's a 30-day turnaround, oftentimes, for 18 them to give us those rides back, so then the 19 billing becomes a longer process. 20 Not to mention that, previous to our MAS 21 takeover, that the billing, that administrative 22 burden, went from about 3 hours to -- a month, to 23 somewhere in the neighborhood of 40 hours a month. 24 So there's -- you know, I think it was said 25 earlier that we operate on some very, very thin 1 margins. 2 So, not only is it the loss of a ride to a 3 taxi provider or a taxi vendor or some other vendor, 4 but then you have an increased administrative 5 burden. 6 Both of those, loss of revenue, increase in 7 expense, all at the same time. 8 They have a negative -- net negative impact 9 on what you can do. 10 And one great example where public 11 transportation was able to support, we had a trip 12 not long ago that went through seven different 13 changes before it finally came to us. 14 Seven different taxi vendors denied the ride 15 before that ride was provided. That ride originated 16 in Genesee County from a small town near Alabama, 17 New York, into Batavia, New York. 18 And, seven different vendors outside of the 19 county were asked to provide this trip. All of them 20 refused it before it finally came to public 21 transportation. 22 In some other cases, we've had taxis come all 23 the way from Olean, which is on the upsides of an 24 hour and a half to two hours south of Batavia, just 25 for transportation. 1 So these are impacts that really have 2 negative -- especially some of the customers out 3 there, they're very accustomed to one way, and then 4 you implement some changes, it becomes very 5 confusing. 6 We have some customers that call up and they 7 ask, "I called MAS. Do you see my rides?" 8 We check the system. 9 "No, we don't." 10 "I'll call back." 11 They call again, and you get this same 12 consistent: 13 "I've called. Do you see the rides?" 14 "No." 15 "I've called. Do you see the rides?" 16 So we could spend two or three times on the 17 phone with these same customers. 18 They're asking MAS to utilize public 19 transportation. We are not seeing the rides 20 assigned to us in any way, shape or form. 21 So these are some of the net negative impacts 22 that we're seeing, overall, even with some of the 23 small positive increases that we've seen in 24 Genesee County. 25 MICHAEL DERADDO: If I may, I have one thing, 1 gentlemen? 2 Just as early as two weeks ago, in RTS Seneca 3 in Seneca County, they have habitually given rides 4 to two group homes, one out of two very -- two 5 different areas -- two group homes, two different 6 villages. 7 Two weeks ago they were informed, when 8 they're -- the group home was trying to set up the 9 rides, You cannot take Seneca. You cannot take 10 RTS Seneca. In other words, you can't take public 11 transit. 12 This was happening quite a bit during the 13 transition, that I know of and aware of. 14 You cannot take public transit to divert them 15 to the private transportation companies. 16 It's been quite a lull, and I was actually 17 surprised, but, two weeks ago, because I had the -- 18 you know, the Seneca office call the group homes, 19 and, by name, and they know exactly, 20 (unintelligible), that you cannot take RTS Seneca. 21 Well, now, we have now raised and since 22 elevated that issue; however, that business practice 23 hasn't gone away. 24 And that's very disheartening. 25 And, you heard different business practices 1 or techniques they're using: the three days, and it 2 takes six days for a pass. 3 I can tell you, with Ontario, we sold a bunch 4 of -- used to be tokens, for passes. 5 And in January we stopped honoring tokens, 6 and now went to, actually, an actual pass. 7 And, we're waiting for -- trying to 8 coordinate with them, we have to switch those out. 9 They haven't switched or purchased another 10 pass since. 11 So -- 12 SENATOR SEWARD: It's interesting that -- it 13 would appear that from the anecdotes that we've 14 heard today, that the MAS, I mean, there's -- even 15 people are trying to stay on the public system, 16 they're just -- they're making it difficult to do 17 so. 18 MICHAEL DERADDO: Yes. 19 Yes, sir. 20 SENATOR SEWARD: I just had one quick 21 question regarding the taxi rates. That's something 22 new that you presented. 23 What does that mean, in effect? 24 Does that mean, in effect, you actually have 25 switched to -- you have some taxi vehicles? 1 JAMIE MOTT: No, sir. 2 We actually still utilize -- 3 SENATOR SEWARD: What does taxi rate -- 4 JAMIE MOTT: -- we still utilize our ambulate 5 buses, but, Department of Health has created various 6 rates and rate levels that you can apply for. 7 So, we actually applied for the taxi rate. 8 The Governor's new budget, for some 29 rural 9 counties, that taxi rate was elevated to $10 per 10 pickup and $2.20 per mile. 11 To give you a comparison: Before that, 12 before the Governor's budget was signed and that 13 occurred, Orleans County's taxi-level service was 14 $2 per pickup and $2 per loaded mile. 15 Which, quite honestly, that's a pretty 16 sizable increase in terms of the amount of revenue 17 that a taxi system will be able to bring in over 18 miles. 19 MICHAEL DERADDO: It's my understanding 20 that -- what Jamie is talking about, we're utilizing 21 our Dial-a-Ride buses like other entities. 22 JAMIE MOTT: Correct. 23 MICHAEL DERADDO: It's my understanding that 24 there was an initiative and there was an effort, in 25 order to level the playing field, to bring the 1 public transit into the fold, to give us the right 2 of first refusal, which is great in policy, but it's 3 not being adhered to. 4 So, Dial-a-Ride services for -- you sign 5 up -- so our Dial-a-Ride services are taxi rate, if 6 you will. 7 So, that was the attempt to get us in line. 8 Even so, even now, all of my counties, except 9 one, is at that $10 and 2.20. Still being told that 10 we're more expensive than taxis. 11 I don't get it. We're all at the same rate. 12 [Laughter.] 13 MICHAEL DERADDO: So -- I -- I just -- 14 gentlemen, I mean, my business guidance and 15 direction, yes, we're waiting on this -- we're going 16 to do this study and we're going to see what it 17 comes in. 18 But, I'm looking elsewhere. I'm moving on, 19 trying to form -- continually trying to form various 20 partnerships. 21 I mean, we're a steward of government funds, 22 obviously, as a public transit authority. 23 Services will change. 24 And, depending on the level of other 25 partnerships that we create, that will decide if it 1 will increase or decrease, or stay the same, 2 because, right now, the projection's not looking 3 good. 4 And I -- subject to anymore questions, 5 I thank you for your time. 6 SENATOR O'MARA: Thank you. 7 Next, Robert Zerillo. 8 I'm not sure. 9 It says "New York State," but, do you want to 10 come up? 11 Yeah, yeah, come up together. 12 Good afternoon. 13 Who would like to start? 14 JIM: I can start. 15 Again, Senators, I want to thank you for 16 conducting this meeting, as well as the one back in 17 Albany. 18 I represent First Transit, which operates 19 nine rural public transit systems in New York State. 20 We have over 300 full-time drivers, over 21 70 part-time -- 75 part-time drivers, 22 50 administrative staff, 30 technicians. 23 The systems that we operate in these rural 24 Upstate New York counties operate in areas that have 25 a poverty rate that is above the national and the 1 state average. 2 The ridership that is comprised the public 3 transit, many of them are on public support or 4 assistance in -- of some sort. 5 The life for public transit after the State 6 takeover has been well-documented here today, so, 7 you know, I'm not going to spend a whole lot of time 8 talking about that. 9 But I think what's really important is that 10 the drive to save Medicaid dollars has taken 11 precedent over the quality of care and the 12 integrated community-living policies and mandates 13 that the Department of Health themselves have. 14 The people that we talked about, the 15 low-income and poverty-level people in the 16 communities we serve, also need to go to the grocery 17 store, they need to have social activities, they 18 need to get around town, basically, at their will. 19 This is being taken away from them. 20 Cortland County, which is a county that we 21 operate, from the testimony earlier, talked about 22 having to eliminate a cost reduction that was 23 necessary to keep the system viable in the rural 24 areas where the people live. 25 That service is gone. 1 We were able to make it viable by 2 coordinating with Medicaid, and using those funds to 3 coordinate a system and have something available for 4 people in the rural areas, the rural-poor, to get 5 them into the cities, the shopping centers, for 6 regular social activities. 