More than three months after the statewide privatization of Medicaid, area providers and patients say they still are struggling with payment issues and inconsistency with services.

Jon Romaine, executive director of Area Residential Care, said the Dubuque nonprofit has observed multiple complications since a trio of managed-care organizations took over Iowa’s Medicaid program April 1.

“It has been real confusing, not only for the providers, but also for consumers of Medicaid services — especially those who have disabilities,” he said. “The transition occurred too quickly and we are dealing with the problems while they (the state and the MCOs) are trying to fix everything.”

Another complication emerged Friday, when union representatives complained that many in-home care providers in Iowa’s Consumer Directed Attendant Care program are not being paid for their services.