Mississippi Today

‘What am I going to do?’: Wheelchair user says Medicaid transportation caused her to miss medical visits

Published

3 months ago

August 15, 2024

mississippitoday.org – Gwen Dilworth – 2024-08-15 12:01:16

‘What am I going to do?’: Wheelchair user says Medicaid transportation caused her to miss medical visits

Bonnie Griffith of Clinton missed four doctor appointments in June and July because of problems with the transportation company that contracts with the Mississippi Division of Medicaid.

Griffith, who has a chronic nerve damage condition that requires her to use an electric mobility scooter, relies on Medicaid’s non-emergency medical transportation program to see her health care providers.

But on two occasions, she said drivers refused to transport her because they did not feel comfortable securing her scooter in the vehicle. Electric scooters qualify as wheelchairs under the Americans with Disabilities Act.

A third time, she said Modivcare told her there were no drivers available with the capacity to transport a wheelchair. And another time, the driver never showed up to the location she specified.

In July, she ran out of her medication.

“I have no way to get to any medical doctor at all,” said Griffith, who has severe peripheral neuropathy.

There’s no way to know if Griffith’s issues are unique or widespread. Denver-based for-profit Modivcare’s three-year, $96.5 million contract with the Division of Medicaid mandates it submit “monthly reports” containing information about the percent of scheduled trips that are late or missed each day or exceed 45 minutes longer than the average travel time.

The company assumed the state‘s non-emergency medical services contract on June 8 of this year.

But two weeks after Mississippi Today submitted a public records request for the reports, the agency told the outlet they have no such reports. Spokesperson Matt Westerfield said the reports are not yet due, though he did note that historically, non-emergency medical transportation contractors have struggled to meet the contractual ceiling of 2% late or missed trips each day.

He did not respond to an inquiry about when the monthly reports are due by the time the story was published.

The federally-required service helps Medicaid beneficiaries with no other means of getting to the doctor make it to their appointments. But some beneficiaries and advocates question whether it properly serves people who use wheelchairs and mobility devices.

People with disabilities – not all of whom use wheelchairs – are some of the most frequent users of the service.

Griffith made it to her first doctor’s appointment since the contract began on July 18.

“I feel so much better today just having gotten to where I was supposed to be,” she told Mississippi Today.

Bonnie Griffith prepares to sit in her motorized cart in her home in Clinton, Miss., on Monday, July 29, 2024. Griffith, who has severe neuropathy, missed four doctor’s appointments due to Modivcare’s transport issues with her cart. Credit: Eric Shelton/Mississippi Today

Experts question whether Modivcare’s policy complies with law

Modivcare’s website states that it is the “largest and most experienced broker of non-emergency medical transportation” in the nation. The company provides transportation services in 48 states and reported $118.3 million in profits during the first half of 2024 for non-emergency transportation services alone.

Modivcare contracts with local transportation companies, which give beneficiaries rides to their doctor’s appointments and take them home afterwards.

Advocates argue that the program yields cost savings for states and the federal government by heightening access to preventative medicine and routine health care that helps beneficiaries manage their medical conditions and avoid costly trips to the emergency room.

Griffith said she has relied on non-emergency medical transportation services in Mississippi for over 10 years.

Modivcare spokesperson Melody Lai told Mississippi Today in an email that while the service can transport people who use power carts or mobility scooters, they “will have to either transfer to a wheelchair or ambulate into the seat of the vehicle,” citing concerns about safety while transporting people seated on their mobility device.

Griffith, however, can not walk to a vehicle or push a non-motorized wheelchair by herself.

Her home health aide can accompany her to appointments to push the wheelchair, but Griffith must then give up time with the aide intended to support her personal care needs.

Hunter Robertson, the civil rights team supervising attorney at Disability Rights Mississippi, said he believes Modivcare’s policy is a violation of the Americans with Disabilities Act.

He said drivers can recommend that wheelchair users transfer to a vehicle seat, but can not require them to transfer, according to the latest guidance from the Federal Transit Authority.

“The final decision on whether to transfer is up to the passenger,” reads the agency’s circular.

Robertson said that if a wheelchair fits inside the vehicle and on the lift and can be secured, even if it is not constrained to the comfort of the company, a driver can not refuse to transport a rider.

Scott Crawford, an advocate for people with disabilities and a board member of the Mississippi Coalition for Citizens with Disabilities, disagreed. He said that he believes requiring people using mobility devices to transfer to a seat is an acceptable policy, given concerns that they might tip during hard turns.

However, transportation providers are still required to transport people and their mobility devices, even if the person must transfer to a seat, he said.