7 So, the Department of Health wouldn't support 8 this, the Olmstead Act. 9 You know, I'm sure we'll hear a lot more 10 testimony about what the Department of Health 11 supports as far as people and rural communities, but 12 this flies in the face of that whole initiative, and 13 a lot of the rest of the mandates that the 14 Department of Health would -- would support. 15 The counties that I represent have 16 aggressively, and I can't state that enough, we 17 operated in Tioga County. I can tell you that Sean 18 and I work diligently with the state manager, to 19 utilize public transit. 20 And the assurances that we were given: That 21 what would happen after, would be exactly what you 22 will see in the future. There's no reason to fix 23 something that isn't broken. The consumers that 24 were using this service should continue. Why would 25 we change that? 1 We were given assurance after assurance in 2 county after county, that this would continue, 3 revenues wouldn't suffer, riderships wouldn't 4 suffer. 5 This is not the case. 6 You've heard it today, and we don't see 7 anything in the future. 8 Livingston County, Orleans County, just 9 before me, they're being told you cannot use public 10 transit, when the assurance was, "Nothing will 11 change. We will continue to do this. It makes 12 sense." 13 The representative right here from 14 Otsego County, who uses the system, wants to use it, 15 and has given hurdle after hurdle to prevent him 16 from using the system. 17 This isn't a wise use. 18 These buses are out there, the public funds. 19 Broome County talked about the money that's 20 been made available for -- to put these public 21 transit systems in place. 22 There's seats available on these systems, 23 they're not being utilized. 24 I'm having difficulty understanding that. 25 As many others here this morning, I want to 1 thank you for the two-year reappropriation of the 2 emergency funding from DOH in order to support the 3 public transit systems that have been drained of the 4 Medicaid ridership, until an appropriate solution is 5 found. 6 There's a situation that I know you're aware 7 of, I think Chemung County has brought it to your 8 attention, regarding the application the counties 9 are being required to fill out for the -- to become 10 Medicaid providers. 11 They're given an actual vendor application to 12 complete so that they can become a Medicaid 13 provider, so that their county's public transit 14 system can receive funding. 15 The new deadline is August 1st, which is only 16 about a week away. That, if the county hasn't 17 completed this application, which the only way I can 18 think to describe it, is the typical "square peg in 19 a round hole." 20 It is not the application for a municipal 21 entity to fill out. 22 It is a provider application. 23 It asks for things that are just 24 unreasonable, that are unnecessary. 25 And when we met in Albany, not at your 1 meeting, but we met with MAS and with all the 2 stakeholders in Albany, I asked the person 3 responsible for the application, and this was my 4 exact words: 5 Because I've a Medicaid provider, 6 fee-for-service provider, for 35 years, so I'm very 7 familiar with the system, I'm very familiar with 8 applications. I've done many of them, and I've 9 operated in this system for 35 years. 10 I asked how this application fits the need of 11 a county? 12 The material you're asking for, the 13 questions -- you're asking for driver-license 14 number, social security numbers, the vehicle-license 15 numbers -- the county doesn't have this to put on 16 the application, and the applications are being 17 returned because they're incomplete. 18 So I said, "Why don't you come up with an 19 application that suits a county, and that they could 20 meet the requirements that you're asking for?" 21 And she said, "That would take the government 22 years to accomplish." 23 That was the answer. 24 And I -- my response was, "So then you 25 weren't ready to roll this out." 1 Which, as you can imagine, got brushed under 2 the table. 3 But the reality is, this -- there's so much 4 inconsistent information. And, you know, from 5 county to county, the counties that I represent, 6 have all struggled with this. None of them have 7 been able to complete it. 8 The deadline is August 1st. 9 The ramifications, we're told, is funding 10 will -- for non-emergency Medicaid transportation, 11 which we're doing precious little of, but, still, 12 some will be taken away. You know, they will not be 13 able to provide that funding. 14 Just for an example -- 15 SENATOR O'MARA: Jim, are you aware that 16 taxicab companies are required to provide that 17 information? 18 JIM: Yes, yes, yes, but it's not hard for an 19 individual to provide information. They give their 20 own social security number, they give their license 21 number, the vehicle they're driving, and, you know, 22 that's not difficult. 23 First Transit has a Medicaid Provider Number. 24 We meet all the requirements for the state's 25 fee-for-service obligation to transport people. 1 What the State is asking is that, in 2 Chemung County's case, which you're familiar with, 3 they also fill out this vendor application. 4 It -- it's not appropriate. 5 It's asking, you know, Did you register your 6 car with a dog-license application? 7 It just doesn't fit. 8 There's no -- 9 [Laughter.] 10 JIM: There's no similarity between the 11 information that they need and they're requiring 12 from these counties. 13 So, you know, that part has been extremely 14 difficult. 15 The information has been inconsistent at 16 best. 17 I'm being very kind by saying, 18 "inconsistent," because no one -- in fact, again, 19 traveling from county to county, I work with each of 20 their representatives, to try and figure out what 21 the State's looking for, and there hasn't been a 22 similar conversation with any of them. 23 So, it's been extremely difficult. 24 I'm taking a lot of time here, but the last 25 thing that I want to thank you for, and ask that you 1 would continue to champion, is the interagency 2 coordinating committee that's already available, yet 3 not enacted. 4 You know, I opened up by talking about the 5 employees that we have, and, you know, the people 6 that depend on working in public transit for their 7 livelihood. 8 Again, they're people that live in these 9 communities, we're able to train, to certify, to, 10 you know, give them a standard of life with 11 paychecks and benefits. 12 I really feel for people that are -- as in 13 Tioga, you know, we had over 30 employees in Tioga, 14 lost their livelihood due to this transition that 15 makes no sense. 16 These buses are still out to there, the seats 17 are still available, but now you just find another 18 way to start putting people in taxicabs and 19 different services that just adds an additional 20 burden to the taxpayers. 21 SENATOR SEWARD: Thank you. 22 SENATOR O'MARA: Thank you. 23 JENNIFER CARLSON: I think I'll just add to 24 this from a policy perspective. 25 SENATOR O'MARA: You can identify yourself 1 for the record, please? 2 JENNIFER CARLSON: Oh, I'm Jennifer Carlson, 3 and I work with First Transit. I represent them in 4 Albany. 5 So, I've been working with you folks on 6 trying to pass this legislation, which the Senate 7 did. 8 Just to clarify, the Senate did actually pass 9 the legislation for the -- to -- for the interagency 10 coordinating committee to meet. 11 We had some difficulty in the Assembly. 