NY takes back Medicaid transportation funding, threatens county bus lines

Monica Sandreczki
April 2, 2014

New York state had funded the Cortland County public bus line to help transport Medicaid recipients to their medical appointments. But the county recently lost that money when New York started spending it through a centralized call-in service instead. And this could have a big impact on some residents.

It’s a drizzly day in Cortland. Joyce Dowd is leaning against the bus stop shelter in front of the courthouse waiting for the number 5. Today’s like every day – Dowd catches the 2:30 bus to head about 15 miles down the road.

"My daughter lives at the trailer park there," says Dowd. "But I go to Cincinnatus because she works at the Dollar Store and I go out there and see her a lot.”

She’ll chat with her daughter at work then walk to the social services office to hang clothes and empty garbage in exchange for food. Then she heads back on the 4:30 bus, only staying in Cincinnatus for an hour.

Up until last year, New York State sent money to counties to help transport people on Medicaid to their doctor’s appointments. Like a lot of rural counties, Cortland spent that money on its public transit system.

That’s all changing. As part of Governor Cuomo’s Medicaid Redesign Initiative, the state took back the Medicaid funds. Now the money is spent directly on each trip to the doctor. Patients call into a regional service that figures out the best way to get them to the doctor. Often, it’s a private taxi.

In Cortland County, that left a half-million-dollar hole in the public transit budget.

Cortland head of public transit, Dan Dineen is worried about the future of the bus line.

“Any business loses 40% of their revenue and you have to start looking at other avenues,” says Dineen.

And that could mean partnering with a group with a high need for the bus system or making cuts. Right now, it’s uncertain.

The New York Department of Health is in charge of spending the state’s Medicaid money. According to a department spokesman, the new system is the best way to get Medicaid patients to their appointments. But Dineen says the money was doing much more good before the change.

“The public transportation system is designed for people’s everyday lives," says Dineen. "So it’s not just to transport individuals to medical appointments, but to get to pharmacies and grocery stores.”

Dineen says he’s tried to explain the county’s dilemma to the Department of Health, but got little response.

Counties hit hardest used Medicaid money for 15 to 40 percent of their public transit budget. Tioga County has already raised their prices. Tioga and Madison Counties are considering shutting down their bus lines all together.

Joyce Dowd in Cortland County says she doesn’t know what she’d do without the bus. Dowd has tried taking a local cab to see her daughter, but it was $120 round trip. She can’t afford that. She tried walking to Cincinnatus, too.

"If I miss my bus, I’ve walked from Marathon before and then the cop says ‘where you going?’ well I says ‘I’m walking because I don’t have no way home.’ He was going to arrest me and I said ‘really? I’m not doing nothing wrong. I didn’t commit a crime.’ You know, it’s embarrassing," says Dowd.

She can’t work because of a learning disability, so she lives off social security and disability.

"I see my grandson as much as I can, I mean, because if I don’t, I want him to know who I am and right now he holds his hands out. And he’ll come to me and just look at me and laugh.He’s funny though. I love him. He’s my little peanut.”

Last week, the Cortland County legislature voted to support a state senate initiative allowing counties to opt out of the call-in service.