Previously, I noted that US Rep. Charlie Gonzalez (D, San Antonio) and three of his
colleagues sent a letter to Governor Perry expressing their concerns over the
manifest failures of the THHSC privatization effort.
At the time, I could not determine who the other signers of that letter were, so I sent an inquiry to Rep. Gonzalez's office.
I got a response today, so here for your reading pleasure is the letter in question:
The three other signers were Reps. Al Green, Lloyd Doggett, and Chet
Edwards. Now we just need to find out if Governor Perry has a response.
Posted by Charles Kuffner to Budget ballyhoo Comments (0) TrackBack (0)
Wednesday, May 31, 2006
Special to the San Antonio Express-News
The San Antonio Express-News has published several news stories and columns about the state's plan to add new ways for Texans to apply for services such as Medicaid and food stamps. But all have failed to include an important point of view - that of the client.
(Actually, many articles have addressed those concerns of the clients- specifically the ones who are already dealing with the call centers that are not getting their benefits.)
I understand the concerns of special-interest groups and employees worried
about the loss of state jobs.
(Once again, this isn't even about the jobs. Furthermore, rumor has it that enough people have left that hardly anyone will be laid off....)
But my primary focus is on the millions of Texans who rely on our
services. We are listening to their voices, and they tell us they are ready for
change. A recent survey of more than 1,000 Texans enrolled in Medicaid and other
health and human services programs found 80 percent of clients said they
would be interested in applying by phone, and 82 percent want to be able
to apply outside of normal work hours.
(That is, until they actually do and realize what a confused mess it all is and that any benefit to applying by phone is far outweighed by the time it takes to deal with an actual caseworker and get the actual case completed in a timely fashion)
We recognize that some clients prefer to conduct business in person at a
state benefits office.
While the Express-News is fond of saying the state "will shutter state
offices," the truth is that we will maintain more than 200 offices across
Texas. San Antonio will continue to have four state benefits offices.
Two San Antonio offices will close - one is located on the same block as
another benefits office and the other is within five miles of two other offices.
The project is not without its share of critics.
There are some who philosophically oppose outsourcing state functions to
the private sector. I appreciate that political position, but our approach has been driven by the statutory requirement to determine the most effective and efficient
way to deliver services. Our analysis found that contracting for call center services would generate more savings than state-run call centers.
(YOUR analysis says that, but none of the others actually do)
All calls are answered in Texas (when they actually GET answered, that is), and one of the four call centers is located in San Antonio. The contract includes strict performance standards to ensure the state doesn't pay for services that aren't delivered, and we have identified several areas where improvements must be made.
In the meantime, we have delayed the rollout of the new system.
The Express-News recently ran an article about a letter signed by four
members of the Texas congressional delegation opposing our efforts to
expand the ways Texans can apply for state services ("Congressmen attack
privatization plan," Thursday).
I was disappointed that the paper did not give equal attention to a letter
signed by 20 Texas representatives in support of the project. As these
leaders pointed out, there is a clear need for change.
Our system is badly out of date.
It uses a computer system built on a language that colleges no longer
teach. Its one-size-fits-all approach makes it especially difficult for the
working poor - people who must take off work to go sit in an office.
We still send Medicaid letters to clients each month - at a cost of almost
$750,000 for each mailing.
(Then change that, THAT expense has NOTHING to do with call centers at all.)
I understand and expect that a project of this magnitude will be closely
watched by the public, legislators and the press.
We will continue to monitor the project's performance; act quickly and
aggressively to improve shortcomings; and provide regular updates on our
Certainly, we still need to improve the project's performance, but that is
not an argument for maintaining an inefficient and outdated system.
We're still in the earliest phases of this project, but we remain
committed to creating a system that works better and costs less.
Albert Hawkins is Health and Human Services executive commissioner.