12 So, I just wanted to thank you for that, 13 because, you know, credit needs to be given. 14 From a policy perspective, and from dealing 15 with DOH and dealing with the Governor's Office and 16 the Department of Transportation, there are a lot of 17 folks that go into this pot of, How do we deal with 18 transportation? 19 A couple of the things that I think should be 20 highlighted here that really need to be dealt with, 21 have to do with the transportation side, as opposed 22 to the Department of Health side, which we all know 23 and we've all heard has been a true challenge. 24 But, from a policy perspective, on rural 25 public transportation, the State needs to do a shift 1 as to how it funds those counties of transportation. 2 It's a little different when you have upstate 3 authorities, and some them are here, and you've even 4 heard their struggles, and they have the capacity of 5 pooling together their resources, where some of 6 these other counties don't have that same capacity. 7 But, if we're looking at upstate 8 transportation, and everybody talks about upstate 9 transportation, they're not really talking about 10 these little rural counties. 11 They're really talking about the larger areas 12 of the state: Syracuse, Rochester, Buffalo, Albany. 13 And so what happens is, those folks get the 14 bulk of upstate-transportation money, whether it be 15 capital funds or whether it be operating funds. 16 And then the little counties kind of get 17 what's left. 18 And so I think to look at some real 19 solutions, we have to look at the policy around 20 public-world transportation, not upstate 21 transportation. 22 So that's one thing that I think that we 23 really need to work on. 24 I think with the Department of Health and 25 some of the issues that these counties have all 1 faced, again, like Jim, I have heard from all of 2 them, and so, collectively, they all -- they're all 3 having the same issues. 4 It's not as if -- I know we've heard a lot of 5 anecdotal stories, and that's the easiest way for 6 some of these folks to convey what's happening, but, 7 they're all the same. We're not talking about 8 different issues in different counties. 9 They're all, really, basically, the same 10 issues. 11 The information that they get from the 12 Department of Health, is all different. 13 And I think MAS is, you know, taking its 14 lumps today, and, probably, rightfully so in some 15 areas. But, also, they are kind of stuck between a 16 rock and a hard place because Department of Health 17 really sits on them. They don't do a lot of the 18 decision-making on their own. It really comes from 19 the Department of Health and those folks, so in a 20 lot of ways, they're doing what they're told. 21 And since MAS is their customer, as the 22 Department of Health, that's what they're going to 23 do. 24 Their customer is not the counties, and so 25 their level of responsibility is not to the counties 1 and making it easier for the counties. It's to make 2 sure that the Department of Health is happy with 3 them. 4 So, that's an area where you're seeing a lot 5 of these issues, I believe. Not all, but a lot of 6 the issues. 7 I don't really believe that you can unring 8 the bell of the transportation manager. 9 I think that is something that the Governor 10 is firmly behind, and, so, I think that is something 11 that we probably are going to have to work with, 12 although, obviously, we would all like to have an 13 opt-out. 14 I don't necessarily see that as being 15 something that we could truly accomplish. 16 However, there are some issues with the 17 Department of Health and their selective following 18 of federal policy, having to do with Medicaid funds, 19 and dealing with transportation. 20 So, when I say "selectly," when it suits 21 them, they will say, Well, we can't do that because 22 of federal policy. 23 When it doesn't suit them, they will ignore 24 the federal policy. 25 One place where this is very clear has to do 1 with patient choice. 2 The counties have been told over and over 3 again, that they are not -- that they're -- that 4 they can't tell a Medicaid customer which 5 transportation to pick. That it's patient choice, 6 which is in federal regulations. 7 And so, therefore, the system cannot be set 8 up for public transportation to be the first form of 9 transportation. 10 Except, in federal regulation, under the 11 Deficit Reduction Act, there was clarification 12 language that came out from the feds that said, If 13 the state uses a third party, they are not obligated 14 to offer patient choice, customer choice. 15 But, any time you bring that up with DOH, 16 they deny it. 17 But it's, actually, it's in writing, it's in 18 statute. 19 So, I think that there are ways, and probably 20 you folks can work with the Governor's Office on 21 this, that DOH could be more cooperative, which 22 would result in more coordination, which would 23 result in more utilization of public transportation. 24 I don't think that's a big hurdle. It 25 shouldn't be a big challenge. 1 They are covered under federal regulations. 2 You know, it's well within the State's rights to use 3 public transportation. 4 And, in fact, even in the RFP that went out 5 to solicit a manager, it was clearly stated in there 6 that they would be required to use public 7 transportation first. 8 So when -- I think, when all of these folks 9 were told, "Nothing's going to change," it was based 10 on that information. 11 Except, at some points, and you know, 12 Department of Health has its own polices outside of 13 what some of the representatives of the people's 14 policies are, they decided that they were going to 15 do it differently. 16 And so when they rolled out these programs in 17 these counties, you know, Jim is right, no, they 18 weren't prepared. 19 And I don't think that's MAS's fault. 20 I think they were given deadlines by DOH, 21 but, they were not given the opportunity to go out 22 and learn the counties, they were not given the 23 opportunity to get up to speed with software. 24 Some of these counties have very 25 sophisticated software that they bought years ago, 1 through federal funds. Some of it is more advanced 2 than what MAS has. 3 And so I think that if they were -- all given 4 the opportunity to work together on this, this could 5 have rolled out pretty successfully. 6 So, I think that there are areas there that 7 we can improve. 8 And I ask you, as, you know, the members of 9 the Senate, it's very difficult for these folks to 10 hold their feet to the fire, DOH, and the people who 11 command DOH, to follow the federal regulations. 12 But you folks can help to do that. 13 That's really important. 14 And it's a message that gets lost because 15 it's not -- you know, it's not anecdotal, so it's 16 not as interesting. 17 But, it is factual, and it is one of the 18 areas I think that we can improve the situation that 19 these folks are facing. 20 So, you know -- on that point. 21 But, again, we also -- in the budget this 22 time around, we all fought very hard to change -- 23 and NYPTA was part of this conversation, to change 24 how you fund these areas of transportation. 25 And, so, I think, you know, NYPTA would be 1 more -- would be a better speaker to this. I'm not 2 as well versed in -- I find how transportation is 3 funded quite complicated. 4 But, I'm sure that NYPTA has a better 5 perspective on that. 6 But, I think that that's something that we 7 really need to focus on. 8 BOB ZERILLO: I'm Bob Zerillo. I'm policy 9 director for the New York Public Transit 10 Association. That's "NYPTA," not the 11 Physical Therapists Association. 12 [Laughter.] 13 JIM: Usually comes up on the Internet when 14 you search it. 15 BOB ZERILLO: Thank you, Senator O'Mara and 16 Senator Seward, for holding this, and for your 17 support of transit, not just this year, and not just 18 rural transit, but transit across the state. 19 We appreciate that. 20 You've heard from a number of our members 21 here. 22 Jim is a member of RGRTA. 23 BC Transit. 24 We represent transit systems from the MTA 25 down in New York City, to some of the smallest in 1 the state. 