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Medicaid funding cut threatens SWRTA services

Posted: January 31, 2012 4:20 p.m.
Updated: February 1, 2012 5:00 a.m.

In its fourth decade, the Santee Wateree Rural Transit Authority (SWRTA) continues to provide services to Kershaw County. However, changes to the agency’s funding may cause the SWRTA to cut some of those services, according to Executive Director Ann August.

The SWRTA recently lost funding from a Medicaid contract, forcing the agency to appeal to both Kershaw County and Camden City councils for additional money. The agency provides a variety of services, including SmartRide commuter trips from Kershaw County to Columbia, demand response paratransit services, disabilities and special needs transportation, Medicaid transportation, and transportation services through the Workforce Investment Act.

August tries to explain to people that the agency is not just a Medicaid transportation provider.

“We provide public transportation, so that means not only are those individuals that are on Medicaid using the vehicles for medical appointments, a lot of them ride the vehicles in some cases to go shopping or they’re dealing with quality of life issues so it’s a lot of different things that people ride the bus for,” August said.

She said she believes in order for a municipality to be “viable,” it must have public transportation options.

“It’s a part of economics. I always say that transportation is the key to education and economic development. If you can get people transported so they can go to school, get their education (and) get their training, then eventually they will get jobs. And if they get jobs, then, of course, that brings money back into community and that begins to turn over.”

August said that when the S.C. Department of Health and Human Services (DHHS) went to a brokered system for Medicaid non-emergency transportation services in 2007, the level of funding and service started to decline.

“The state Medicaid program went to a brokered system, and what they did was, instead of us dealing directly with DHHS, a broker came in out of Atlanta that we started doing service with,” she said. “During that period of time, service started to decline. They started bringing in a lot of what I call ‘mom and pops’ from out of state.”

The brokers split the Medicare funds between public transportation entities and private “mom and pop” transporters, August said. Consequently, the SWRTA began to see a decrease in mileage and funding, according to August.       

“Our costs and our billing are based on miles, so the less miles you have, the less revenue you have. It goes hand in hand,” she said.

DHHS spokesman Jeff Stensland said that prior to the broker system, the working relationship between DHHS and the transportation agencies wasn’t very efficient.

“We were seeing a large inflation in expenditures. We weren’t seeing that many people utilizing non-emergency transportation, but there was a huge spike in expenditures year after year,” Stensland said.

He said the brokers are better at holding down costs and providing better services since they’re more specialized compared to DHHS itself.

“Most states now do contracts with non-emergency transportation brokers,” he said. “They have 1-800 (telephone) lines that people can call and they’re very efficient in terms of scheduling rides for folks, so it’s been kind of a good thing for the beneficiaries and the program.”

S.C. Department of Transportation (SCDOT) Chief Transit Planner Doug Frate said funding for the state’s public transportation agencies is split between federal support and a non-federal match.   

“The feds provide their funding for operating assistance on a 50-50 split with 50 percent being Federal Transit Administration (FTA) formula funding and the other 50 percent is non-FTA,” Frate said. “(T)hat could come from any sources that are non-FTA related, including local funding, state funding, Medicaid transportation, or even other federal funding resources that may allow their programs to match FTA funding.”

Frate said that unlike the Medicare funding, the funds from SCDOT weren’t relegated to any specific trip purposes.

“It may be job-related, it may medical-related, it may be recreation-related, but there is no specific purpose and there is no specific population segment, it’s just open to the general population,” he said.

In the past, August said, the SWRTA was able to provide that non-FTA match through other funding; specifically, substituting the residual funds from the Medicare contract and grant money from SCDOT.

Kershaw County Administrator Vic Carpenter said there was not an immediate opportunity for the county to appropriate funding since no money was allocated in this current budget cycle.

“They (SWRTA) have been able to restructure some of their revenue and expenses and they were able to extend their window several months so it’s not a ‘we need it by next week or the doors shut down,’ but they’re asking for it in a timeframe that would fit more into our budget process,” Carpenter said. “Clearly, transportation is something that is a benefit to a community and it affects us all. But obviously the issue is how much can you afford. If council believes that’s something we need to include in the budget, then we’ll work it in, but any increase comes with a decrease somewhere else.”

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