Saturday's News Roundup

Privatization lessons learned-Austin American Statesman

Undoing the damage-Texas Health and Human Services acknowledges the shortcomings of its privatization plan - Houston Chronicle

Texas scales back plan to privatize its social services
By LIZ AUSTIN PETERSON-Associated Press

Blogs commenting on the "mess":

HHSC Reverses Course on Welfare Privatization - Fr. John Whiteford

More Privatization Tales - Eye on Williamson County

State finally cuts bait on Accenture - OfftheKuff

Wasn't Such a Good Idea to Privatize Social Services with Accenture (Remember them? Used to be Arthur Anderson Before ENRON!) - Somervell County Salon

Accenture gets the Clear Lake Axe - Bay Area Houston

Full Speed Ahead into 2007!

Remember when I posted a reader's letter to many reps/state officials regarding the Women's Health Program?

Well, that reader has received ANOTHER response...this time from the Comptroller's Office...it was posted in the comments, but I feel it's worthy of being on the blog itself so no one misses it:

This was from the Comptroller's office:

Dear (worker):

Comptroller Strayhorn has received your e-mail regarding Medicaid's new
Women's Health Program, its potential negative impact on the troubled TIERS
system and potential problems that could result for families receiving other
types of financial assistance.

She has asked me to respond to you. We are forwarding a copy of your e-mail
without your name to the attention of Anne Heiligenstein, Deputy Executive
Commissioner for Program Services, Health and Human Services Commission. Alert local employees are often the first to realize potential problems and issues
involved in the application of new policies, programs and procedures within the
context of complex systems.

It is important for staff to stand up and be heard so that unforeseen negative consequences can be avoided. We applaud you for having the courage to do so. We are confident that Ms. Heiligenstein will investigate your concerns and make any appropriate changes in the Commission's plans so that the new program can proceed without creating additional problems for our state's neediest families.

If you need further assistance, please contact me by e-mail at vicki.anderson@cpa.state.tx.us.

Sincerely,
Vicki Anderson

Let this response serve as a reminder to all of
us "in the field"- your voice CAN be heard. I encourage everyone willing to email whoever you can as much as you think possible to get the word out. We do have a voice, and we WILL be heard.--hhscemployee

Merry Christmas!

I'm going to take a break from all things HHSC for the Holidays, but let me say to anyone reading here that I wish you a VERY MERRY CHRISTMAS and a GREAT 2007!

To my fellow workers: The work you do for the people in the State of Texas means something. You continue to work under very pressured conditions, yet somehow we are able to help those who need us. Because of the work we do, there are families in Texas who will be able to have a little hope for the holidays and the New Year. No matter the pressure we feel from those "in charge"- what you do is important. We are feeding children, keeping kids covered under Medicaid so they can get medical care, and we are helping those who need us make a better life for themselves and their families. Don't let anyone "out there" make you feel like you aren't in the business of HELPING OTHERS. We are. We can make this agency what it once was. We just must continue on trying to get others to see the same things we do.

In the News

Of course, we all know HHSC has been in the news quite a bit for the last few days...rather than link every article, you can check them out by clicking HERE.

Women's Health Program

I got this from someone who sent the following to all his/her reps......it would be great if any and everyone could take this letter and send it to their reps as well:

I sent this email or a little longer version to all the State representatives and Senators (also dewhurst) I may not be working by the end of the week, but I will get heard..

Dear Representative whoever:

Let me start by introducing myself. My name is Worker (used my real name and Town in the emails) and I am a Texas Works Advisor in Whereeveryouare, TX. As you most likely know by now, HHSC has been trying to push to get privatization for the issuance of State benefits (Food Stamps, Medicaid and TANF) for quite some time now, and have had limited success to say the least. The Feds have put a hold on any further rolling out of the system until HHSC can show that the system works.

HHSC is going to start a new Medicaid program on January 1st, called "The Women's Health Program." It is explained in Texas Works Bulletin 07-05 (http://www.dads.state.tx.us/handbooks/TexasWorks/res/Bulletins/index.htm) In theory, it sounds like it could benefit a lot of women in Texas, but there are a couple of issues that I am concerned with.

The program is designed to help women between the ages of 18 through 44 who meet the eligibility criteria. This limited benefit Medicaid program provides health screenings and risk assessment exams for preventable conditions. It also provides family planning counseling and contraceptives to eligible women. The problems that I have with the program have really started to bother me:

1.) It is not a full coverage Medicaid program. The women that would qualify for this program are probably not going to be able to get any treatment for problems that are found…It provides coverage for gynecological exams, related screenings, and birth control. If during any of the exams or screenings a problem is found, they have no medical coverage to pay for any related treatments or medications. They are probably over the income limit for adult Medicaid and TANF, or they would more than likely be on one of those programs already. It doesn't make sense to me to cover someone for a diagnosis, but then not let them be helped for treatment.

2.) This program is being worked through the TIERS system. It has already been shown that this system is flawed, and the government has put a hold on any further rolling out of this system. All of these women between 18 and 44 that apply and are certified for this Medicaid program are going to be in the TIERS system, which means that all associated cases that they have (Food Stamps, Children's Medicaid, etc.) are going to be converted to TIERS cases, along with all other people on those associated cases. In my estimation, in any given week probably 40% to 60% of the women applying for Adult Medicaid in my office are doing so to get birth control. Being the pessimist that I am, I am seeing this program as a ploy to get more people into the TIERS system, so that if and when the powers that be realize that the system is too flawed and cannot save the state any money, there will be too many clients in the "new" system to just trash it and return t the "old" system (which is still working fine.) Once a person is taken off of the SAVERR system and put into TIERS, they can't be put back (although there used to be a way to correct mistakes that would put clients back into the SAVERR system.)If I were a woman between the ages of 18 and 45, and there was a program that would help me to get birth control plus medical screenings for women's problems, I think I would jump at it. If I knew anything about the problems with the TIERS system, and knew that I was going to have to have all of my cases worked through that system for the rest of time, I might think twice before applying. Couldn't this program be implemented through the SAVERR system? They have created more complex programs through this system before.What I am trying to say is that the public (and our government) need to be informed COMPLETELY about this program before it is implemented. Something has to be done to keep all of these clients from being converted to the TIERS system, or there may be more problems than anyone wants to deal with.Thank you for your time, and I apologize that I am sending this so late in the game. I am not a political activist; I just kinda go with the flow of things…usually.

This whole privatization issue has bothered me from the start, mainly because of the way that things were done, not the privatization itself, and I guess I have just gotten fed up. It seems that since HHSC has been stopped from rolling out anywhere else, they are going to virtually roll out with numbers of clients instead of with actual offices in areas.This privatization is adversely affecting workers, clients and it seems the general public now.

Please feel free to forward, cut & paste, or otherwise get this letter to whomsoever you see fit to inform them of the issue. I would rather be kept anonymous for obvious reasons, but if you need or want to, you may use my name and address as a source.

The sender then received a response to his/her letter which - with permission - is being posted below:

Dear Mr./Mrs. (Worker):

Thank you for your information regarding The Woman's Health Program. I understand your concerns with this issue, and it is something our office will research further. I agree with you about the problems associated with the Texas Integrated Eligibility Redesign System (TIERS).

In a report issued by the Texas Comptroller' s office in October, TIERS was credited with having many difficulties, such as not processing dates correctly, not distinguishing between eligible and ineligible members in a household, and failing to determine residency status.Thank you again for the additional information, we appreciate it.

If you have any questions in the future, please do not hesitate to contact our office again.

Thanks
Katherine

Katherine Frolow
State Representative
Pete P. Gallego
Texas State Capitol - 4S.5(o) 512-463-0566(Second e-mail)

One thing I found interesting was that in the Q&A last week (was it last week?) someone had asked about this:

According to Texas Works Bulletin 07-05, applications for the Women’s Health Program are to be processed by special Texas Works Advisors in TIERS. Does this mean the rollout has resumed? This will increase the workload for the workers who are trained in TIERS. Is the state looking at providing training for this program?