The following comments (in blue) were left on this issue, I didn't want anyone to miss them:
You know I have no problem with a client applying by phone or internet if it better fits their needs, but why not let US work those cases and answer those phones. IF the focus is REALLY on clients wanting a change why not change it in a way that actually helps them AND retains tenured staff who know what they're doing. DADS has a 1-800 number that when dialed automatically rings at the closest local office. Why do we need huge call centers when we could do the same as DADS? The savings just ain't there so they need to just throw out that talking point. I can tell you that 80% of MY clients don't want this change. They nearly all want our office to stay open so that we're there when they need us.
Us too. To expand on that- why not just plan and let local offices be open until 8- and staff accordingly. It's not impossible to do.The clients also want us there. There is something reassuring to know you can walk into a local office, and actually TALK to the person who interviewed you and finished your case. Or actually TALK face to face with the Supervisor if there is a problem. The way of the world is moving everything to call banks- problem is, if I don't like the call center I deal with at Cingular, I can change companies....I have choices. Clients do not.
How low will we go? Check out Yahoo! Messengers low PC-to-Phone call rates.
Tuesday, May 30, 2006
I appreciate your fervor in defending your job (Do you really think this is just all about my job? Then you haven't been reading here long if that's the case- this is so much more than a 'job'-this is about client services. I can get another job, the clients can't pick a different agency to certify them for Food Stamps and Medicaid although I'm sure they wish they could.) You should, however, consider the thousands of people who have gainful employment precisely BECAUSE of the privatization of this epartment. (At the expense of those who received a layoff notice? At the expense of those who have left already?)
(Wow, is that why Midland lost 10% of its workforce in 7 days?)
There are still kinks that need worked out (I think the clients would agree). After all, the SA branch was not to be fully operational until the end of April - Accenture/MAXIMUS opened it up 4 months early to get a head start.
(A head start that caused thousands of applications to come back to the local offices? It wasn't to be operational until the end of April? Now it's the end of May....hmmmmm........still not operational and I guess that's why workers from across the state are IN San Antonio helping with the backlog of 17,000 case actions *which is costing the State a bundle with mileage and hotel expenses.)
You are sorely misguided on the salary of the workers. EVERYONE, make much, much more than $8 an hour. I should now, I work there. The average wage for the team I am working on is over $40,000/yr.
(The $8 per hour has been quoted in MANY newspaper articles, this isn't a number I just made up off the top of my head. And if Accenture is paying 'everyone' WAY more than that and this is what the State gets for it's money then we are in a bigger mess than previously thought. I guarantee that the State employees were paid less (much less) than $40,000 a year and did the job well....so well in fact that the State of Texas has consistently earned Enhanced Funding bonuses from the Feds due to our accuracy in casework. I bet a years worth of my paychecks that the Enhanced Funding bonuses are NO MORE....and since you "work there", I'm curious as to what it is that Accenture is paying you $40,000 a year to do exactly? Can you email me a job posting?)
Someone with your talent in Health and Human Services should look at getting employed through Accenture. (I don't think so....let Accenture clean up their own mess....I'll stick to working in the local office, helping the clients we serve) Many of your collegues have and make much more than they did working for the state. (I've yet to hear from even ONE who is making so much more, but anyone who came from the State and has gone to work there in a capacity OTHER THAN upper management can email me anytime with the specifics.....I'm talking about those who work there who actually talk to the clients, deal with applications, deal with policy.) Maybe then you could be part of the solution rather than bitching about the negative aspects of it. (Me staying in the local office and not jumping ship is part of the solution. I've not left - I continue to go to work, do my job, and help the people I serve....you call it bitching? Well, that's O.K. Last I checked, I'm free to have an opinion and if telling the truth is 'bitching' then so be it.)
If anyone that works for Accenture wants to email me a 'guest post', please do. I'll post it. I won't even edit it.