2 So, we have a statewide view of public 3 transit. 4 I would say, really, I have a couple of 5 things I wanted to just touch on, and most of these 6 have been raised by our members here already, but 7 I think they're still important. 8 The point was made before that this was 9 really, unintended consequence. 10 You have this -- this new initiative was put 11 forward without thinking about the impact on public 12 transit, on other riders, other than the Medicaid 13 program, and that's really been a huge part of the 14 problem, is the lack of planning, upfront, to make 15 sure that there weren't unintended consequences. 16 The loss of ridership and the loss of revenue 17 on public transit has been severe, and you've heard 18 those examples. 19 That loss has really been to public transit 20 service, not just to the Medicaid program. The 21 Medicaid riders are getting their trips. You know, 22 may not be on transit, may not be the way they want 23 to have them, but they're getting, in most cases, to 24 where they need to go. 25 But it's the economic impact on others who 1 have lost their trip to work or their trip to the 2 grocery store, or other examples. 3 You know, that is -- it's small, but there is 4 an economic impact in those localities all around 5 the rural areas. 6 The point was made before, the public 7 investment is already there. You know, federal and 8 state and local monies already been invested in 9 public transit and we should use it. 10 And there were a lot of examples brought up 11 earlier from a number of the counties about how 12 they've done the right thing. 13 They've tried to be efficient, partner, share 14 services, coordinate services; do everything they 15 can to lower cost. 16 And, Senator O'Mara, I think you used the 17 example before, a spoke was pulled out of the wheel 18 on them, an important spoke. 19 There was a lot of revenue in ridership to 20 those systems, and it's kind of had a major impact 21 in a lot of these counties. 22 So, it's unfortunate, but, we need to do 23 something about it. 24 It's not an easy problem to solve. 25 More funding is needed upstate for transit 1 systems; rural systems, especially. 2 But, upstate transit has been underfunded 3 until the most recent year budget. They've gone 4 some time without increasing funding, and, 5 certainly, rising tide floats all boats. 6 That's -- that would help. 7 Certainly, rural areas need some additional 8 help; rural transit needs additional help, given the 9 loss of this big spoke. 10 And as Jennifer said, our transit association 11 does support your legislation, it supports your 12 efforts so far, and, please keep going. 13 For a solution, it's a very difficult issue 14 to get to, and we don't have a specific solution. 15 The coordinating council may help to get 16 there. 17 This has been a topic that's been discussed 18 at the last two of our statewide transit 19 conferences. It's taken up quite a bit of time at 20 our conference. And I think it will still be a 21 session on, this fall, because so many of our 22 members are impacted, and it's so important. 23 So, from NYPTA's perspective, we're going to 24 keep trying to work on it with you and others. 25 So, we appreciate your efforts. 1 SENATOR O'MARA: We've seen over the last 2 year or two, so-called, hold-harmless funds coming 3 to try to fill this gap. 4 To what percentage is that -- or, how much of 5 that hole is being filled by this additional aid? 6 JIM: The -- the loss, as Tioga mentioned, is 7 pretty much, consistently, about a third, or a 8 40 percent of the revenues, since MAS has taken 9 over. 10 Public transit systems have lost 30 to 11 40 percent of their revenues. 12 The hold-harmless has been close to 13 50 percent of that -- those lost revenues in the 14 19 counties that were -- it was made available to 15 last year. 16 And we're eternally grateful for you 17 providing that, and, again, for next couple of 18 years. 19 But, what I think we need is the committee, 20 that has the ability to provide some studies, that 21 had some teeth, that can develop real coordinated 22 systems with real future funding. 23 You know, going forward, it will support a 24 rural system, because, as Jennifer mentioned, 25 they're significantly different than even smaller 1 urban areas. 2 JENNIFER CARLSON: I think that's a, really, 3 kind of an important point, in that, you know, 4 planning of funding. 5 So, we all work in the budget. 6 And, you know, for smaller municipalities 7 that try and budget for their public transportation, 8 they have no way of, at this point, knowing -- it's 9 very difficult for them to budget in the coming 10 year. 11 So the hold-harmless money actually is for 12 the previous year; and, so, it doesn't really help 13 them planning, going forward, because they don't 14 know -- except for this next coming year, because we 15 got it for two year, they don't really know if 16 they're going to be getting this funding. And so it 17 leaves it very challenging for municipalities to 18 budget for something like this. 19 And with the tax cap, and so on and so forth, 20 it makes it even more complicated. 21 So I think that this interagency coordinating 22 committee, which, you know, they do in several other 23 states, successfully, and have very good results, 24 these are the issues that need to be brought up with 25 these different agencies who are all involved, and 1 have that real accountability by the folks that are 2 appointed by the Legislature to participate in these 3 conversations. 4 These folks have nowhere to go, except for 5 the forums that you hold, to discuss these issues. 6 No place. 7 There's some really ambitious folks that do 8 this conversation on base camp, and they all get to 9 talk to each other; however, you know, that's kind 10 of where it stops. 11 There's nothing -- it's very difficult for 12 them to take action after that. They're all 13 individual counties and so they don't have a unified 14 voice. 15 If they had representation on the 16 coordinating committee, then they would have a 17 voice. 18 And, so, I actually think it would make it 19 much easier for the administration, and some of 20 these agencies, DOH, to deal with the issues, 21 because then it isn't piecemeal anecdotal. You 22 know, it's a cohesive language coming out of a body. 23 And so, you know, Tom, you and I have had 24 these conversations several times, like, we laugh 25 about it, really. 1 Well, we're actually asking DOH and the State 2 to do something that's not going cost them money, 3 because these folks want to coordinate. They 4 understand that the resources are limited. They 5 understand they're not going to get a lot more 6 money. 7 They just want a voice, to be able to figure 8 out how to do it. 9 It's not going to cost the State anything, 10 and you know the hurdles that we have faced. 11 BOB ZERILLO: Just one other point on that 12 hold-harmless money, too, that that was always meant 13 to be a transition. You know, hold-harmless for a 14 year. And it was grateful that it got extended for 15 two years. 16 But, someday, that may go away, so it's not a 17 permanent fix. 18 Just as the extra money in the DOH budget, 19 you know, I can't imagine will continue forever. 20 JENNIFER CARLSON: No, that -- no, the deal 21 was, is that we -- the reason why they gave us that 22 money, is so we would have time to fix what was 23 going on. 24 But, once that conversation stopped, nobody 25 wants -- you know, DOH has these meetings, and these 1 folk go in, and DOH runs the meetings and they run 2 the agenda, and it's really all about what they want 3 to talk about. And some of these people who travel 4 all the way to Albany, walk away not having been 5 heard at all. 6 And so, I mean, that's just -- it hasn't 7 worked. 8 We've given it a couple of years, and, you 9 know, I know that everybody here, you know, true 10 efforts. 11 That's not -- it's not the solution. 12 And so, you know, there really needs to be 13 something else. 14 SENATOR O'MARA: All right. 15 Thank you. 16 SENATOR SEWARD: Thank you. 17 SENATOR O'MARA: Ulster? 