Applications for the Women’s Health Program, which begins Jan. 1, will be processed in TIERS by a new HHSC eligibility unit created just for this program. The new unit has 34 staff, including 25 eligibility advisors, who will process all Women’s Health Program applications statewide. These employees are receiving training in TIERS and the new program and will be ready to process applications Jan. 1. The rollout of the new eligibility system remains on hold.

Of course, you realize the Q&A did NOT address the fact that once a client is certified for this program, all cases will convert to TIERS which means LOCAL ART WORKERS will be the ones having to process those applications and reviews. The "new unit" will only certify someone for the WHP, not have to deal with overflow that will occur when this client's other cases end up in TIERS.

Other Links/News

Eye on Williamson County has a post up today regarding fraud within HHSC.....

Dig Deeper Texas has a post up (kinda late in posting this, sorry) regarding Albert Hawkin's involvement with the Texas Health Institute.

****************************************************
TEXAS STATE EMPLOYEES UNION
EMAIL BROADCAST UPDATE TO MEMBERS

VICTORY FOR TSEU, TEXANS

HHSC announces partial cancellation of IEES/Accenture project

"New Strategy" could be beginning of the end for failed experiment

HHSC will announce publically later today a "new strategy" on its call center experiment and the Accenture contract. In a tacit acknowledgment that the experiment is a failure, HHSC will

* Drop most plans for Accenture to do eligibility work. The HHSC announcement says that in the "rebalanced model" Accenture will scan the case documents into the system, run data-broker checks, and report the information to state staff, who will proceed with the case.

* The JSAP system put in place to decide who will get state jobs under the new system will be scrapped.

* 900 Texas Works positions that are currently considered temporary positions will be converted to regular full-time positions

* Cut the contract by $356 million (about 30%) and end it in 2008 instead of 2010

* Accenture will take over direct operation of CHIP eligibility from Maximus. (This is probably the result of Maximus' plans to reduce its participation in the IEES project after losing nearly $50 million on the "Texas Project" in 2006)

* No further roll-out with Accenture. The pilot in Travis, Hays, and Williamson counties will be resumed "after a rigorous readiness review" and "with a more limited role for the vendor". No other roll-out will be attempted before the contract ends in 2008.

* The HHSC announcement also says that TIERS will be rolled out statewide over about 18 months beginning in January 2007.

TSEU'S POSITION:
It's a good start. Now, cancel the contract, rebuild eligibility, look hard at TIERS.

The announced changes are a welcome sign that HHSC is moving in the right direction in managing this failed experiment, but the $543 million that will still go to Accenture will be wasted, and the time from now to the end of 2008 will be wasted trying to keep a failed experiment on life support.

* The contract with Accenture should be cancelled. Several provisions allow the state to cancel at any time. We have already paid Accenture over $120 million and there is no indication that the State of Texas will get any value from this contract: the remaining $543 million will be throwing good money after bad.

* We should start right away on rebuilding our capacity to provide human services eligibility to the people of Texas . Converting the temporary positions to regular status is a start, but we need to hire an additional 1000 or more staff, and rebuild our capacity to train them.

* Before we commit more resources or cases to TIERS, the whole system must be evaluated by competent staff who are not paid by HHSC. If the system can be fixed, it should be. If it cannot be fixed, it must be replaced

News Release

NEWS RELEASE

Albert Hawkins
Executive Commissioner

Date: Dec. 21, 2006
Contact: Stephanie Goodman or Ted Hughes, (512) 424-6951

HHSC Announces New Strategy to Modernize Eligibility System

AUSTIN — The Texas Health and Human Services Commission (HHSC) today announced a new strategy to modernize the state’s eligibility system and make it easier for Texans to apply for services. Under the plan, the state will retain some functions originally envisioned to be performed by the private sector, reduce the terms of the contract, and change management of the Children’s Health Insurance Program (CHIP).

"We remain committed to implementing a system that works better for consumers and makes efficient use of taxpayer dollars," said Health and Human Services Executive Commissioner Albert Hawkins. "We have evaluated the results of our pilot and concluded that we need to take a different approach to achieve our goals."

Hawkins said the new strategy includes rebalancing the roles of the state and the private sector.

"Our goal from the beginning was to design a system that efficiently supports state workers and keeps complex decision-making in the hands of trained, experienced state employees," Hawkins said. "The pilot has shown us that we need to redraw the line between the state and private sector to clarify that the private sector is there to provide a support role to state staff."

In June 2005, HHSC concluded a competitive procurement process and entered into a contract with the Texas Access Alliance (TAA) for call center operations, CHIP processing and eligibility determination, maintenance of the TIERS computer system and enrollment broker services. Most of the functions, including CHIP processing, have long been performed by the private sector. The critical new elements in the contract included establishing call centers and moving some work currently performed by state eligibility workers to the private sector.

Under the original contract, for example, vendor staff image food stamp, Medicaid and TANF applications into the system and attempt to verify some information through independent sources. If an application lists no cars and the independent check indicates the household has a car, vendor staff attempt to resolve the discrepancy before sending the case to state staff. In the rebalanced model, vendor staff will image the case into the system, run the independent checks and submit all the information promptly to state staff who will decide how to proceed.

Within the contract, management of CHIP will change with Accenture taking over responsibilities previously handled by Maximus. CHIP eligibility determination, which is less complex than most other social service benefits, has been handled by a private contractor since the program’s inception in 2000. The state changed contractors in November 2005 and has noted several ongoing performance issues since that time. The most serious issue involved unnecessary letters to CHIP applicants requesting more information. A review found that in some of the cases, the requested information was either on the original application or had been received by the subcontractor and not attached to the case properly or within required timeframes. This issue led the state to implement manual checks to ensure that families were not inappropriately disenrolled.

Other elements of the state’s new strategy include:

Modernizing technology by converting cases statewide to the state’s new computer system. In early 2007, HHSC will begin a gradual conversion of 8 million food stamp, Medicaid and TANF clients to the Texas Integrated Eligibility Redesign System (TIERS). State workers will continue to process all cases, and all state benefits offices will remain open.

Recovering $30 million in state costs through service credits and discounts.

Reducing the contract by $356 million. The original contract was valued at $899 million and expired at the end of fiscal year 2010. The revised contract is valued at $543 million and ends after fiscal year 2008.

Resuming the pilot in Travis, Hays and Williamson counties with a more limited role for the vendor in food stamp, Medicaid and TANF cases once the technology solutions are in place to support improved performance. The state will not expand the pilot beyond the current three counties during the current contract term.

Converting 900 temporary positions in eligibility offices to regular-status positions to help stabilize the state workforce.

"We recognize that modernizing a system of this size and complexity is never easy," Hawkins said. "But we remain focused on implementing a system that finally allows Texans to choose how they want to apply for services, is built on modern technology and makes the most of limited state resources."

__________________________________________________
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Just received this...hmmmmmmm

HHSC to make announcement about Accenture deal

By Staff | Thursday, December 21, 2006, 10:14 AM

 

Texas Health and Human Services Executive Commissioner Albert Hawkins will make an announcement this afternoon about the state’s controversial $800 million-plus deal with the Texas Access Alliance, a commission spokeswoman said. The Texas Access Alliance, led by Accenture LLP, was hired to run an enrollment system for food stamps, Medicaid and Temporary Assistance for Needy Families. The privatization of tasks formerly done by the state was supposed to save the state money and make it easier for Texans to enroll by allowing them to sign up via phone, Internet, fax, mail or in person instead of just in person.

 

But when the private group took over in Hays and Travis counties nearly a year ago, the system became plagued with problems. Some Texans eligible for public assistance were declared ineligible or received benefits late. Hawkins delayed statewide rollout of the new system, and some legislators have called on him to cancel the contract. Commission spokeswoman Stephanie Goodman did not say what the announcement will be, but she did say: "I promise you a headline." Stay tuned.

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Spin

I've read and re-read the article that is linked below, and something kept standing out to me and that was the response from HHSC:

"Commission spokesman Ted Hughes said that, although officials are sensitive to the stress workers are under, the shift is part of the transition to a more automated system. In the long run, the changes should decrease workloads for eligibility workers, Hughes said. Plus, it has already allowed people to apply for benefits over the phone or through the Internet, he said."

