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The original item was published from 5/3/2019 11:30:00 AM to 5/27/2020 6:31:50 PM.

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Posted on: May 3, 2019

[ARCHIVED] Impact of Recent Changes to the Medical Assistance Transportation Program

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The following information was presented to the Chester County Commissioners by Gary Krapf, President, Krapf Coaches and Rover Community Transportation, at the Sunshine Meeting on Wednesday, May 1:

On June 22, 2018, the state legislature passed an amendment to the Human Services Code (HB 1677) directing the Department of Human Services (DHS) to provide the Medical Assistance Transportation Program (MATP) through a statewide or regional full-risk brokerage system. The Governor approved the measure the same day, despite a recent Transportation Research Board report noting our Commonwealth’s Shared Ride model has the third-lowest MATP cost nationally. Later in June, DHS issued a Request for Applications (RFA) for a statewide or regional broker to administer MATP services

Our Concerns:

  • The incentive for implementing a full-risk brokerage was an understanding of an additional federal draw down for DHS of up to $15 million. However, further analysis shows the ultimate cost to the Commonwealth will be significantly higher.
  • Across the Commonwealth, MATP costs exceed 30% of the Shared Ride/Paratransit programs. Removing the MATP from the Commonwealth’s coordinated system will result in the need to increase revenue from the remaining funding sources, including the MATP program, by INCREASING THE COST TO THE COMMONWEALTH BY 23% OR $31.5 MILLION*.
  • Under the worst-case scenario where local transit providers would lose all MATP trips, the Commonwealth would experience a $63.8 million increase in costs for providing this program.
  • Counties in the Commonwealth will no longer maintain local control of these services; the delivery of the services will be transferred to a broker without knowledge of the local area or the consumers. This will result in the loss of personalized service at the local level, forcing a “one size fits all” program for some of our most vulnerable citizens.
  • Pennsylvania’s coordinated system is a national model of efficiency. Brokering MATP service will result in many MATP trips being removed from that coordinated system. To address this change, the transit providers will need to:
  • Reduce the geographic service area and hours of service, meaning seniors and persons with disabilities will see a reduction in available service; and
  • Increase costs since reduction in coordination will result in a significant loss in service productivity resulting in increased state and local program funding and customer co-pays

Our Requests:

We respectfully request the Administration and General Assembly take steps to suspend the award of the RFA. We also ask you to support Sen. Baker’s SB 390 and Rep. Hershey’s HB 986. These bills would suspend the award until the Joint State Government Commission can conduct a study of the positive and negative impacts of providing MATP through a full-risk brokerage model.

If you have further questions on this important matter, please feel free to contact us at your convenience. Our contact information is enclosed.


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*Analysis Assumptions:

• In states where brokering occurred, coordinated transit system realized a 40% reduction in coordinated trips. (Source: TRB)
• Systems will lose the management of mileage reimbursement and other pass-through revenue trips on MATP as the broker will manage those directly
• Systems will lose the administrative revenue that comes from management of mileage reimbursement and other types of pass-through trips.
• Systems on average will reduce system costs by 5% by finding efficiencies in service and reducing administrative costs.
• Communities will want transit systems to maintain the same level of service as they provide today, with wait times on-vehicle times and hours of service relatively unchanged.

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