“It is vital that transportation providers allow people to bring their ‘legs’ (mobility device) with them when they are transported, assuming they will fit,” he said. “There are plenty of ways of securing a scooter or walker so that they won’t move.”

Robertson said non-emergency medical transportation services are a critical service for people who use wheelchairs.

“There is a limited amount of public transportation or transportation that is accessible when you are a wheelchair user or a power cart user,” he said. “The non-emergency transport is one of the few ways to safely get to doctor’s appointments on time … while using your mobility aid.”

Matt Westerfield, spokesperson for the Mississippi Division of Medicaid, said that Modivcare provided wheelchair securement training to 451 drivers prior to Modivcare’s contract beginning on June 8. He noted that from then to the end of June, there were 4,984 trips completed using wheelchair accessible vehicles.

Modivcare’s contract with the Division of Medicaid specifies that each wheelchair vehicle must have a wheelchair securement device that meets Americans with Disabilities Act guidelines.

In response to questions about the company’s adherence to the Americans with Disabilities Act, Lai wrote in an email, “Modivcare complies with all applicable laws, quality is very important to us and we provide training as may be required by law.”

Modivcare did not respond to specific questions about the contractor’s compliance with the Americans with Disabilities Act and declined Mississippi Today’s request for an interview.

Problems with transportation are not new for Medicaid beneficiaries

Griffith said the challenges she has faced with Medicaid transportation are not specific to Modivcare. She remembered unreliable transportation during the period another company contracted with the state for the service.

On several occasions, her driver did not pick her up from her appointment.

“I was offered a ride … by someone who had seen me still waiting there,” she said.

A 2021 report on non-emergency medical transportation by the federal Medicaid and CHIP Payment and Access Commission cited nationwide concerns about limited supplies of wheelchair vans, late pickups, ill-equipped vehicles and long call center wait times.

Some states have sought to heighten regulation of the companies that provide such services. In 2023, a bill in the New Jersey Legislature to establish performance and reporting standards for Medicaid transportation brokers died in committee. The legislation came after the New Jersey Department of Human Services fined Modivcare $1.7 million between 2017 and 2022 for failing to meet contract requirements, including missing scheduled pickups, according to the Bergen Record.

In Georgia, Modivcare and Southeasttrans, another non-emergency medical transportation company, were fined over $1 million from 2018 to 2020 for picking up patients late, reported KFF.

Over 450 complaints have been lodged against Modivcare in the past three years, according to the Better Business Bureau.

In July, Griffith’s nurse practitioner detected atrial fibrillation, or an irregular heartbeat, during an examination.

She worries about being able to get to visit her cardiologist given the unreliability of Mississippi’s non-emergency medical transportation.

“What am I going to do?” she asked.

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

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Mississippi Today

Senate panel weighs how much — or whether — to cut state taxes

Published

5 hours ago

November 4, 2024

Staff Editor

mississippitoday.org – Taylor Vance – 2024-11-04 15:42:00

A group of state senators on Monday grappled with how much to slash state taxes or if they should cut them at all, portending a major policy debate at the Capitol for next year’s legislative session.

The Senate Fiscal Policy Study Group solicited testimony from the state government’s leading experts on budget, economic and tax policies to prepare for an almost certain intense debate in January over how much they should trim state taxes while balancing the need to fund government services.

Senate Finance Chairman Josh Harkins, a Republican from Flowood whose committee has jurisdiction over tax policy, told Mississippi Today that he wanted senators to have basic facts in front of them before they help decide next year if Mississippi should cut taxes.

“We’re getting a tax cut the next two years whether we do anything or not,” Harkins said. “I just want to make sure we have all the facts in front of people to understand we have a clear picture of how much revenue we’re bringing in.”

Mississippi is already phasing in a major tax cut. After a raucous debate in 2022, lawmakers agreed to phase in an income tax cut. In two years it will leave Mississippi with a flat 4% tax on income over $10,000, one of the lowest rates in the nation.

However, the top two legislative leaders, Lt. Gov. Delbert Hosemann who oversees the Senate and House Speaker Jason White, have both recently said they want legislators to consider new tax cut policies.

Hosemann, the Republican leader of the Senate, has publicly said he would like to see the state’s grocery tax, the highest of its kind in the nation, reduced, though he hasn’t specified how much of a reduction or how long it would take for the cut to be implemented.

White, a Republican from West, said last week that he would like to see the state’s 4% income tax phased out and have the state’s 7% grocery tax cut in half over time.

“We are hoping to construct a tax system that, yes, prioritizes certain needs in our state, but it also protects and rewards taxpayers,” White said last week.

But it’s difficult to collect accurate data on the state’s grocery tax, and state lawmakers must grapple with a laundry list of spending needs and obligations based on testimony from state agency leaders on Monday.