So, in reading that I'm struck - it's kind of like that spokesman from Iraq that would constantly get on TV and tell his people that Iraq was winning when we first went over there- although obviously everything he said was absolutely false.

Officials are sensitive to the stress workers are under? Is that why pressure continues to be put on local office staff that they must maintain timeliness? Integrity in cases? How does one do that when workers are having to see upwards of 20 appointments per DAY? What about the stress the clients are under, and take out on staff? There are folks in Texas who are going without benefits Mr. Hughes. WITHOUT MEDICAID, WITHOUT FOOD STAMPS, WITHOUT CASH ASSISTANCE TO PAY THEIR BILLS. What Mr. Hughes fails to realize is that when clients go without, it's US in the local offices that bear the brunt of THEIR frustration. WE are the ones blamed because their child needs a prescription filled and the Medicaid isn't done yet. It's us they blame when they have to go to the local food bank for help because there aren't enough hours in a day to see 20 clients and finish all the cases that are ready to be finished. What about, Mr. Hughes, the stress workers' families are going through while mom/dad are having to work late evenings and every weekend? In the long run the changes are going to decrease workloads? When is that Mr. Hughes? When TIERS works? When TAA figures out how to do their jobs?

Are we still harping on the "applying by phone" and "internet" thing? Seriously? Again, let's remember that while a client can call 2-1-1 and apply for Food Stamps- or PARDON ME- can give their info to an operator who will basically complete an application for them, then MAIL the application to them for their SIGNATURE and then refer the client to their LOCAL office- this is not "applying by phone". Internet? Apparently, we are all forgetting the clients we serve. Sir, most of our clients don't have PHONES much less internet. Let's not forget also, that it serves little purpose to apply by phone when one must still have an interview to get certified. When it's taking over a month to get an interview scheduled and THEN pended for more information- how convenient is THAT? How about this- for all the workers reading here- when a client calls you to complain at how long it's taking to get an interview or get their cases finished, tell them that at least now they have the option to apply by phone and the internet and ISN'T THAT GREAT?! After you get screamed at and told that applying by phone doesn't get them what they need- then tell them that THAT is the stance that those in charge take- that it's busy, and the offices are understaffed- BUT BY GOD CLIENTS CAN NOW APPLY BY PHONE AND INTERNET. See how that goes over and refer them to Mr. Hughes.

I wish every office in the State of Texas got with the Union and staged their own rally. I think it's amazing. It's time to do something. It's time to stop letting the puppets in State Office continue to pile work on and then say it's all great and wonderful.

If enough news gets created- then maybe someone will start listening.

Rally in Waco!

Thanks for the links and the heads up commenters-

 

There was a "Rally" in Waco Tuesday- workers who are evidently fed up and feeling like their voices are not being heard.

 

You can read the article HERE

 

and you can watch the TV Spot HERE.

 

I would imagine that if you are interested in doing something in your area, you'd contact the Union.

 

Wow.  Just wow.

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Let's Shake things up!

We've got quite an audience reading here guys....it's time to shake some of this up before the session starts in January.

 

Email me your stories.  I'm going to post them all on this blog- we are going to put this out there.  I think so far, employees who "complain" are doing so because of our "jobs".  We all know it's not that way.

 

Email me from an anonymous email address- I don't want to know your name.  I just want your stories.  The more, the better.  This blog is being read by representatives across the STATE!  Make your voices HEARD. 

 

All I ask is that you tell me your tenure- or a figure around your TENURE.

 

You don't have an anonymous email address?  It's easy to create one at Yahoo! or Hotmail. 

 

Tell me what kind of support you are getting.  How many appointments.  We must do this y'all.  We have to.  It's time.

 

Forward my blog to all your co-workers.  Tell them it's time to make a stand.

 

If you want to email me from your own email, and it has your name- know that I would never EVER under any circumstances EVER reveal where a story comes from. 

 

Let's shake it up.  We don't have long.

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Interviews per day

I'd like advisors reading (or anyone else who knows the answer) to tell me how many appointments you are seeing a day.

 

Do you get a workday or any worktime at all?

 

Is your office mandating interviewing on Saturdays?

 

What can we, as the remaining HHSC employees, going to do to make our voices heard?

 

Is there anything we can do?

 

What would YOU be willing to do to make your voices heard?

 

Do we need to all flood our local representatives with emails telling them that they are not getting the full and true story about what is going on in the local offices if they are depending on THE POWERS THAT BE to give them the info?

 

If someone reading has a good blanket statement would could all send to our reps, would anyone do it? 

 

If we come up with that, would you send the link of my blog to every coworker you have to get everyone on board?

 

WE MUST DO SOMETHING.

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Want to start your own business? Learn how on Yahoo! Small Business.

Hits?

The blog has received many hits today from www.texasweekly.com.....

 

It's apparently accessible to paid "subscribers"- so I'm unable to see what everyone is coming here in reference to.

 

If you can shed some light, please email me!

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Letter to the Editor: Private doesn't equal good

Austin American-Statesman
12/1/2006

Re: Nov. 15 article, "Foster care plan under review":

We must stop blindly believing that anything done by government can be done better by the private, for-profit sector.

Some activities (prisons, medical care, public schools, military supply and enrollment for state benefits, as examples) are done better by government workers - at a lower cost.

Most work previously done by government and contracted to for-profit companies ends up costing more and providing less. Business owners spend less on training, wages and health coverage to increase profits.

Chairwoman Jane Nelson, R-Lewisville, was "the only senator to attend" last week's meeting of the Senate Health and Human Services Committee.

Assuming there are other committee members, where in bloody blue blazes were they?

Mack Waldrip
Austin

Opinion: Texas Medicaid seeks to improve women's health, save tax dollars

Staff EditorialHouston Chronicle12/5/2006

It's taken well over a decade. Other states have been doing it for years. But next month Texas will embark on an efficient plan to save as much as $430 million – and incalculable social costs – by averting unintended, Medicaid-paid pregnancies and many illnesses related to them.

Early in December, the federal government gave verbal approval to Texas ' request for a Medicaid waiver to give extensive health screenings and birth control to 1.5 million uninsured women. Under Texas ' five-year demonstration project, Medicaid will waive some of its ordinary eligibility rules.

In Texas , a single mother with two children can't make more than $308 a month and be eligible for Medicaid. That's about 14 percent of the federal poverty line. The new waiver allows women 18-44, who are at 185 percent of the FPL or less, to get a wide range of health screenings, family planning information and birth control.

The savings, both monetary and societal, should be enormous. In 2002, Medicaid paid for a staggering 52 percent of all Texas births. Each routine delivery cost about $9,000. Now consider this: In 2003, according to state officials, 45 percent of the documented 328,311 live births here were reported as unintended.

What if Texas Medicaid hadn't had to finance so many unplanned deliveries? What if the low-income mothers who gave birth to those unplanned infants had had counseling, information about birth spacing and contraception to keep their families the size they desired?

Finally, what if more Texans could be born into families — and a community — better able to care for them, emotionally, physically and financially?

This was the vision the 2005 Legislature pursued when it finally authorized the state to seek the Medicaid waiver. Lawmakers had tried to pass previous versions of the bill since 1993 without success. During that time, more than a dozen other states successfully took advantage of this expanded health care opportunity.

Now Texas will be on board, starting in January. It's strictly a demonstration project: The federal government will only renew it if Texas can satisfactorily answer a set of evaluating criteria. Among them is the $430 million question: "To what extent did the waiver reduce the number of unintended pregnancies resulting in live births for women who are at, or below, 185 percent of the poverty level?" *Now, does everyone realize that these cases are going to be worked in TIERS statewide? That any woman that applies for this benefit will then become a "TIERS client"- no matter her location in the State? By doing so, any case she has from that point forward- Food Stamps, Medicaid for her children- will then also be in TIERS. Which means they get to call the "call centers" for certification. In other words, if 50% of our cases locally have a woman in that age group who will qualify for the new program will then be in that convoluted system? Good luck with that.