Subject: FW: Insulting remarks made by chief clerk2nd email which was sent to the employee only: (nothing has been changed)
Date: Fri, 26 May
2006 10:53:53 -0500
, "Katherine Yoder" CC:firstname.lastname@example.org
I received this email this morning from an employee of HHSC. Obviously a
very angry employee as you will see. (Not angry, just overwhelmed and in the midst of what is actually going on.) I feel like I need to defend myself because
it seems like the email I sent to you, Commissioner, was completely taken out of
context and my intentions were misunderstood. The Committee of Human Services is not in the business of insulting the agencies we oversee, badgering them, or
anything of the like. (I didn't think so either) It is my job to make sure that I take any issues in regard to your agency and direct them to you, in the most tactful way I can. I apologize immensely if I failed to be diplomatic.
I don't know how the email was "forwarded quite a bit," because the three addresses above were the only addresses the email was sent to. Again, if the email I wrote to you in early May seemed abrasive and offensive, I apologize. It was only meant as a red flag.
Please know that we all know how hard you all work and appreciate your responsiveness.
Subject: RE: Insulting remarks made by chief clerk
Date:Fri, 26 May 2006 13:39:07 -0500
Although I feel your email was highly inappropriate and unprofessional (inappropriate? unprofessional? really? What's wrong with 'honest'?), I wanted to write you and let you know that I have a more of an understanding than you may know, of the situation local offices are in. (How? Are you a worker? Have you ever been a worker? If not, then you have NO IDEA of the situation the local offices are in.) When I wrote that email, I addressed it to the Commissioner (The commissioner is actually Albert Hawkins, not Anne), not to staffers. (You have to know that emails go from top to bottom. Especially when it's an email complaining about the work we are doing). I empathize with the overwhelming workload placed on your backs on a daily basis and the stress that must cause. I understand that you all receive and influx of complaints and reprimands, rather than words of encouragement and support. Your defensiveness is justified (but highly inappropriate and unprofessional?) and hopefully improvements are on the way.
The Chief Clerk who did not make insulting remarks (is it professional to sign this way and not with your NAME?)
Monday, May 22, 2006
In theory, there's nothing wrong with the state hiring an outside contractor to handle applications and enrollment systems for several major state social service programs, including Medicaid and food stamps - if the contractor can operate effectively and save taxpayers' money. Such a change also should make it easier for thousands of Texans who qualify to use such service programs, even if several thousand state employees lose their jobs.
In practice, though, the state's five-year, $899 million contract with an overseas consulting firm, Accenture LLP, is off to a terrible start. So terrible, in fact, that the Health and Human Services commissioner, Albert Hawkins, has been forced to ask about 1,000 state employees who were to be laid off by the end of the year to please don't go - and offered them $1,800 bonuses to stay. The offer came a month after the commissioner postponed any statewide rollout of the eligibility program because of problems.
The problems included too many clients left on hold for way too long, too many employees making too many mistakes in determining eligibility and errors such as dropping 6,000 kids from the children's health insurance program - their parents had not been told of a new enrollment fee. The children were reinstated.
Some legislators are angry and are rightly demanding that state Comptroller Carole Keeton Strayhorn review the program, which was touted as a way to save the state $646 million over five years. Strayhorn, a Republican running for governor as an independent, welcomed the invitation to take shots at a program launched under the incumbent, Gov. Rick Perry.
She's already called the program "a perfect storm of wasted dollars, reduced access to services and profiteering at the expense of Texas taxpayers." Strayhorn's description might be correct, though saying so before the review, not after, could undermine the credibility of her staff's audit. One issue to be determined, for example, is whether the program's problems are the result of profiteering, honest misjudgments or simple incompetence.
The program is one result of House Bill 2292, by former state Rep. Arlene Wohlgemuth, R-Burleson, which in 2003 ordered a massive reorganization of the state's health and human services departments and agencies. The bill included a provision to examine possible cost savings if the state outsourced the process of applying for and maintaining the eligibility rolls of Medicaid, the Children's Health Insurance Program, food stamps and the Temporary Assistance for Needy Families program. And it directed the state to consider possible savings from enabling applicants to use call centers and Internet connections.