18 Are you alone from Ulster? Or Greene? 19 Greene, I got on here too. 20 All right. 21 ROBERT DIBELLA: My name is Bob DiBella. I'm 22 the director of transportation for Ulster County 23 area transit. 24 We were switched over to MAS way back in 25 2008, so we were one of the first ones that this 1 debacle happened to. 2 I -- it's a broken record, basically, you're 3 going to hear a broken record, because the same 4 things that occurred to almost every county here, 5 occurred to Ulster County, and so we had to make 6 some decisions very quickly. 7 We lost around 15,000 riders the first year. 8 We had to make some decisions, to go from a 9 deviated system to a fixed-route system, and with 10 complementary paratransit. 11 But in doing that, the fixed-route system 12 goes through the urban areas, not the rural areas; 13 and, so, for all intents and purposes, rural service 14 was cut way back in 2008. 15 The rural routes that we used to run, we had 16 to pull them in. 17 And that was the way that we managed to 18 survive. 19 We went from 240,000 riders now this year -- 20 or, last year we did 430,000. 21 That's all well and good, and it's rosie, and 22 we've managed to work our way through it, but the 23 folks in the rural areas are the ones that were 24 affected, and affected deeply, and are still 25 affected today. 1 So I won't go into all of these notes here 2 that just say the same thing that everyone else has. 3 The system is not working for the rural areas 4 at the moment, and needs to be fixed. 5 Thank you. 6 SENATOR SEWARD: Any ideas how to fix it? 7 ROBERT DIBELLA: Well, the real problem that 8 I see is that MAS doesn't know the area transit 9 systems. 10 Now, they don't necessarily have to know the 11 area transit systems if they have a scheduling 12 system that does the work for a dispatcher. 13 But their scheduling systems -- I use 14 Trapeze, which is a great little system. 15 Their scheduling systems don't work. 16 And until they can make every county -- bring 17 every county into a system that says, They're going 18 from here to here, what's the best way of doing it? 19 Can we use public transit first, or, do we go to a 20 taxi? 21 All of the time that we carried Medicaid 22 customers, it was regular fare. 23 We never charged above regular fare, which 24 meant we were always less expensive than taxis. 25 And even being less -- considerably less 1 expensive than taxis, we lost, virtually, all of our 2 business. 3 Until that changes, you're going to have -- 4 you're going to have to make decisions, and most of 5 those decisions will be limiting service to rural 6 areas. 7 SHELLY O'REILLY: My name is 8 Shelley O'Reilly. I'm from the ARC of 9 Ulster-Greene, so I represent, actually, 10 two counties. 11 I'm fairly new to the public transportation. 12 I came from school busing. 13 And I've been working with you, Mr. DiBella 14 here, and we're working on coordination. 15 And I've been sitting back and listening to 16 everybody saying what's going on, and, I'm hearing a 17 lot of energy saying what has happened in the 18 negative impacts, but I haven't heard a lot of 19 solutions offered. 20 What we have currently is, we have -- for 21 example, Ulster-Greene, we have 200 vehicles in 22 Bob's county. We go to areas that Bob doesn't. 23 So we have overlaid our current routes, like 24 our fixed routes, and we can help each other, and 25 we're currently working on that. 1 We've done that in Greene County, and now 2 we're absorbing Greene County's public 3 transportation, and it's going to go from 100 miles 4 a day, to 900 miles a day, where people can actually 5 get to work on a daily basis. 6 So we're working together. 7 But now I'm hearing about this Medicaid, and 8 I'm thinking, why do I want to do this? 9 It's kind of scary. 10 [Laughter.] 11 SHELLY O'REILLY: No, really, it's kind of 12 scary. 13 And, what we do have is, we have a system in 14 place where everybody knows to call this place. 15 So why can't we call this organization that 16 they're calling -- I'm sorry, I'm not real familiar 17 with it -- and instead of them scheduling it, have 18 them give you a choice? 19 Here are contact information for the mobility 20 manager or the coordinator in your area, because 21 those are the experts of what's going on in your 22 community. They know your routes. And if they 23 don't know your routes, they know who to call. 24 Like, I know to call Bob. Bob knows to call 25 me. 1 So, we're working together, and we all know 2 each other. 3 Transportation is a very tight-knit system. 4 So why can't the individual call, and instead 5 of that person who knows nothing about us or what we 6 do or what's available exactly in that area, give 7 them a number, like a referral number, and say, Here 8 is your contact information. Here is your mobility 9 manager. Here's your coordinator -- your area 10 coordinator. Contact them. 11 And now you have two choices. 12 You can go public transportation -- the 13 coordinator would tell them: You can go public 14 transportation, and it's free, or, you can go to a 15 private taxi for your convenience, but you're going 16 to pay a co-pay. 17 So put some of the responsibility also on the 18 individuals. 19 So then if an individual wants to go to the 20 grocery store, they may not be able to take public 21 transportation. They might need a taxi. 22 But, you know what? They might have a 23 $5 co-pay. 24 Put some of the responsibility on that 25 individual also. 1 Now, if they're paying a percent of it, and 2 the individual is getting a choice, and it's hitting 3 them in the pocketbook a little bit, now you're 4 going to have the taxicabs are saying, Wait a 5 minute. They're not going to want to pay these 6 $50 fees anymore. 7 They're going to start -- the public's going 8 to say, Wait a minute. I can ride this for free, 9 and I might be inconvenienced by 10 minutes, I'm 10 going free. 11 So, now, the taxicabs have to look at, Well, 12 wait a minute. We're getting these unreasonable 13 fees, so what can we do to be competitive? 14 So then you have the difference of: 15 Public transportation. We're here to serve 16 the people. We're not here to make a dime. We lose 17 money. We know that. We're here to serve the 18 people. That's our goal. 19 The cabs that are getting most of what I'm 20 hearing, what is their intention? 21 To make the money. 22 So, you know, I don't know, maybe I'm crazy. 23 I don't know. 24 SENATOR O'MARA: Not at all. 25 Not at all. 1 SENATOR SEWARD: Just by, if we're able to 2 make it easier, through providing that phone number 3 by MAS, to those that choose to take a -- the public 4 transportation, rather than making it difficult, you 5 know, you're making it easier, that alone would be a 6 big step in the right direction. 7 SHELLY O'REILLY: It makes it easier, and it 8 lets that individual have their own choice. 9 SENATOR SEWARD: Exactly. 10 SHELLY O'REILLY: So, okay, this cab can pick 11 me up and take me anywhere I want to you go, but 12 it's going to cost $50 dollar. So, if you have to 13 pay 20 percent, then I have 10 bucks coming out of 14 my pocket. 15 If I call -- if I go with the public transit 16 and the fixed route, I have to walk two blocks, but 17 it's going to be free, then I might choose to walk 18 two blocks. 19 But it gives me the choice. 20 And then it makes everybody a little more bit 21 more competitive. 22 SENATOR SEWARD: Exactly. 23 SHELLY O'REILLY: It just kind of evens the 24 playing field in a way. 25 SENATOR O'MARA: Too much common sense 1 involved in that theory, though. 2 [Laughter.] 3 SHELLY O'REILLY: So that's just kind of my 4 take on it, because I've just been listening to 5 everybody here, because like I said, I'm new to 6 this. 7 But, I don't know. 8 Anything else, Bob? 9 ROBERT DIBELLA: Well, the only thing -- 10 SHELLY O'REILLY: Coordination? 11 ROBERT DIBELLA: -- I would say, as far as 12 the county system, we cover 92 percent of all of the 13 medical facilities in the county on our fixed-route 14 system. 15 So there really isn't a reason why they 16 shouldn't be put on fixed route; and, yet, they're 17 not put on fixed route. 