This will be a special challenge, as the Texas waiver does not include coverage of teens or emergency contraception, both of which could help the state meet its savings goal. Texas also has to keep the project budget neutral — for Washington and Texas both.

Luckily, the federal government is arming the state for success, paying $9 for every $1 Texas spends. The feds are willing to invest this because it's well-established that higher levels of poverty correlate to lower insurance and higher levels of unintended pregnancy and poor health outcomes.

The equation shouldn't have taken Texas so many years to add up. By finally taking advantage of this chance to improve women's health care, however, the Legislature will save Texas millions in Medicaid costs. What can't be quantified will be the corresponding benefit: families with fewer health problems and with children who are wanted, cared for and better prepared for adulthood.

Group says kids were wrongly denied Medicaid

Group says kids were wrongly denied Medicaid

Elizabeth Pierson
Valley Freedom Newspapers
12/5/2006

AUSTIN — About 3,800 Texans, most of them children, were denied health care through Medicaid during the first three months of a new federal rule that requires proof of citizenship, according to an advocacy group for families.

Medicaid applicants since July 2006 have had to show proof they are U.S. citizens, whereas previously they had only to say they were citizens. The result has been that thousands of eligible citizens who qualify for Medicaid have been rejected because they can’t access their birth certificates in other states, or because state officials aren’t confirming their births in this one, said Anne Dunkelberg, associate director of the Austin-based Texas Center for Public Policy Priorities.

The data Dunkelberg received from the Texas Health and Human Services Commission do not confirm how many of the 3,800 rejected applications came from illegal immigrants. She can’t say with certainty that none were illegal immigrants, but experience tells her the number was at most very low, she said.

“After 20 years of policy work on health, we have a hard time getting just families of non-U.S. citizens to come in and try to qualify,” Dunkelberg said. “There have never been large numbers of people coming in and trying to fake out the Medicaid system.”

Medicaid is the federal-state health care program for low-income adults and children. It serves 1.9 million children in Texas , including more than 200,000 children in the Rio Grande Valley , as of May 2006, the latest data available.

Officials at the Texas Health and Human Services Commission are looking into the numbers brought to light by the CPPP, said spokesman Ted Hughes. “I don’t know for sure yet whether we have such a number, where we could definitively say, ‘These people were denied because they couldn’t prove citizenship,’” he said.

Dunkelberg said the data she received from the state did not separate the 3,800 people by geographic region. It did show that two-thirds were children and 200 were infants younger than 1 year old. State rules require speedy enrollment of qualified babies born in Texas . Dunkelberg thinks many who were denied would have qualified but couldn’t have their birth certificates sent promptly from another state, she said.

Others may be victims of recent downsizing of state eligibility workers. State workers who are left processing applications may not know they can search Texas ’ electronic database of birth certificates to confirm whether a child was born here, Dunkelberg said.

State workers routinely check the database, Hughes said. “It’s a standard practice to check that election database assuming there’s no other document offered,” he said.

Dunkelberg said the state has dealt well with the federal policy, for the most part. “I think they’ve done about as good a job that a state can do,” Dunkelberg said. “I think it’s an unfortunate federal policy that wasn’t well thought-out.”

Rant

It's been a while since I've "talked" about what's happening in the local offices.

I've noticed a few things lately. Namely, the first "wave" of people we lost (late last year, after the "pink emails" came out) were due to the layoff notice. Now, we are losing people who have TRIED to stick around but the workload and expectations have become too much.

Anyone, as I've said before, on the outside thinks that this job is easy. They think that all we do is push some paper around and give away all the taxpayer money while we sit back and laugh at all the money we make doing nothing.

Nothing, and I mean NOTHING could be further from the truth.

Sadly, the Agency that was DHS is gone- and the good work put out by said agency is gone as well. Quality is at an all time low. Let's not even talk about "timeliness". I'm sure if FNS came in and read a bunch of Food Stamp cases they'd find that most were probably wrong. Not because we all just don't care- but because we have people hired off the street, who have had 15% of the training that new hires USED to get and they are just flying by the seat of their pants. Tenured workers are getting loaded with more and more and more- and most of the TANF and it's just TOO. MUCH.

Clients are suffering. People are going WITHOUT basic needs because we don't have the staff to see anyone like we used to before. Our local office has 15% of the tenured workers we used to have. FIFTEEN PERCENT. The workload has NOT slowed down or stopped.

Sinking. Those who were trying to hold on are leaving now.

How scary.

Interesting

This was in comments, but I wanted to put on the blog so that more people might notice...any insight?

Actually, Albert is still lying. I did an open records request and have in
my possession the copy of the sole source justification dated 12/28/05 for over
1,000,000 dollars to the Texas Health Institute. I do not know why Al must
continue to lie, maybe because the truth in this case is not his friend.The sole
source justification essentially states--because we picked them to do it-- and
is unsigned.There is no RFP or award announcement that was ever made. It was a GIFT. A non-competitive retainer to pay this group to lobby for privatization.
The staff of this non-profit are mostly former staff to legislatos turned
lobbyist.BTW--the Chief Operating Officer at DSHS (Health) worked for Michael
Toomey(lobbyist for Philip Morris and Texans for Lawsuit Reform)and Maximus. In fact, he was in charge of the Maximus call-center project in California and came here to work during negotiations with Maximus for their contract for Texas call
centers at a 70,000 paycut. Interestingly, he worked here before as the CHIP
Bureau Chief, gave the CHIP eligibility contracts to Maximus, then went to
Maximus for a 75,000 raise. Cool.

Really, they must not know that at the Texas Hospital Association or they would surely have corrected their website. BTW--the Board of this group is mainly made up of THA members, including the THA president and several HOSPAC members. People who get what they want from Al Hawkins. Like Jim Springfield, THI Board Member, HOSPAC Board Member, Texas Association of Health Plans Board Member, and Perry Appointee to the Department of State Health Services Council. Also, as a matter of fact, the President of Valley Baptist Health System and beneficiary of an HHSC application to the Federal Government to restrict all non-emergency inpatient healthcare services for Medicaid recipients in Cameron County to his hospital system. This from Al-the big proponent of competition and choice?I have done my research really well. The stories will continue to be more incriminating--and accurate. There is alot of corruption needing to be exposed and it will continue to be until Al is gone, arrested, or exposed as dishonest and in collusion with lobbyists.

Happy Thanksgiving

Here's to all my fellow HHSC employees and everyone else who comes around this blog.....hope you have a very happy safe RELAXING Thanksgiving!

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Email to employees........Good Luck Williamson County

As you know, we have been evaluating the possibility of converting additional cases to TIERS. This will allow us to continue to move cases to a modern, upgraded system while work continues on improvements to the larger integrated eligibility system. Earlier this week, we completed the final readiness assessments and determined that we are ready to convert clients at our two Williamson County offices to the new computer system.

 

We selected Williamson County for this conversion because 25 percent of the clients in those offices already are on TIERS, and many of the workers have experience using the new system. ART workers will fill in at the Williamson County  offices while the rest of the staff receives training. In addition, ART workers will be on hand to assist with the transition.

 

The actual case conversion will take place over the weekend. As part of the conversion process, each case is examined to ensure that the benefits calculation in the new system matches the previous calculation to the penny. A team of 19 ART workers will review any cases that do not match exactly and resolve any issues before cutoff next month.

 

We’ll begin processing all new cases in TIERS on Monday. The transition should be seamless for clients, and state workers will continue to process all cases. The conversion will provide Williamson County clients with the ability to check the status of their case by phone or apply online.

 

If you have questions or concerns, please let your supervisor know. One of the keys to any computer conversion is to identify and address issues quickly. You are on the front lines, and we need and value your input to make the transition successful.

 

Thank you for all your hard work and your commitment to our clients.