Eventually, a contract was awarded to Texas Access Alliance, a consortium anchored by Accenture, an American consulting company officially headquartered in Bermuda. (Locating in Bermuda can help a company reduce the income tax it owes to the federal government, but apparently does nothing to lessen the company's willingness to make money off other American taxpayers.)
Strayhorn is right to take a good, hard look at this program. But she should not let her electoral ambitions interfere with her staff examining the contract performance with objectivity.
Defenders say savings, efficiency in social aid programs will take time
01:04 AM CDT on Sunday, May 28, 2006
By ROBERT T. GARRETT / The Dallas Morning News
AUSTIN -- Texas' health and welfare agencies are undertaking the most sweeping and rapid privatization of social services in the country, but the experiments are plagued with problems. Tens of thousands of aid recipients can't get through to privately run call centers. Thousands more poor families are complaining that their children were wrongly denied health insurance. At state hospitals and schools for the mentally impaired, head nurses must slog through new and burdensome online payroll duties. Conservative policymakers who championed privatization predicted it would save money and make services more efficient. But so far, the state has had to dial back its savings estimates and rescind planned layoffs of hundreds of eligibility workers.
Liberal policy analysts and advocates for the poor say Texas rushed into outsourcing without a good plan or enough testing. Some lawmakers in both parties vow to re-evaluate the push, especially before the state begins next year to privatize a highly sensitive task -- caring for abused and neglected children. Others, such as conservative commentators and Albert Hawkins, Gov. Rick Perry's point man on social services, defend privatization. (Of course, what better political football than to show taxpaying Texans that the WELFARE business isn't going to 'eat' up their money anymore. Although, we are learning everyday, that it's not the case.) They insist change will be worth the initial pain as private firms help the state trim administrative fat, verify recipients are eligible and better serve the needy. And, they note, privatization is here to stay, because Republican legislative leaders won't go back to -- or pay for -- old ways of checking eligibility and running programs. "It makes so much sense that the only reason that someone would be opposed to this is that they're beholden to state employees," said former Rep. Arlene Wohlgemuth, R-Burleson. (Excuse me Ms. Wohlgemuth? What was that? The ONLY reason that someone is opposed is because of the state employees? Are you serious? If anyone was beholden to us, they'd have listened to our input when all this was first talked about. Because we, as State Employees, knew ALL along that this would not work.) She pushed through the 2003 law that strongly encouraged using privately run call centers and other cost-cutting techniques. Ms. Wohlgemuth said she's "absolutely astounded" that critics "would like to take this system back to the dark ages," when employed adults had to take off work to go to field offices and wait in lines to apply for benefits for their children. (Well, thank GOD you, Ms. Wohlgemuth lost the race with Chet Edwards.....and we are rid of you in State Government. If you believe all of your own rhetoric, then it just goes to show that you truly have no clue what goes on in a welfare office. Period. Let me explain: The 'dark ages' as you call them actually got folks certified in a timely manner and according to Federal Policy. There is nothing wrong with upgrading an old system. No one is against that. But as we have learned through TIERS- a system cannot 'think' for you. The Advisor interviewing a client still has to know and understand policy. How long has TIERS been out now? And it STILL doesn't work? THAT, Ms. Wohlgemuth is 'dark ages'. You talk about employed adults having to wait in line for benefits- let me tell you- if the State took care of their employees, paid them what they are worth, trained them as they should be trained, and provided them with the tools to do their jobs- offices would run smoothly. There wouldn't be turnover. The offices would stay fully staffed. When you have an office that is fully staffed with well trained workers who know how to do a case quickly and accurately, then I would believe that 1 hour of someone's time every 6 months would be worth the total sum of benefits that they NEED. Who hasn't waited in line for something? So we, as the public, will wait for a table at Red Lobster for an hour but not expect a client to wait that same length of time to verify their eligibility for benefits that are paid by the taxpayers of this country? So we, as the public, see nothing wrong with just handing out benefits to anyone? Do we, as a compassionate fellow citizen, not want to see a family in need be able to talk to someone in person and get whatever they are eligible for as well as referrals to local community resources? Do you think the clients who have dealt with TAA so far think it's been easy and convenient? Whereas someone used to be able to come to the local office for a face to face interview, and be certified the same day if they had all their information- OR- make ONE more trip to return needed verifications....now, clients who deal with TAA have to make SEVERAL phone calls, never getting the same person- and make SEVERAL trips to have information faxed to TAA- some of which is not even REQUIRED verification according to policy- and THAT is more client friendly? It seems as though Arlene is quite lucky....she's no longer a representative, which means it's not HER office that is having to deal with her constituents calling to complain about not getting their benefits. It is someone elses's problem.)
