A new health plan for low-income elders and people who are permanently disabled or blind is showing early signs of trouble, but care providers and the state said the transition for its 37,000 Medicaid clients is going well except for a few bumps.

The state Quest Expanded Access, or QExA, program began Sunday under two new health care providers: 'Ohana Health Plan, a unit of WellCare Health Plans of Tampa, Fla., and Evercare Quest Expanded Access, part of the UnitedHealth Group Inc.

Three days into the program, advocacy groups, health centers and individuals have complained that people who are in the new plans are having problems getting their drugs, are concerned about transportation and worried about the continuity of care.

"This thing is going to be a mess for a while," said Bob Nakata, president of Faith Action for Community Equity, a grassroots advocacy group. Nakata said his group has received dozens of complaints, mostly about obtaining drugs, but he suspects other issues such as selecting a primary-care physician will also cause problems for patients whose doctors are not signing up with the two plans.

Dr. Dennis Ayon said he has a patient who requires high doses of morphine, but that someone in Evercare decided to limit her dosage. Another patient was denied antidepressants, he said.

"These guys are practicing medicine without a license," Ayon said, adding that the problem has created additional paperwork at his office, taking time from other patients, and for which he would not be paid.

State officials said a computer system error was responsible for people not getting their medication on time and that the problem should be fixed by Monday. Plan spokesmen said care coordinators and plan assistants are following up on complaints and working to resolve problems.

Evercare is trying to make the transition as seamless as possible, but when issues arise, it is aggressively addressing them, said Tyler Mason, spokesman for Evercare.

Addressing the drug issue is difficult without knowing specifics, but the fact that morphine is involved raises a warning, Mason said, adding that he would be willing to talk directly to the doctor to help resolve the issue.

David Heywood, executive director of Evercare, said the company is very experienced with this population, which is fragile.

"We're fully prepared to work through these issues and make sure they get the access to the care and continuation of the care," Heywood said. "My sense is we're doing pretty well. There's some bumps in the road."

The computer problem is not related to QExA, said Toni Schwartz, spokeswoman for the state Department of Human Services, which oversees QExA.

"With the start-up of any new program, it's never perfect," Schwartz said in an e-mail. "Overall, there have been minimal problems with this start-up, and a majority of people in QUEST have experienced a smooth transition into QUEST Expanded Access (QExA) program."

Emerence West cares for her 87-year-old mother, who just transferred into the QExA program. Under the old system, they would use TheCab to get to appointments, and the health plan covered their transportation.

Under the new program, she said, she was told she has to make an appointment for transportation. If an unexpected medical problem arose and the doctor told her to bring her mother in right away, they might have to wait up to four hours, West said she was told.

An Evercare care coordinator tried to reassure her, but she said she's not convinced, especially since the person couldn't answer other questions about the plan and had to get back to her.

"I'm disabled, suffering from general anxiety disorder," West said. "This (program) is designed to drive me right up the wall."

The ombudsman for QExA said they are fielding many calls, most of which can be handled over the phone. There are about two calls a day that require calling the plan provider, and they respond immediately, said Leolinda Parlin, director for Hilopa'a Family to Family Health Information Center, program ombudsman.

Plan participants shouldn't see any change in service with the new programs, and that's one of the issues the ombudsman helps with, Parlin said.

"The plans can change vendors, but the same level of service and expectation should be provided," she said.