 

Anne Heiligenstein

Deputy Executive Commissioner for Social Services

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Houston Chronicle Article.......leave your thoughts in the comments

Software glitch snarls state's checks for fraud
Audit's findings add to concerns of inadequate staffing at public assistance call centers

By JANET ELLIOTT

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A couple of posts down, the letter from Brent Connett is posted- and in comments, an anonymous commentor did some research (thanks!) and came up with the following:

When you google Brent Connett and see that he is a "policy analyst" for the
Texas Conservative Coalition Research Institute, it all is clear. One would
think that the definition of a conservative is a person who abhors waste of tax
dollars, yet here we have a "conservative" who will support a global profiteer
like Accenture even as tax dollars are drained away from the tax payers and from
the poor people we are supposed to be serving. It just shows how hypocritical
they are. We know Accenture is profiting even as they delay and incorrectly
providing federal benefits. It's just nuts.

I was checking some more on Brent Connett and see that his boss at the TCCRI is Tom Delay's indicted buddy John Colyandro. A little more looking and guess what? The TCCRI was instrumental in writing HB2292 for Arlene Wohlgemuth who was (I am not sure if she still is) on the board of directors for them. In 2003 she wrote a big old thank you to them for being so instrumental in providing the framework for 2292. So it makes sense that they get a little defensive when the facts get in the way of their little masterpiece.

I just thought that tidbit of info was interesting enough to post in case anyone missed the comments.

CPPP article

OfftheKuff posted yesterday about an article that the Center for Public Policy Priorities (CPPP) just released....."Updating and Outsourcing Enrollment Public Benefits: The Texas Experience".

 

Off the Kuff gives a good synopsis of it.......

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Albert Hawkins gives HIS spin on recent allegations and questions regarding his ethics....

This following was posted on the Employee Intranet on November 6th. Spin in Mr. Hawkins. Spin it.

Staying Focused on Our Work

Recent media stories have reported that gubernatorial candidate Chris Bell
has filed an ethics complaint against me. I want to assure you that any
allegations of corruption or misconduct are utterly without merit. Perhaps
the explanation of the circumstances below will establish some
context.

When I became HHSC Commissioner in 2003, I was asked to assume the post
held by the two previous HHSC Commissioners on the board of the Texas
Health Institute. The Texas Health Institute is a non-profit organization
devoted to health policy research. I considered the position to be
honorary and agreed. I think that it is important to note that I have
never attended a meeting of the board, never participated in any board action
and never exercised any fiduciary duty on behalf of the board or the
Institute. I have received no financial benefit of any kind and have no
financial ties to the Institute. Unfortunately, because I never considered
this post as anything other than honorary, I overlooked it when I filed my
personal financial statement with the state Ethics Commission. I have
submitted a corrected statement.

While the Institute has received a competively awarded contract
through the Department of State Health Services, I had no prior knowledge of or
involvement in the procurement or contracting decision at State Health
Services.

While this is clearly a personal distraction, I do not want it to detract
from the work you perform for the people of this state. I remain focused on
taking care of the business of this agency, the HHS enterprise and the State of
Texas .

Albert Hawkins — Nov. 6, 2006

Few new things of interest.....

Welch goes from comptroller's office to HHSC

Texas Weekly11/10/2006

Ken Welch, the funds management guru at the comptroller's office (the guy who actually does know where all the state's money is at any given time), left that agency for the Health and Human Services Commission, where he's the new budget and fiscal policy director.

HoustonChronicle.com
http://www.chron.com/disp/story.mpl/editorial/outlook/4312101.html
Letters: No horror story on CHIP

THE Chronicle's gratuitous insults directed at the state's effort to modernize its social service eligibility system and the company that won the bid to help with that process, Accenture, should be retracted(see the Oct. 29 editorial "Horror story").

Ever since the overhauling of the system began, the Texas StateEmployees Union has led the effort to derail the program and to undo the social service reforms passed by the 78th Legislature. Part of its strategy has involved tarring the reputation of the firm that is helping the state implement the new system. And now the Chronicle appears to have bought into the misguided efforts of TSEU, referring to Accenture as "Bermuda-based," as if where it was incorporated has any bearing on its work for the state *doesn't it? Why would taxpaying Texans want a company based in BERMUDA (because they ARE based in Bermuda) taking care of the poor in Texas? Why else, other than make a profit on the poor, would Accenture even WANT this job?*. In fact, Accenture employs 27,000 people domestically, including more than 3,000 in Texas , and pays federal and state taxes. The editorial tossed a vile canard at the company by calling it "aspin-off of disgraced Arthur Andersen," even though Accenture was incorporated more than a decade before Andersen's implosion. In covering the eligibility system and the Children's Health InsuranceProgram, the Chronicle pushes anecdotal accounts of processing errors as the main cause of declines in the size of CHIP, when, in fact, the following are the leading reasons for CHIP disenroll-ment (based on October 2006 data available on the Health and Human Service's Website):

"45 percent didn't return renewal packet" *packets they never got? packets they received and turned in more than once? Hmmmm.*
"19 percent exceeded CHIP income limits"
"17 percent were Medicaid eligible"
"11 percent didn't pay the renewal fee" *renewal fees that clients never got a notice about until AFTER the fee was due and the case was already closed?*
"5 percent aged out of the program

The Chronicle would do well to leave off the wild allegations and join an essential program to bring Texas ' social services into the 21stcentury.

BRENT CONNETT Austin *Do you work for Accenture?*

More great press....

Foster care privatization on hold
E-mail raises questions about whether one bidder for $500 million state deal had inside information.

TSEU Broadcast Email

TEXAS STATE EMPLOYEES UNION EMAIL BROADCAST UPDATE TO MEMBERS November 2, 2006

STOP ANOTHER HIGH-TECH BOONDOGGLE: PRIVATIZATION OF STATE AGENCY I.T. THREATENS TAX DOLLARS, AGENCY EFFICIENCY, JOBS

Last year the Texas Legislature passed HB 1516, which authorizes the consolidation and privatization of the information technology (IT)/data center departments of 27 state agencies.

The plan will merge much of the IT functions ofthe agencies into one or two data centers, one of which must be located in SanAngelo, and then contract out operation of the data center(s) to a private contractor. This plan will be yet another high-tech boondoggle, like the Accenture/eligibility services and the Convergys/AccessHR projects that have wasted vast sums of money and reduced the ability of state agencies to fulfill their missions. Over 500 agency positions are due to be eliminated or transferred to a contractor under this proposal. A list of the agencies to be affected follows, below the list of DIR Board members. According to the current schedule, a contractor is to be selected in December2006. This date would make it much for difficult for the Texas Legislature to look at this plan again. Many suspect that the date was chosen to make this plan a "done deal" before the Legislature has a chance to reconsider it.

TSEU believes that our recent experience with high-tech outsourcing contracts should be a warning, and that this plan should be cancelled. At a bare minimum, the speeded-up implementation should be slowed down to allow the Texas Legislatureto reconsider the plan. Several legislators have expressed these concerns, and have suggested that, at a minimum the implementation schedule should be slowed downto give the Texas Legislature a chance to look at it again. Rep. Jim Pitts, of Waxahachie, is the chair of the House Appropriations Committee.

He would have the power to call for a slowdown in the roll-out of this plan.

TIME IS CRITICAL: DIR is scheduled to select a contractor in December.

TAKE ACTION TODAY to save tax dollars, quality services, and state jobs.

Slow down the headlong rush into another boondoggle that will put millions of tax dollars, and the operating efficiency of 27 state agencies, at risk.

1. Get involved. Contact Mike Gross at TSEU (mgross@cwa-tseu.org, or (512)448-4225)

2. Get state agency IT employees involved. Do you know a state worker in anagency IT/Data Services department? Have them contact TSEU to get involved

3. Call your state legislator ASAP. Ask him/her to: A. Contact Rep. Jim Pitts, chair of the House Appropriations Committee, and askhim to call for a delay in the roll-out of this plan. B. Contact Governor Perry. Ask him to direct that the plan be delayed. C. Contact members of the DIR Board and ask them to call for a more thorough analysis of this project, and a delay in the roll-out schedule to allow legislative review.

