Trena Cilley of Benton worries she will lose the Kennebec Valley Community Action Program rides that take her to and from dialysis treatments in Fairfield three times a week.

Cilley, 77, stays at the Dialysis Clinic on Ridge Road for about four hours each time. She is afraid, not only for herself, but for the dozens of others who receive dialysis there weekly and could lose their KVCAP transportation by Jan. 1.

That is because the state Department of Health and Human Services last October awarded the “nonemergency transport” contract for eligible MaineCare recipients to Modivcare, a for-profit health care services company based in Atlanta. Modivcare, valued at more than $300 million, is the largest transportation broker company in the country and serves 20 states, including Maine.

Modivcare, which currently provides rides for people in eight of 16 Maine counties (Androscoggin, Aroostook, Hancock, Franklin, Cumberland, Oxford, Washington and York), including large population centers of Portland, South Portland, Lewiston, Auburn, Biddeford, Saco and Sanford, according to DHHS.

Modivcare has come under fire recently for its transportation brokerage over complaints from Mainers who claim they’ve been left at appointments or declined rides without explanation.

Penquis, a community action program based in Bangor, which for the last 10 years has been the broker responsible for scheduling rides for eligible MaineCare patients in Somerset and Kennebec counties, appealed that decision. A state-appointed panel upheld the appeal, and now it has returned to court, according to Penquis officials. While that process is ongoing, the state extended the contract with Penquis to the end of this year.

KVCAP officials are concerned about what will happen, with a change of broker from Penquis to Modivcare.

“If Modivcare becomes the broker, we have no idea if they will use KVCAP,” said Michele Prince, KVCAP’s chief operating officer. “They haven’t reached out to us. MaineCare is probably close to 90% of the trips we do.”

The change, she said, could be devastating for KVCAP’s transportation system, which also provides rides for people with low income, seniors and those with child protection needs, for which KVCAP gets small grants to transport them. Prince described the KVCAP transportation system as like a three-legged stool and if one leg is removed, the whole stool is destabilized.

“We’ve been working with Penquis for 10 years,” Prince said. “We’ve worked really hard over the past many years to build a system that works well. We’ve spent millions of dollars to increase our fleet. Just a year-and-a-half ago, we purchased a garage to do our maintenance which made things so much better.”

The idea, according to Prince, is to coordinate transportation so it’s the most efficient and cost-effective as possible for people. If KVCAP goes to Jackman to pick up someone who is eligible for nonemergency transportation, the vehicle could also pick up two or three people needing rides for other purposes. Not being able to group them together isn’t an efficient and cost-effective way of providing services, she said.

“If we go to Modivcare, we don’t know if we’ll be providing any MaineCare (nonemergency transport) trips,” Prince said. “We imagine it won’t be near the level we have been doing in the past — and maybe not at all.”

Beyond that, KVCAP and its drivers know the community, are based in the community and know the people, according to both Prince and Cilley.

“The funding that comes into KVCAP all goes out to the community, not shareholders,” Prince said. “We are investing in our communities.”

NEEDED RIDES

Cilley said she does not have full MaineCare and therefore does not receive nonemergency transport rides through that avenue. She receives Social Security benefits and earns too much to get many services, but does get a scholarship that enables her to stay with KVCAP transportation.

While she has a large family of children and grandchildren who tell her not to worry because if she loses her rides to dialysis, they will make sure she gets there, Cilley said they would have to leave their jobs to drive her and that is not sustainable.

“It’s a job, twice a day, three times a week,” she said. “It’s not feasible.”

A KVCAP transit bus carries individuals Wednesday to the Dialysis Clinic Inc. in Fairfield. Some riders worry that a new company hired to schedule trips could mean they will not have the same reliable transportation to important appointments. Rich Abrahamson/Morning Sentinel

She said KVCAP drivers are friendly and sociable and share stories about their lives and families, and the riders depend on them for their sociability.

“It’s very, very much needed,” Cilley said.

Carol Sharrow, 57, of Augusta said she rides the KVCAP Explorer to her job at a retail store, to medical appointments at MaineGeneral Health, the grocery store, gym and other places, as she doesn’t have a vehicle and doesn’t drive. She and a lot of other riders are scared they will lose KVCAP transportation, and an outside entity will come in that doesn’t know the people and the area.

If KVCAP goes away, Sharrow says she could lose her employment.

“It could be devastating to me,” she said. “I’ve had great experiences with KVCAP. They’ve been good to me. They’re professional. They know the people, they know the schedule. It’s concerning to me because I’m working hard at continuing to move forward in my life and better myself. I just don’t want to see that going backward.”

Kennebec Explorer driver Roger Campbell, right, holds the door Wednesday for Trena Cilley, 77, of Benton at Dialysis Clinic Inc. in Fairfield. Campbell says the transit bus he drives carries eight passengers. Rich Abrahamson/Morning Sentinel

She said she is a fan of the state of Maine and hopes Penquis wins the appeal and DHHS will see Penquis and KVCAP’s value from years of providing good service.

“I don’t want to lose that and I don’t want other people to lose that,” she said.

‘NO DESIRE TO CHANGE THAT’

Myra Orifice, Modivcare’s senior director of operations in Maine, said this week that the company has been in Maine since 2013, covers five regions of the state and uses community action programs in every one of those regions for MaineCare nonemergency medical transport patients.

KVCAP and other community action programs, she said, will keep every member that they transport as long as they meet the state’s requirements for compliance.

“Every region that we were awarded, we contract with (community action programs) in that region,” Orifice said. “We have no desire to change that. It would be foolish for us to interrupt a system that is working well.”

Orifice noted, however, that Modivcare also hires subcontractors other than community action programs to cover trips, as it can’t rely on only one provider.

“You have to have a network of many so that all members are able to get a ride, not just what’s available,” she said.

Trena Cilley, 77, of Benton arrives for dialysis Wednesday after riding aboard a KVCAP transit bus to the Dialysis Clinic Inc. in Fairfield. Kennebec Explorer driver Roger Campbell, in back, says the transit bus carries eight passengers. Rich Abrahamson/Morning Sentinel

Orifice said it is important to note that community action programs perform only 2.3% of all trips in the five Maine regions Modivcare covers because volunteers have retired and aged out. She is based in Modivcare’s South Portland office and said the company employs more than 100 people in Maine.

The Maine Monitor reported earlier this month that some riders reported Modivcare was not reliable — for reasons including that they were left at appointments and declined rides without given a reason why. Modivcare, however, said complaint levels have been low.

Orifice noted that the Monitor story included comments by the director of a cancer center in Maine who said she has made 100 trips to Bangor to pick up patients left at appointments and not picked back up. “The facility in that (Maine Monitor) article is not a MaineCare facility, so we would not transport members there,” Orifice said. “I, honestly, ran every report possible to see where this came from and I can’t identify any of that occurring. The state also did the same.”

Orifice said she and Department of Health and Human Services officials also reached out to a woman interviewed in the story who reported being denied rides and not picked up, and they have not heard back from her.

“No one has returned any of our inquiries to verify the information,” she said.