18 SHELLY O'REILLY: So, then, now you can have, 19 you take that one number, it's assigned to that -- 20 for that one specific day. It can only be used 21 once. 22 So now they would call me or call Bob, or 23 whoever our coordinator is, and they would input 24 that number into the database, schedule the trip, so 25 everybody can see it. 1 Then when it's done, the individual can go in 2 and say, Hey, they'll waive my fee next time if I go 3 in and just do like a survey. 4 How was your trip? 5 Was it on time? 6 You know, people like money. 7 UNIDENTIFIED SPEAKER: Senators, to add to 8 that, thank you all very much for having us here. 9 As Shelly mentioned, the ARC of Ulster-Greene 10 is new into the public transit industry in 11 Greene County. We will soon be providing that 12 service to residents. 13 And as Shelley mentioned, we're already doing 14 the service throughout the county, so it makes sense 15 for us to partner with the county, because we 16 already have, eight routes? 17 SHELLY O'REILLY: In Greene County we have -- 18 we're going to have nine. And in Ulster County, we 19 have fourteen. 20 UNIDENTIFIED SPEAKER: Which Greene County 21 only had one, per day, that changed, daily. 22 So, again, we hear a lot about collaboration, 23 we hear a lot about partnership. 24 And it just seems to me that it seems pretty 25 disconcerning (sic) now that that's not happening, 1 and MAS isn't utilizing the services that already 2 exist through the public sector, and that moneys 3 that could be used to bolster public transit, which 4 we know is not, you know, a winning entity when it 5 comes to finances, is being taken somewhere else. 6 And, secondary note, again, here for more 7 research, to become a better public transit 8 provider, seemed very disconcerning (sic) to find 9 out that, you know, New York State, one of the 10 largest users of Medicaid dollars on the national 11 level, and to find out that this new way of doing 12 things isn't really being any more efficient with 13 our Medicaid resources, but seems to be actually 14 using more of our Medicaid resources. 15 And, being that the ARC of Ulster-Greene and 16 other ARCs throughout the state, ARCs, also 17 referred to, are primarily funded by Medicaid, and 18 we're fighting for dollars to support people that 19 have such disabilities that they desperately need 20 essential services, and now to find out that monies 21 that were supposed to be utilized to, you know, be 22 more efficient with transit services, are now going 23 up instead of down; and, yet, there are 24 organizations here fighting for Medicaid dollars, 25 and to find out they are being used in such, I don't 1 know, inconvenient, or unconstitutional, ways, 2 I guess you could say. 3 So, thank you for what you're doing here, to 4 listen to us, and, hopefully, putting some remedy to 5 the problems that are existing. 6 SENATOR O'MARA: Thank you. 7 SENATOR SEWARD: Thank you. 8 Thank you all. 9 SENATOR O'MARA: I think we're down to two 10 remaining groups, and then we'll be done. 11 Let's go with Chemung, Allegheny, and 12 Cattaraugus. 13 You have reps still here from there? 14 No one from Allegheny or Cattaraugus is here 15 that wishes to speak? 16 They're both on the list. 17 We heard from you already, Jim. 18 [Laughter.] 19 SENATOR O'MARA: But, no, you can come up. 20 You can come up. 21 (Off-the-record discussion.) 22 SENATOR O'MARA: You will be in next group. 23 UNIDENTIFIED SPEAKER: There are other 24 counties that weren't on the list. 25 SENATOR O'MARA: Yeah, I have them on the 1 list here. That's the last group. 2 Okay. 3 JIM AREY: Good afternoon. 4 My name is Jim Arey. I'm director of the 5 Elmira-Chemung Transportation Council. 6 I not only deal with transit, but I also deal 7 with highways and bridges, I have a role. 8 Chemung County contracts out with 9 First Transit. They are a private operator to 10 provide public transportation. 11 The County has staff like myself to help to 12 provide the oversight on the system, to make sure 13 they follow the required federal and state 14 requirements. 15 I do have some information, some data, to 16 share, in terms of what the transition has meant to 17 Chemung County. 18 In 2013, we averaged 66 Dial-a-Ride trips per 19 day. 20 I'll hand you this information so you can 21 have it. 22 In 2014, the number had dropped to 19. 23 In 2015, now, January through June, it is 24 13 trips per day. 25 We are on the cusp of, perhaps, not providing 1 the county contracting out to provide this service. 2 In terms of financially, in 2013, the amount 3 of money, on an annual basis, would have been a 4 million two. It dropped to 270,000. 5 In '14, and in '15, it looks like it will 6 drop to about 170,000. 7 And, recognize, while it's not possible for 8 us to separate out how much of that is on the 9 fixed-route service back in 2013, because it was a 10 coordinated system, so we didn't separate those 11 rides out, and in terms of the funding, right now, 12 where the Medicaid money for Dial-a-Ride trips is 13 90,000 a year. 14 So, again, I will -- Jim, do you want to pass 15 that out? 16 And we are certainly thankful for the 17 hold-harmless funding that we received in 2014. It 18 allowed us to continue providing some service. 19 Note, that we've already made some of the 20 transition that needed to be made. 21 We cut 2 1/2 transit routes. 22 How do you cut half a transit route? 23 Well, in spite of what you've heard, we 24 provide -- we did provide service in Tioga County, 25 going to both Waverly and the Robert Packer 1 Hospital. That was one of the routes that we had 2 offered to cut because we could not afford to do it. 3 Rather than that, we partnered with 4 Tioga County, and now we go to Owego. 5 Less trips, but we provide the trips from 6 Elmira down to Waverly, down to Zaire and to Owego, 7 that provide some of the health-service clients 8 transportation that needed it to Owego. 9 I will note, even though we've informed MAS 10 that we are providing that transportation, so some 11 of the people could take the bus from Owego to the 12 Robert Packer Hospital. Same for Waverly, we've had 13 zero passes bought to go on that fixed route. 14 So that's -- I'm not going to belabor that 15 point. 16 SENATOR O'MARA: And how long you have been 17 doing that? 18 JIM AREY: We've been doing that since 19 December of 2014. 20 We partnered with Tioga. 21 You know, one of the answers, the folks here 22 I'm sure are well aware, whenever you get a chance 23 for coordination, you do it. 24 And looking at that we are already providing 25 service to Waverly, and Zaire, and that that route 1 was underutilized, and knowing that it served a lot 2 of Tioga County residents, we partnered with 3 Tioga County, and said, We can work on a budget that 4 will help us to continue some level of service. 5 It's not the same level of service, but it is some 6 level of service. 7 Having been in the public-transportation 8 business a long time, I knew once public transit 9 service was out of Tioga County, as you've heard, 10 the opportunity to get it back just usually is not 11 there. 12 So we're holding on by a thread to provide 13 some service in Tioga County, but it is one of the 14 ways that we can coordinate. 15 We also had a 15 percent fare increase that 16 happened in 2015 also. 17 So those are the ways that we help deal with 18 the loss of funds. 19 You know, those were services that we cut, 20 that were fixed-route services. 21 You know, you've heard what happened to a lot 22 of our Dial-a-Ride. 23 There are some other Dial-a-Rides that we 24 have contracts to provide pre-k, handicapped, 25 transportation. 1 We have some other contracts that we've had 2 all along. 3 That's part of the coordination that we've 4 done. 5 Chemung County's been in the coordination 6 business since the early '90s, so we continue to do 7 that when we get the opportunity. 8 Some of the demand-responsive service that we 9 cut, we are currently seeking a new federal fund 10 availability to provide transportation on a 11 Dial-a-Ride basis to folks that are not on Medicaid, 12 or that are handicapped, to medical facilities and 13 to employment. 