For information on how to contact your legislator, go this link on the TSEUwebsite: http://www.cwa-tseu.org/hhsc_fdstmp_contact.html

DIR BOARD MEMBERS
William L. Transier, DIR Board Chair Co-Chief Executive Officer, DirectorEndeavour International Corporation, HoustonTerm: 02/01/2003 to 02/01/2009, Appointed by the Governor

The Honorable Charles Bacarisse Harris County District ClerkHarris County, Houston Term: 07/17/2006 to 02/01/2007, Appointed by the Governor

M. Adam Mahmood, Ph.D.Professor of Computer Information Systems & Business AdministrationThe University of Texas at El Paso, El PasoTerm: 02/01/2001 to 02/01/2007, Appointed by the Governor

The Honorable Debra McCartt MayorCity of AmarilloTerm: 02/01/2006 to 02/01/2011, Appointed by the Governor

P. Keith Morrow CIO & Vice President of Information Systems 7-Eleven, Inc., DallasTerm: 03/07/2005 to 02/01/2011, Appointed by the Governor

Cliff P. MountainManaging MemberAccent Capital, LLC, Austin Term: 02/01/2003 to 02/01/2009, Appointed by the Governor

Bill Wachel Principal/Owner The Wachel Group, DallasTerm: 02/01/2003 to 02/01/2009, Appointed by the Governor

Robert L. Cook Executive Director Texas Parks and Wildlife DepartmentTerm: 02/01/2005 to 02/01/2007, Ex officio

Brad Livingston Executive Director Texas Department of Criminal JusticeTerm: 02/01/2005 to 02/01/2007, Ex officio

Adam Jones Associate Commissioner for Operations and Fiscal Management Texas Education AgencyTerm: 02/01/2005 to 02/01/2007, Ex officio

AGENCIES TO BE AFFECTED

Department of Criminal Justice
Department of Information Services
Department of Licensing and Regulation
Department of Public SafetyGeneral Land OfficeDept. of Aging and Disability Services (DADS)Dept. of Assistive and Rehabilitative Services (DARS)
Dept. of Family and Protective Services (DFPS)
Dept. of State Health Services (DSHS)
Health and Human Services Commission (HHSC)
Office the Attorney General
Public Utility Commission
Railroad Commission
Secretary of State Alcoholic Beverage Commission
Building and Procurement Commission
Commission on Environmental Quality
Dept. of AgricultureDept. of Insurance
Dept. of Transportation
Texas Education Agency Higher Education
Coordinating Board Parks and Wildlife
Library and Archives Commission
Workforce Commission
Youth Commission
Water Development Board

Today's News

Bell files ethics complaint against Perry appointee

Sunday

Off the Kuff talks about the article regarding Hawkins association with the non-profit group- here's another article as well:

Perry's health chief under fire-Hawkins will consider resigning from nonprofit board.

Edited to add this: Here is a post I did back in April- read the comment. Hmmmmm.

Later this week, I'm going to start reading the 171 pages of the audit- reporting what's there so you don't have to read the whole thing.....what I HAVE read so far is interesting....and there are things Accenture didn't do that the State Employees would have NEVER gotten away with.... of course.

In case you missed the link to the audit findings...you can find them here: Strayhorn Audit.

Links

HHS Commissioner Fails To Disclose Information

Houston Chronicle Article

News from Lufkin

"Off the Kuff" has a great write-up regarding the audit- go HERE to read about it.

Of course, don't forget to check CAPITOL ANNEX everyday- he has great information about news around the state, including news regarding HHSC.....

Go THERE!

Ok, so Strayhorn's report is out- you can read it HERE!

Here is a link that is inside the report also, that will take you to 171 pages of PDF files showing her actual letter about what is going on with Accenture....

Interesting reading.....

So, what do you think happens next?

Ramblings

I'm going to ramble some as my thoughts are scattered.....

1- has everyone heard about the new 2-1-1 menu options? Now, if you are a TIERS client (and there are many statewide) you can't call 211 unless you are in Travis or Hayes Counties. You are referred to your local office. Problem with that is every office doesn't have a worker/clerk available to do TIERS inquiry. So, if the client comes in for help about their case, and it's an office WITHOUT an ART worker, then what? Figures.

2- how is that jsap job placement going for everyone? How about AccessHR? Had any problems with leave? Savings bonds? If you haven't - consider yourselves lucky. This privatization is GREAT (/sarcasm)

3- have you workers been told that you surely can work weekends and late if you have to in order to stay somewhat caught up? Is this an option that is given to you more as a demand rather than something to help you out? Wow- I guess TPTB think we don't have households to take care of or kids to care for.

4- if you are a client, or someone who helps clients (Advocacy Inc and San Antonio Food Bank!)- please enourage them to contact FNS. FNS regulates the Food Stamp Program. Having to wait 40-50 days is against policy. Problem is, it's not the fault of local office staff, but rather this scheme to line someone's pockets through contracts....local office staff are doing all they know to do to do everything as fast as possible. But interview 15-20 clients per day, 4-5 days per week leaves little to no time to finish cases UNLESS that worker wants to work Saturday AND Sunday. This misconception that the public has that all we do is 'push a few buttons' to make it happen isn't so. I wish it were that easy. I'd encourage all clients to show up for office appointments rather that do by phone. Yes, it can be inconvenient- but I can assure you that a client that shows up **proof in hand** will get finished THE SAME DAY THEY ARE INTERVIEWED in most cases. Otherwise, it's more waiting.

5- Lead times are out of control. Management of lead times has become unrealistic. The offices are not staffed enough to maintain the 'staus quo' and acceptable lead times.

Clients are going without, employees are working in an unorganized chaos- while Albert Hawkins touts that we have a stable workforce. I'd love to see Mr. Hawkins come on in and sit in a lobby one day. These clients are FURIOUS at the long waits for appointments, the inability to get through to their workers on the phone (because we are all on phone interviews) and having to wait to get questions answered.

Oh, and "Hi!" Accenture (I know y'all still read here!)...got any insight? Y'all all caught up over there?

Check this out.

THIS is a good post...check it out.

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Chris Bell Commercial

He talks about firing Accenture:

 

http://www.youtube.com/watch?v=lnDfcsz9lJA

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Check this article out

http://www.chron.com/disp/story.mpl/front/4261398.html

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Discouraged

I write tonight discouraged.  Don't get me wrong, I've been discouraged for some time,  but it has reached a point ....

 

The "Powers that Be" have RUINED HHSC.  They have ruined what used to be a good agency that did good things.  We were the last resort for those desperate and in need, and we were there to help.

 

The "Snowball" effect of the work is full speed ahead.  When you couple the change in policy to do ALL interviews by phone (thereby cutting out the opportunities some clients used to have to sit and wait all day, hoping to take someone's place if they missed an appointment) AND the mass exodus of good tenured employees- everything has spun out of control.  Lead times are awful.  By the time we get to interview a client, they are already pissed COMPLETELY off that it has taken so long to get an interview.  Couple that with the fact that because they are being interviewed by phone, they most ASSUREDLY will have a delay in processing their case because they aren't there in person to give you necessary information.  So they are pended.  When they DO finally get their mail (after 2-3 days) then that leaves them with about 7 days to get their information together.  When they turn the info in, it is the client's expectation that their case be completed IMMEDIATELY.  However, how does one do that when they are interviewing all day long?  It's lose lose.  Workers are overwhelmed to the point that there are numerous employees across the state who are suffering real medical problems due to stress.  Clients are going without necessary services- their kids are going without Medicaid.  Their households are going without adequate food.  Bill money is used to buy groceries, meaning that NOW, the bills are behind.  It's never ending.

 

Everyone in my office is seeking other employment.  Before long, the only workers the office will have will be temps who were inadequately trained. 

 

Through all this, you have Albert Hawkins giving lip service to our "stable workforce".  What?  GIVE ME A BREAK.  IT'S ANYTHING *BUT* STABLE. 

 

Hawkins and Co. and still talking about rolling TIERS out to other areas.  Yes, please- let's add to the already growing problems with TIERS and put MORE clients in that convoluted system. 