Celia Hagert, an expert on food stamps who monitors the call-center push for the progressive Center for Public Policy Priorities, said the state has actually had to spend more to determine eligibility. The state cancelled 1,000 layoffs this month and has sent managers and workers to various cities to fix glitches, she said. "We've deployed an untested, badly performing system that's causing people to lose benefits," Ms. Hagert said, noting that 108,000 fewer children are enrolled in health insurance programs than were six months ago. State agencies "are asking the Legislature for more money to keep the administrative functions afloat. The exact opposite of what they promised is what's happening now." Mr. Hawkins, the state health and human services commissioner, has acknowledged the problems. But he and conservative supporters say they are temporary, the result of the transition to privatization. Other analysts are concerned the problems will only grow as more state functions are outsourced.
What's happened as the debate intensifies, the state faces a host of challenges:
*About 42 percent of the nearly 60,000 people who called a children's health insurance call center in Midland from May 15 to May 21 hung up before they could reach an operator. The contractor, a group led by Bermuda-based Accenture Ltd., blamed the delays on an unexpected surge in calls. (Of course they do. They certainly aren't going to take any of the responsibility, are they?)
*Turnover has soared among the $8-an-hour operators hired by an Accenture subcontractor. In one week this month, 15 operators quit at the Midland call center, and 23 left an adjoining operation that handles applicants for welfare, food stamps and adult Medicaid coverage. That's a workforce turnover of about 10 percent in seven days. "Midland is a very competitive employment market right now," with a joblessness rate of 3 percent, said Accenture spokesman Jim McAvoy. He vowed that the company will intensify its recruiting efforts. (Nevermind that those $8 an hour employees realized that this was a disorganized system. 10% in 7 days? The State never even had those kinds of numbers.)
*Average wait times for callers trying to apply for welfare, food stamps and adult Medicaid coverage exceeded 20 minutes on six days in March. Waits dropped to under a minute or two in April. But on two days this month, they leapt to about 13 minutes. Mr. McAvoy attributed the surge to a state demand that each operator receive at least 40 hours of extra training. "The good news is we are already seeing results" from that training, he said. (Is that why we've been told to no longer refer callers to 2-1-1? It's sure going to make those numbers look good, isn't it?)
*The state said this month that a call center run by Accenture in San Antonio can't perform its main job -- gathering all information needed so a state worker can quickly decide on applications by adults in a tryout area, Travis and Hays counties. Computer systems don't talk to one another and don't allow the state to track how fast cases are resolved, said Stephanie Goodman, spokeswoman for the Health and Human Services Commission.
*Repeated delays in rolling out the system beyond metropolitan Austin forced the state to offer $1,800 retention bonuses to 1,000 state workers whose jobs were scheduled to be eliminated this year; 900 others will still get pink slips. More than 2,000 have quit and have not been replaced since October 2004. (Other than to insure children, Dallas-area residents probably won't start using the call centers until next year.) (There are many who are eligible for a bonus who are still looking for other jobs. The bonus isn't going to keep people in understaffed offices where simple office commodities like pens aren't even provided. It's gotten so overwhelming in the local offices that a bonus isn't going to take away the stress of having to do more than is possible.)