Mississippi currently has a 7% sales tax, which is applied to groceries. The state collects the tax but remits 18.5% back to cities. For many municipalities, the sales tax is a significant source of revenue.

If state lawmakers want to reduce the grocery tax without impacting cities, they could pass a new law to change the diversion amounts or appropriate enough money to make the municipalities whole.

State Revenue Commissioner Chris Graham said the Mississippi Department of Revenue, the agency in charge of collecting state taxes, does not have a mechanism in place for accurately capturing how much money cities collect in grocery taxes. This is because the tax on groceries is the same as non-grocery items.

However, Graham estimates that the state collects roughly $540 million in taxes from grocery items.

The other problem lawmakers would have in implementing significant tax cuts is a growing list of spending needs in Mississippi, a state with abject poverty, water and sewer and other infrastructure woes and some of the worst health metrics in the nation.

Representatives from the Legislative Budget Office, the group that advises lawmakers on tax and spending policy, told senators that lawmakers will also be faced with rising costs in the public employee retirement system, the Medicaid budget, public education, state employee health insurance, and state infrastructure projects.

State agencies, including the employee retirement system, also requested $751 million more for the coming budget year.

“That’s the billion dollar question, I guess,” Senate Appropriations Chairman Briggs Hopson, a Republican from Vicksburg, said. “How we’re able to fund basic government services?”

Harkins and Hopson said the committee would likely meet again before the Legislature convenes for its 2025 session on January 7.

A House committee on tax cuts has also been holding hearings, and White in September held a summit on tax policy.

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

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Mississippi Today

Already dire lack of affordable housing for low-income Mississippians on verge of worsening

Published

9 hours ago

November 4, 2024

Staff Editor

mississippitoday.org – Simeon Gates – 2024-11-04 11:00:00

In Mississippi, where there’s already a dearth of 50,000 or more affordable homes for extremely low-income residents, that number could grow in the next five years.

Housing units available under the federal Low Income Tax Credit program could lose their affordability by 2030 –a number estimated nationwide to be 350,000 with 2,917 in Mississippi, alone; 496 in the state already have.

The federal program responsible for most of the nation’s affordable housing is expiring.

The Low Income Housing Tax Credit, introduced as part of the Tax Reform Act of 1986, provides for developers to buy, build and restore low-income housing units. Under the deal, the housing only needs to stay low-rent for 30 years. Construction began in the early 1990s.

Some LIHTC housing will remain affordable due to other subsidies, nonprofits, state law and individual landlords.

“I think the low-income housing tax credit has done everything that it can to address the need for affordable housing around the state,” said Scott Spivey, executive director of the Mississippi Housing Corporation, a state office that administers the program and works with the state government and those in the affordable housing industry to create and support affordable housing

Spivey supports the proposed Affordable Housing Credit and Improvement Act, a federal bill that would expand upon the low-income housing tax credit in several ways, including giving developers more credit for certain projects for low-income households and changing tenant eligibility rules.

The bill was introduced in the House and the Senate last session, and is co-sponsored by Mississippi Sens. Cindy Hyde-Smith and Roger Wicker and in the House by Reps. Mike Ezell, and Michael Guest. As of this spring, both bills are in committee.

While housing has become a major issue for Americans, getting legislation passed has been challenging. “Everybody knows that housing is an issue, but it gets caught up with everything else…and it kind of gets lost in the shuffle,” said Spivey.

This issue is especially important in Mississippi, where demand for housing is high across all incomes.

“All the market studies that we see that come with the applications tell us that there’s a huge need for affordable housing across the state at all the income bands” said Spivey.

According to the National Low Income Housing Coalition, almost a third of Mississippi renters are extremely low income; 65% of them are severely cost burdened, meaning they spent more than half their income on rent. The majority of these households are seniors, disabled people, single caregivers of young children, people enrolled in school, or other.

Director of Housing Law at the Mississippi Center for Justice, Ashley Richardson said housing problems worsened after Mississippi stopped participating in the federal rental assistance program in 2022.

MCJ’s work on housing includes a statewide eviction hotline, investigating instances of housing discrimination, and more.

Richardson praised the LIHTC program, but echoed Spivey’s concerns. “Even with the affordable housing we do have in Mississippi, we are still at a lack,” she said.

The National Housing Preservation Database estimates Mississippi is short 52,421 affordable and available rental homes for low-income people. The National Low Income Housing Coalition puts the figure at 49,478.

Richardson wants the state to deal with issues like providing more tenant protections and rental assistance. There’s also a need to improve homes that are rundown or in poor condition, and many housing nonprofits are running out of funding.

Spivey said people should talk to their property managers and learn about their rights. MHC’s website has resources for homebuyers and renters.