 

On top of all this- TPTB are still expecting the local offices to schedule clients timely (within 20 days) and finish the cases timely.  There. Are. Not. Enough. Workers. In. The. Local. Offices. To. Accomplish. This.  Why does no one see this?  Or better yet,  "Those in charge" just don't care.  Period.  They don't.  But, the staff in local offices who are dealing with an ever increasing workload (an impossible workload) and increasingly irate clients ARE supposed to care?  Why?  No one else does.

 

I've said all along I wasn't one to jump ship.  I was going to stick it out.  I felt like I owed it to my clients, and my coworkers to stick it out.  I don't feel that way anymore.  No one does. 

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Do you Yahoo!?
Everyone is raving about the all-new Yahoo! Mail.

I've not forgotten the blog!!!

I'm here- but have neglected to post.....and I'm sorry.

 

When you work until 7ish each night and weekends, the blog kind of falls by the wayside.

 

Work is.......the same.  Busy.  We are hiring temps, but those aren't benefitting us enough to make the workload manageable.

 

Workers are currently completing cases as best and as fast as they can.  I would imagine that if most of the cases worked now in local office were pulled for QC, they'd be full of errors.  I'm sure clients are being certified incorrectly- not because we are unable to do the job, but because we must do the job so fast (when you are interviewing up to 20 clients a day?  Quality is not high on the priority list- getting the case FINISHED is what matters)....we miss things.

 

There are still many MANY problems with clients who are in the TIERS system- and this will likely continue to be a problem until Accenture is FIRED and we rebuild the agency.  This will probably never happen.

 

Does anyone want to guest blog once in a while?  Email me a story- whats happening in your area- what frustrates you the most?  I'll post it.  Anonymously - of course.

 

I'm going to try to do better with the posting.  If you notice an article that you think needs to be put out there, please send it to me.

 

I had one email regarding a race with Van Taylor?  About a commerical that the incumbent opponet voted for Food Stamps to be given to Illegal aliens.  Of course, we all know that is not true- I'll try to put a link up to his site at some point or if some kind soul reading could find it for me, and send me the link- I'll post THAT.

 

I hate when wanna be representatives use welfare, once again, as a political football when they have no clue what they are even talking about.

 

Let's talk about the fiasco in Texas with privatization......

 

So, email me something if you want, and I'll try to get better about posting!

 

Hang in there!

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Get on board. You're invited to try the new Yahoo! Mail.

Price Tag for TIERS so far?

Go HERE and read about it.

Computer System Audit

Audit Reveals Security Gaps - But No Breaches - in Public Assistance Computer System

Corrie MacLaggan
Austin American-Statesman
8/25/2006

 

Personal information about Texans who receive public assistance could be at risk of being accessed by computer hackers, according to a new internal audit of the Health and Human Services Commission.

 

The audit, conducted for the agency by Clifton Gunderson LLP, identified several vulnerable areas of the computer backbone of the state's new system for determining eligibility for food stamps, Medicaid and other programs.

 

However, the study did not uncover any security breaches.

 

The computer system, TIERS, and the new call centers handling public assistance enrollment have been targets of criticism recently. A private group, the Texas Access Alliance, anchored by Accenture LLP, is administering the computer system and call centers.

 

The state has halted statewide rollout of the new enrollment system until problems with a Central Texas pilot program can be fixed.

 

Stephanie Goodman, a spokeswoman for the Health and Human Services Commission, said the computer system works well and is an improvement over the old one.

 

*Wait, what?  It works well?  TIERS?  Actually, it does not work well, and you can ask any worker across the STATE that deals with TIERS and they will tell you the same thing.  Maybe it's an improvement over the old system once it IS working, but that's not the case yet.  It may never be.  I guess that's why local staff who work in the TIERS system are told to not 'bad mouth' TIERS to other staff across the Regions who aren't in TIERS yet.....but we all know the truth, don't we?

 

"What you want to do with an internal audit is test every possible way the system could conceivably fail," she said. "That doesn't mean it has failed. All tests like this reveal some weaknesses somewhere."

 

The audit found:

 

• The agency does not have a plan for monitoring computer system performance and security.

 

• The Texas Access Alliance does not ensure that all employees have background checks, increasing the risk that people with criminal backgrounds could access sensitive information.

 

*Sensitive information that includes people's name, dates of birth, social security numbers, bank account information, job information, living arrangements, etc.

 

• Computer user accounts are not always removed when employees change jobs or stop working for the agency or its contractor.

 

• Fraud prevention and detection controls for the system are not fully implemented.

 

"The audit shows that after costing $300 million and after three years in pilot, TIERS still isn't ready for prime time," said Will Rogers, a spokesman for the 12,000-member Texas State Employees Union, which has opposed the new public assistance enrollment system.

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So I suppose this means the State Employees really ARE good at what they do?

Need Help Applying for Public Benefits? Find Answers Saturday in Austin

Corrie MacLaggan
Austin American-Statesman
8/22/2006

 

For Central Texans who have had trouble enrolling in public assistance recently, here's a message from local officials: Try again.

 

On Saturday, anyone who needs help applying for Medicaid, food stamps, the Children's Health Insurance Program or Temporary Assistance for Needy Families can come to the Austin Convention Center for help. State workers will be on hand to help with applications and answer questions.

 

The event is sponsored by the local legislative delegation, Mayor Will Wynn and the Austin City Council and nonprofit organizations. It is a response to problems some residents of Hays and Travis counties have had since the state turned over public assistance enrollment for those counties to a private contractor in January.

 

State officials have halted statewide rollout of the new system until problems with the Central Texas pilot can be resolved.

 

The problems include eligible Texans being denied services and talking to call center representatives who could not answer their questions.

 

"To the people who need those services, these glitches are measured in pain and illness untreated by a doctor," state Sen. Gonzalo Barrientos, D-Austin, said.

 

Organizers recommend that participants in Saturday's event bring documents to facilitate enrollment, such as birth certificates, driver's licenses and proof of income and residence. For help determining what documents to bring, call insure-a-kid at 324-2447.

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Little Sunday Reading.....

You can listen to an interview that Albert Hawkins did with Texas Public Policy Foundation ... if you can stomach it. Click HERE.

I hate to give DabJab any traffic- but you have to read this article and the comments that are there as well.......HERE is where you'll go for that.

What it is becoming out there....

As has been mentioned time and time again in the comments and on this blog- the media has no idea what is really going on. Used to, the articles pointed to the long hold times that people had when they called the call-centers.......now the articles all point out the long wait times at local offices WITHOUT mentioning that the reason the local offices are in such disarray is because we are severly SEVERLY short staffed.

We have offices working under 50% staffing. We have offices around the state with NO clerical support- workers are having to bear this. We have offices where there isn't anyone available to do the most mundane tasks- opening and distributing mail (for example)...and yet, it's almost as though the intent is to make the "State Employees" be the bad guys. Afterall, aren't we- the "state employees" the ones who are against Accenture/TAA just because we are "disgruntled" and angry we are losing our jobs? So what better way to "show" everyone why we need a "new system" than to have the local offices tank, little by little, and become inefficient and unable to handle the workload.

Is that what all this is?

Do you want to guest blog? Email me what you would like posted...and I'll post it. It's all anonymous, but if you want to put where you are- what area- that's fine.

Hang in there guys.

Worker tells of training problems with state contractor

Accenture group failed to give her knowledge she needed
By Corrie MacLaggan
AMERICAN-STATESMAN STAFF
Friday, August 11, 2006

When Amanda Morris started working at a private office that enrolls Texans in public assistance, she was trained to enter information into a computer about people who want to apply for benefits.

But she immediately found that most cases didn't involve signups. Clients needed to renew benefits, make changes to their accounts or update their address.

Thao Nguyen
AMERICAN-STATESMAN

Problems at the Texas Access Alliance may have affected public assistance recipients such as Diana Acosta, an Austin mother of two. Acosta, 43, who is on disability and does not have a job, said she received her food stamps two weeks late one month and her children were not enrolled in Medicaid for three months because TAA representatives said they did not have paperwork she had sent repeatedly.

And she didn't know how to do that.