14 So, that is a way, and that will be 15 approximately 50,000 a year that we're seeking in 16 federal assistance. 17 If we're able to do that, we'll be able to 18 offer that service there. 19 I don't know if we'll be providing Medicaid 20 transportation. 21 It only makes sense, from coordination and 22 from financing, that we would, but we're down to 23 13 trips a day. 24 And one point, I think Jim previously raised 25 a very valid point. 1 If on August 1st we are not an enrolled 2 provider, the County isn't, which doesn't make any 3 sense. 4 I'm sitting here with the operator of the 5 system. He's the provider of the transportation, we 6 contract with him. 7 To have the County do it, and to think that 8 the county exec, or the deputy county exec, and 9 county employees, would put their social security 10 numbers out there on a form, for transportation 11 they're not providing, literally. They're 12 contracting for it. 13 The county contracts with the private 14 operator to get economy. That's why they do it. 15 And now to turn that back and make it into 16 something where you don't get the economy, if the 17 County has to fill out every form on every piece of 18 business that's done by First Transit, in duplicate, 19 to what they're already doing, does that make any 20 sense? 21 Does the County want to be in that business 22 for 13 trips a day? 23 The taxi companies, it's -- you've heard the 24 stories. 25 I think the only part that I would add to the 1 taxi companies, and other providers of 2 transportation, is that MAS has, literally, 3 recruited taxi companies and other providers of 4 transportation to come into Chemung County. 5 Where do we go from here? 6 What are we asking in terms of, what can be 7 done? 8 I think what can be done, is that it needs to 9 become a priority for the majority in the Senate, 10 where, I'm sorry, but it has to be the leadership at 11 this point. 12 In order to get the Department of Health and 13 Department of Transportation together, to figure out 14 what the correct approach is for funding for this, 15 the state of New York, for public transportation, 16 that's what needs to happen. 17 I appreciate your efforts, but it's now a 18 point where it's clear that the Department of Health 19 is not listening. 20 So the only way they're gonna listen is if 21 the Governor's sitting there with you, with your 22 leadership, talking about this, and they're given 23 direction to fix it. 24 Absent that, we'll come back again and talk 25 to you about our horror stories. Or, maybe by then, 1 Chemung won't be participating because we'll no 2 longer be providing trips. 3 Understand, for their convenience, and their 4 economy, we're selling $80,000 worth of passes and 5 tokens every year, just like we were before. 6 Before this happened, First Transit was 7 coordinating all the trips, and the majority of our 8 trips were made on fixed-route transit. 9 They already were. 10 All they did was, take advantage of the 11 coordination that we had already done with our 12 private operator. 13 If you want to know the amounts that we got 14 in hold-harmless money, the total between the 15 Department of Health and State Department of 16 Transportation was $850,000. 17 That relates to the more than a million that 18 we lost. 19 Certainly, I'm available for any questions 20 you have. 21 Jim, go ahead. 22 JIM: If I can speak to Allegheny and 23 Chautauqua County, Allegheny, we, First Transit, 24 operates in. Something interesting happened there. 25 Both Allegheny and Chautauqua have a very 1 robust mobility manager that, prior to MAS, actually 2 coordinated all the trips within each of their 3 counties. 4 They, in (unintelligible), in 5 Chautauqua County, they provided -- they provide 6 some service themselves. They contracted out the 7 rest. 8 In Allegheny County, we run a fixed-route 9 system, which the mobility manager, who was funded 10 by the Department of Transportation, encouraged by 11 the Department of Transportation, to develop 12 coordination in the county, took all the Medicaid 13 trips right from the Department of Social Services 14 and put as many as possible on the public transit 15 system. 16 When MAS rolled out into Allegheny County and 17 Chautauqua County, for some reason, they did 18 something that they could never do with the rest of 19 the counties, and the rollouts prior to that: They 20 allowed the trips to be distributed locally by the 21 mobility managers. 22 They allowed the mobility managers to take a 23 look at the trips that were available, put as many 24 on public transit. And the ones that they couldn't 25 put on public transit, then MAS would assign to 1 taxicabs or private providers. 2 They're very successful. 3 And that since has ended. They decided to 4 pull back on that. 5 Not exactly sure why. It may have been 6 working too well, but -- 7 [Laughter.] 8 JIM: But -- 9 SENATOR O'MARA: Did you say AMF -- MAS 10 pulled back? 11 JIM: Yes. 12 It's not whether it's directed from the 13 State, I have no idea. 14 I -- again, just as the operator. 15 So -- and I just received an e-mail this 16 morning, on my way here. I was stopped, I was at a 17 stop, so I read my e-mail at a stop. 18 [Laughter.] 19 JIM: Don't know if there's any troopers here 20 or not. 21 Received an e-mail this morning, that the 22 software that they purchased in Allegheny County 23 through grants and through funding from JARK (ph.) 24 and New Freedoms, is now useless, because, now, 25 they're not able to coordinate any of the trips 1 anymore. 2 So, it's just unfortunate that all of this 3 infrastructure is in place, and we can't use it. 4 I took up way too much time last time, so -- 5 JENNIFER CARLSON: (Not at a microphone.) 6 That was the first two, the first -- right of 7 first refusal that we had asked for in the original 8 legislation. 9 But, for some reason, on the third rollout, 10 they take back counties to do a pilot program. 11 And, so, they've since suspended it, I think, 12 because, you know, MAS isn't -- I don't know how 13 their contract is structured, but I don't think that 14 they get paid for some of those rides. 15 And, so, I think that's probably what led to 16 the disbandment. 17 Because that's what we'd always ask for, was 18 that the counties get the first right of refusal, 19 first, coordinating some people on for education. 20 JIM AREY: Thanks. 21 SENATOR O'MARA: Thank you, gentlemen. 22 Who would like to go first? 23 ROBERTA ZAIRE: I can, just, very briefly. 24 Ditto to everything everyone has said. 25 We're Lewis County. 1 I'm Roberta Zaire. 2 We're extremely rural, very, very small. 3 The only thing I was just trying to kick 4 around, some sort of solution, if NEMT can't come 5 back to the counties, if it can't be done locally, 6 could MAS possibly restructure some of their 7 call-center representatives so that they're 8 responsible for certain counties or certain regions? 9 So instead of getting a call from Binghamton, 10 the same day you get one from St. Lawrence County, 11 at least they might become more familiar. 12 It's -- it's got to be a difficult job. 13 They've got a whole -- the whole northern, 14 everything. They've got the whole state they have 15 to try and figure out. 16 The only other thing was, possibly, which 17 I don't think they would go for, MAS regional call 18 centers. 19 Like, come to Watertown, set up a call center 20 for the whole northern region. 21 Go to Utica, do Central New York. 22 You know, kind of branch out that way, just 23 to make it more manageable, because, it's a beast. 24 So, that's all I had to say. 25 SARA FREIDA: I'm Sara Freida, also from 1 Lewis County Public Transportation. 2 I want to ditto everything that everyone else 3 has said, and to thank you and the other Senator for 4 listening to us and coordinating this. 5 Our NEMT ridership has gone down from when 6 MAS took over in September of 2013. 7 I didn't know we were speaking, so I didn't 8 bring any statistical data. 9 Unlike some of the counties, we don't rely on 10 Medicaid ridership to support our system. 