As the housing crisis goes on, there are options for people struggling to find and keep affordable housing and an effort to take action at the federal and state levels.

Some aspiring low-income homeowners may qualify for Habitat for Humanity, a program that builds homes for families in need. Families who qualify work on the homes alongside volunteers, pay an affordable mortgage and receive financial literacy education.

New applicants must meet the qualifications, including a good debt-income ratio, 125 hours of sweat equity and taking classes on financial literacy, home repairs, and being a good neighbor.

Merrill McKewen, executive director for Habitat for Humanity Mississippi Capital Area, emphasized the importance of housing to individuals and communities.

“There are untold studies that have been done that, you’ve gotta have a safe, decent, affordable place to live. The children are better students, the parents are better employees…it grounds you to a community that you can contribute to and be a part of. It is the American dream, to own a home, which is what we’re all about,” she said.

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

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Mississippi Today

Mississippi Election 2024: What will be on Tuesday’s ballot?

Published

10 hours ago

November 4, 2024

Staff Editor

mississippitoday.org – Bobby Harrison – 2024-11-04 10:00:00

Mississippians will go to the polls on Tuesday, Nov. 5, to elect federal and state judicial posts and some local offices, such as for election commissioners and school board members.

Polls will be open from 7 a.m. to 7 p.m. on Tuesday. To find your polling place, use the secretary of state’s locator, or call your local county circuit clerk.

The following is a list of the candidates for federal and judicial posts with brief bios:

President

Kamala Harris, current vice president and Democratic nominee for president. Her running mate is Tim Walz.
Donald Trump, former president and current Republican nominee. His running mate is J.D. Vance.
Robert Kennedy Jr. remains on the ballot in Mississippi even though he has endorsed Trump. His running mate is Nicole Shanahan.
Jill Stein is the Green Party candidate. Her running mate is Rudolph Ware.
Five other candidates will be on the Mississippi ballot for president. For a complete list of presidential candidates, see the sample ballot.

U.S. Senate

Ty Pinkins is the Democratic nominee. He is a Rolling Fork native and attorney, representing, among other clients, those alleging unfair working conditions. He served 21 years in the U.S. Army, including combat stints, other overseas deployment and posts in the White House,
Roger Wicker is the Republican incumbent senator. He resides in Tupelo and has served in the U.S. Senate since late 2007 after first being appointed to fill a vacancy by then-Gov. Haley Barbour. He was elected to the post in 2008. He previously served in the U.S. House and as a state senator. He is an attorney and served in the United States Air Force.

House District 1

Dianne Black is the Democratic nominee. She is a small business owner in Olive Branch in DeSoto County.
Trent Kelly is the Republican incumbent. He was elected to the post in a special election in 2015. He previously served as a district attorney and before then as a prosecuting attorney for the city of Tupelo. He is a major general in the Mississippi Army National Guard.

House District 2

Bennie Thompson is the Democratic incumbent. He was first elected to the post in 1993. Before then, he served as a Hinds County supervisor and as alderman and then as mayor of Bolton.
Ronald Eller is the Republican nominee. He grew up in West Virginia and moved to central Mississippi after retiring from the military. He is a physician assistant and business owner.

House District 3

Michael Guest is the Republican incumbent and is unopposed.

House District 4

Mike Ezell is the Republican incumbent first being elected in 2022. He previously served as Jackson County sheriff.
Craig Raybon is the Democratic nominee. Raybon is from Gulfport and began a nonprofit “focused on helping out the community as a whole.”

Central District Supreme Court

Jenifer Branning currently serves as a member of the state Senate from Neshoba County.
Byron Carter is a Hinds County attorney and previously served as a law clerk for Supreme Court Justice Armis Hawkins.
James Kitchens is the incumbent. He has served on the state’s highest court since 2008.
Ceola James previously served on the Court of Appeals.
Abby Gale Robinson is a Jackson attorney. She previously was a commercial builder.

Southern District Supreme Court

Dawn Beam is the incumbent, having been first appointed in 2016 by then-Gov. Phil Bryant and later winning election to the post. She is a former chancellor for the Hattiesburg area.
David Sullivan is an attorney in Harrison County and has been a municipal judge in D’Iberville since 2019. His father, Michael, previously served on the state Supreme Court.

Northern District Supreme Court seats

Robert Chamberlin of DeSoto County is unopposed.
James Maxwell of Lafayette County is unopposed.

Court of Appeals 5^th District seat

Ian Baker is an assistant district attorney in Harrison County.
Jennifer Schloegel is a Chancery Court judge for Harrison, Hancock and Stone counties.
Amy St. Pe is a Municipal Court judge in Gautier.