"I trained for three weeks and was put onto the floor with about 2 percent knowledge of how to do my job," said Morris, 21, who works for a temp agency and has been on assignment since March with the San Antonio office of state contractor Texas Access Alliance.

Problems with worker training are one of the reasons the state has indefinitely delayed statewide rollout of that contractor's new call-in system to enroll Texans in food stamps, Medicaid and Temporary Assistance for Needy Families.

Morris' account sheds more light on the problems. A former Texas Access Alliance employee in San Antonio, who asked that her name not be used because it might affect her current job, said Morris' story matches her experience.

The state is paying more than $800 million over five years to the Texas Access Alliance, a consortium of private companies led by Accenture LLP, for the system, which has been in a pilot stage in Travis and Hays counties since January. The privatization was intended to save the state money.

Since the contractor took over, benefits recipients have reported getting inexplicably dropped from public assistance, talking to customer service representatives who couldn't answer their questions and being asked for information they'd already provided.

In response, the private group has retrained its call center employees and overhauled training for new hires, spokeswoman Mindy Brown said this week. Texas Access Alliance "has turned a major corner," she said.

"Our training is intensive and depends on each employee's role," Brown said. "If an employee feels they need additional training to do their job correctly, all they need to do is to speak with their supervisor and additional instruction can be arranged."

Stephanie Goodman, a spokeswoman for the Texas Health and Human Services Commission, said the reports of improved quality is a positive sign but that the state has not yet evaluated that. "We'll measure the success of the training by how well the call-center representatives respond to client questions and concerns," she said.

Morris, for one, said training sessions she's attended recently were just as ineffective as the original.

She admits she's bitter about her job: her boyfriend was one of several dozen people laid off from the San Antonio office earlier this summer, and she wishes she earned more than her $12-per-hour salary. But she says that as a former recipient of food stamps and Medicaid, she's concerned about the experiences of the 3 million Texans who receive public assistance.

"You have no idea how (messed) up this is getting," said Morris, who works with applications and renewals but does not take calls. "There's misorganization regarding documents. Information gets linked incorrectly or lost altogether."

For example, Morris said she recently found that a public assistance recipient had submitted an address change. But an employee flagged the file to indicate a change of state residency, instead. And another employee who handled the case didn't catch the error. So the family was sent a letter asking about their Texas residency, Morris said.

Morris attributes problems like this to a lack of training and co-workers who are "purposely lazy." In May, Health and Human Services Executive Commissioner Albert Hawkins announced that no new applications will be processed in the privately run San Antonio call center until the contractor improves.

Alton Martin, CEO of Customer Operations Performance Center, Inc., a New York-based call-center consultant, said the training problems aren't surprising.

When he asks call-center representatives at various sites whether they felt ready for their job, "about half the time they'll say training was really bad or nonexistent or not appropriate to the task."

Martin, whose company is not working with the Texas contract but has worked with Accenture on other projects, said that call center quality issues often stem from the contract.

"Maybe the state wasn't rigorous enough," said Martin, who works in Austin. "Lots of times people want to throw the vendor under the bus . . . (But) if you want a fast car, ask for a fast car."

Goodman, though, said the state has set a high bar and is doing its own quality checks.

The private call centers — located in San Antonio, Austin, Midland and Athens — are expected to replace some state offices where Texans sign up for public assistance. The new system gives Texans more ways to apply for public assistance — mail, fax, Internet and phone — as well as in person.

Mary Katherine Stout of the Texas Public Policy Foundation, which advocates for limited government, said those who argue for the state to resume public assistance enrollment overlook problems with the outdated state system.

She recently visited a state benefits office in Fort Worth and found that despite having appointments, Texans were waiting hours. One public assistance recipient told Stout she has a rule of thumb for visiting the state office: pack a lunch.

cmaclaggan@statesman.com; 445-3548.

Opinion: Modernizing Texas Social Services

State Rep. Suzanna Hupp
Special to the Austin American-Statesman
8/8/2006

 

Want to take a trip back to the 1970s? Try visiting your local Food Stamps office. You'll find row after row of filing cabinets, computer screens with flashing neon green cursors and an occasional typewriter.

 

What office still has the computers with flashing neon green cursors?  I'm sorry, but I believe I have a new Dell computer (well, 3-4 years old)......could she be talking about the old Packard Bells?  I think those screens were orange.  And typewriters?  That's going back to the 70's?  I know that our office has ONE typewriter in the office that rarely, if ever, gets used.  BUT, it's there in case we need it for anything.  OH!  And if I'm not mistaken- I believe that cases were actually done on PAPER in the 70's.   I wasn't clear that DHS was so "Advanced" in the 70's that we were the ONLY agency with computers.....

 

It's definitely time for an upgrade.

 

Yes it is- and let's not act like IT didn't know that SAVERR (the ancient system that "seems to be able to get things done") COULD be converted to a web based program and upgraded.

 

Recently, in a letter to Health and Human Services Executive Commissioner Albert Hawkins, a number of my colleagues in the Texas Legislature and I reaffirmed our support for modernizing the eligibility system for programs such as Medicaid and Food Stamps. The massive overhaul of an antiquated system has not been easy. But it is necessary.

 

For years there has been an outcry for change to the system. Taxpayer dollars were being exhausted by a very labor-intensive system that cannot keep up with rising caseloads.

 

The new system will modernize the state's computer systems and business processes. It also will allow Texans to choose how they want to apply for services — in person, by phone (FNS still requires a signature to process an application for food stamps, so applying over the phone does nothing more than delay when their case gets started), over the Internet or by fax. These new options are being piloted in four offices in Travis and Hays counties. Although not off to an ideal start, these changes ultimately will make it easier for people to apply for services.

 

During a recent public hearing, a witness explained to lawmakers that she had to drive 30 minutes to a state office to simply pick up a children's Medicaid application (we would have mailed her one, all she has to do is call). This meant hiring someone to watch after her elderly mother and taking her 33-year-old autistic daughter and 10-year-old grandson with her to the office. When she arrived to the "extremely hot and overcrowded" office, she took number 99, only to discover they were on number 30. (the office is overcrowded now that most of the tenured staff has left after getting a layoff notice, and the people left are doing all they can to keep their heads above water) Because of her autistic daughter's reaction to strange environments, she finally had no other option but to leave the enrollment office, no better off than when she had arrived.

 

We must make it easier for Texans to apply for the services they need. (Had she gotten her application by mail, and then sent it back, the Children's Medicaid would have been done WITHOUT an interview even being required and her not having to come to the office again.)

 

In 2005, a statewide poll of Texas benefit recipients found that clients wanted more options, including the ability to apply by phone or Internet from the privacy of their own homes, when applying for benefits.  (Again, the clients that are now in the TIERS program - the one that DOESN'T work - are wishing we'd go BACK to the 'old' way, so that they could actually get their benefits...but I digress.)

 

In the new system, Texans still will be able to apply in person at one of more than 200 offices across the state in addition to the new methods. The system also uses technology and streamlined business processes to reduce costs.

 

All incoming and outgoing correspondence is scanned and saved to create an electronic case file that can be accessed from any state benefits office. That means that clients who move won't have to wait for their case files to catch up with them.

 

The modernization of the Texas social service system has drawn fire, some of which has been justified by issues discovered in the pilot phase. The state has been working closely with the contractor, the Texas Access Alliance, to address those problem areas before expanding the pilot to other regions.

 

But Texans should not forget where we came from — a system that caused frustration for the clients who depended on it and the state workers who administered it (State workers that administered it?  What is that supposed to mean?  That we were part of the problem?  Wow- to think all that hard work, and all that enhanced funding that the "state workers" worked so hard for- enhanced funding money that went straight to the GENERAL FUND...yes, let's not forget where we came from). We have made considerable progress in this worthwhile endeavor, and we are on track to provide Texas with a better social services eligibility system.

 

(If you would like to email Ms. Hupp and give her your thoughts on this article, click below and it will go straight to her page..........leave a comment if you do contact her.....)

 

Hupp, a Republican from Lampasas, represents the 54th District.

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