11 I'm almost considering the direction of maybe 12 getting away from it because it's become such a 13 hassle to manage missed rides or banded rides, 14 disappointed people, people just left halfway; all 15 that kind of stuff that used to be maintained 16 locally -- or, coordinated locally, with more 17 accountability, because our coordinators knew the 18 clients. 19 That's been taken away. 20 The other thing I wanted to mention is the 21 EMED application process that other people 22 mentioned. 23 It doesn't seem to make sense for counties. 24 They couldn't quite tell us why we had to do 25 it. 1 Our deadline to apply was November 1st of 2 last year. 3 I submitted, to the best of my ability, what 4 I could for the County. And about four or 5 five months later, I finally received word that it 6 wasn't complete, you know, because I didn't check a 7 certain box, or whatever. 8 I finally resubmitted that, and haven't heard 9 back from them, so I have no idea if we're going to 10 be dropped on August 1st or not. 11 No idea how that's applicable to our county 12 and what we do, because we use a contractor that 13 already bills with and is already registered for 14 EMED. 15 And the other thing I thought was interesting 16 is, on June 1st, they changed our rates. 17 I think the Genesee people mentioned that. 18 They just changed our rates in Lewis County, 19 so public transportation was now more expensive. 20 No rhyme or reason why. 21 Now public transportation is the same price 22 as taxis, and it is more expensive than the 23 volunteer program, which Sam will speak about. 24 But, we were willing to do it for half the 25 price a month ago, or six weeks ago. 1 Why would they change something that was 2 working fine? 3 And, now, how can I look you in the face and 4 say, We need to put the rides back on public 5 transportation, when now, clearly, we are more 6 expensive. We're not the cheapest gig in town 7 anymore. 8 But, we were willing to be back then. 9 So I thought that was kind of random, that 10 DOH would change the rates without consulting 11 locally. 12 And, again, the unintentional consequences, 13 some places had to increase their fares or cut their 14 fixed routes and Dial-a-Ride services. 15 Overall, that's going to affect more than 16 Medicaid people. 17 You already know that, you've heard that. 18 And it's going to be all over 19 Upstate New York in the rural areas, because the 20 rural areas don't have the urban core to either 21 piggyback or to cushion the effects, or, the 22 unintentional results. 23 And like Chemung County mentioned, 24 Lewis County might have to pull out of NEMT, and I'm 25 not sure if that's a -- just an easy solution or if 1 that makes us a bad player. 2 I don't know. 3 But, thank you for your time. 4 SENATOR O'MARA: Thank you. 5 NANCY DOLA: Hello, and thank you. 6 I'm Nancy Dola, Essex County transportation 7 director. 8 In 2010, DOT determined us to be fully 9 coordinated, and they were using Essex County as a 10 model for the rest of the state. 11 June 15, 2012, we were informed, July 1st, 12 MAS would be taking everything over. 13 2010, the cost for Medicaid transportation 14 was $327,000. 15 2011, it was 331,000. 16 MAS took over July of 2012. The cost was 17 507,000. That does not include the MAS fees. 18 2013, 880,000. 19 2014, 1.7 million. 20 We have 39,000 residents. 21 It cost 165,000 the month of June 2015 for 22 taxis, for 361 people in Essex County. 23 They may be saving money somewhere, but 24 they're not in Essex County. 25 And I don't know if the feds planned on this 1 increase or this date. 2 I know Essex County did not plan on a 3 $100,000 increase in their share for Medicaid 4 transportation for 2014. 5 And, it's going be well over $2 million for 6 2015. 7 A lot of these people thought I was crazy in 8 2012, because I've been on my soapbox for a long 9 time -- 10 [Laughter.] 11 NANCY DOLA: -- and no one wanted to listen. 12 But, boy, as they started taking over, people 13 started calling. 14 And, nothing changes. 15 We used to have 150 rides per month when we 16 were taking the calls and dispatching. 17 We had four in the month of June, and that 18 one person had to fight, and cry, and complain, to 19 be able to ride the bus. 20 SENATOR SEWARD: Those are startling numbers. 21 NANCY DOLA: Yes, they are. 22 Well, I've had a lot of time to compile a lot 23 of numbers. 24 So -- 25 [Laughter.] 1 NANCY DOLA: -- a lot of these people haven't 2 had the chance because, you know, it just happened. 3 And I finally -- I just actually got a 4 report, the one for June. It's the first one I've 5 ever received from our local DSS, and I was floored. 6 $165,000 for taxis in one month, which 7 actually was low, because, in May, it was $184,000 8 for taxis. 9 Taxis that used to exist in Essex County have 10 been pushed out. They can't work because these 11 other taxis, they advertise. The top of the paper 12 says, "New York State Medicaid Transportation, call 13 this number." 14 I have pictures of it, on the sides of their 15 car. 16 It does not say, "Taxi." 17 It says, "New York State Medical 18 Transportation Provider," which, when we started, we 19 couldn't even give a different colored bus ticket, 20 because someone else on the bus may know that they 21 have Medicaid. 22 Now we're telling the public, we're taking a 23 Medicaid person to a medical appointment. 24 SENATOR O'MARA: That's shocking. 25 Great. 1 SAM PURINGTON: Thank you for your time. 2 I'm Sam Purington. I'm the executive 3 director of the Volunteer Transportation Center. 4 We operate a 501(c)(3) non-profit in 5 Jefferson, Lewis, and St. Lawrence county. 6 Our mission is to fill the gaps where public 7 transportation does not exist. That's where we fill 8 in using volunteer drivers only. 9 I have similar stories I can tell. 10 I won't. 11 But I'll talk about a couple of solutions. 12 One suggestion that has made to the 13 Department of Health before, to have corporate 14 compliance, or, compliance, for all the issues that 15 you've heard today from everybody, about missed 16 rides or issues, taken away from MAS and done by an 17 outside party. 18 That would help with that. 19 And then the first right of refusal is, by 20 far, the best solution that I think could be 21 instituted by your group. 22 So, other than that, it's the same story 23 you'll hear across all three counties. 24 So... 25 1 SENATOR SEWARD: Now, are -- is MAS aware of 2 your group? I mean, are you getting calls from -- 3 SAM PURINGTON: Oh, yes. 4 We have seen no increase in Jefferson and 5 Lewis county. 6 We started operating in St. Lawrence County 7 because of the takeover. DSS could no longer 8 operate the volunteers, so we were asked to come in, 9 which was part of our area mission. 10 That is the three counties that we are 11 permissioned, you know, in our mission, that's the 12 three counties we'll operate in. No other counties, 13 even though we were asked to serve in other 14 counties. 15 SENATOR SEWARD: Now, do you have vehicles, 16 or do people use their own vehicles? 17 SAM PURINGTON: They use their own vehicles. 18 SENATOR SEWARD: I see. That's interesting. 19 Well, that's a lot of real estate when you 20 add up -- 21 SAM PURINGTON: That's Connecticut. 22 SENATOR SEWARD: -- Jefferson and Lewis 23 counties. 24 SAM PURINGTON: That's Connecticut, which is 25 not that big of a state. 1 But, that's Connecticut. 2 And, you know, everything they're saying, the 3 misdirection, all that stuff, happens every day, 4 regardless of cost. 5 SENATOR SEWARD: All right. 6 Well, thank you. 7 SENATOR O'MARA: Thank you. 8 That concludes our list. 9 Is there anyone here that's feeling left out? 10 We'd love to hear from you. 11 But, I guess that will conclude our 12 afternoon. 13 I want to thank you all for your time, and 14 expense, for coming here and sharing, reliving, 15 these stories again, that we are continuing to deal 16 with. 17 And we will continue to be working on these 18 issues in Albany, until we get a sensible solution. 19 Thank you. 20 SENATOR SEWARD: Thank you. 21 22 (Whereupon, the state forum concluded, 23 and adjourned.) 24 ---oOo--- 25