*Low-level and midlevel managers, especially those who oversee dozens of employees at state mental hospitals and schools for the retarded, have complained that they can't care for patients and students because a separate outsourcing has saddled them with time-consuming payroll and time card processing tasks. The state shifted duties of nearly 500 human resources workers in the five agencies that Mr. Hawkins oversees to Convergys Corp. of Cincinnati. It has promised "enhancements" that will ease criticism by Mr. Hawkins and the affected managers. (Oh yes, let's not talk about AccessHR)
"What Texas is attempting to do is a radical transformation of service delivery," said Stacy Dean, a former federal budget official who monitors privatization efforts for the liberal Center on Budget and Policy Priorities in Washington. She said the state ignored warnings that fast changes would be a technological and human gamble. Florida spent fours years testing a similar though mostly state-run system, and Pennsylvania, Washington and Utah bit off only small chunks of the job for starters, she said. But Texas officials tried to award an $899 million contract and convert the whole state in 14 months. "They thought they could pull it off without testing the waters," Ms. Dean said. "It's that sort of Lone Star bravado -- 'we can do it when nobody else can, and experience from other states isn't relevant.' " But Jason Turner of the conservative Heritage Foundation describes Texas as an innovative defender of taxpayers. "Looking beyond the government service-delivery monopoly for improvements ... has a long and well-established pedigree," said Mr. Turner, who favored private competition as a designer of former Wisconsin Gov. Tommy Thompson's welfare overhauls and as former New York Mayor Rudolph Giuliani's welfare commissioner. The early bumps in Texas are no surprise, Mr. Turner said. "When major systems undergo a changeover from public to private, start-up failures of various kinds always occur," he said. Political effects Still, early problems have put Republicans -- in both Austin and Washington -- on the defensive. Last week, Texas' eligibility call centers were debated briefly on the floor of the U.S. House. Democrats offered a provision to shut down Texas' plan but relented. Twenty Republicans from Texas circulated a letter urging colleagues to allow the experiment to go forward. They said it will offer convenient, after-hours service to the state's poor and feeble. Comptroller Carole Keeton Strayhorn, an independent candidate for governor, has accepted the invitation of one moderate Republican and two liberal Democrats in the Legislature to scrutinize the call center contract. She has accused Mr. Perry of implementing the plan "in haste" and has said the contract creates conditions ideal for "profiteering." In the Legislature, even Republicans have criticized the call centers. "We should have moved much more quickly to act on the problems," said Sen. Jane Nelson, R-Lewisville, who heads the Senate committee overseeing health and welfare programs. She called the call center problems "inexcusable" and said, "Either get the problems fixed or I assume it would be a violation of the contract, and yank it back." Mr. Hawkins hasn't financially penalized Accenture's group over the problems, though he says he's considering it. (Considering it? What? If local State staff did the shoddy work that TAA does, not only would no one have 'considered' firing the staff, they would have. Period. No doubt about it.) And he concedes that savings have been minimal so far. But he said changes were inevitable because of recent budget cuts. (Oh now the recent budget cuts are to blame....yeah, ok, if you say so.) "Some people, when they're looking at something new, tend to compare against some ideal or something that was perfect," Mr. Hawkins said. "Well, the old system wasn't perfect, either." Rep. Vilma Luna, D-Corpus Christi, a key House budget writer, says the state shouldn't have put itself at the mercy of private contractors. But she predicts that it won't pull back. "I don't know where we will end up," Ms. Luna said. "My sense is there will be some effort to make the call center model work. But it may have to be modified."
Gauging gains and setbacks Here's a look at the progress of the state's efforts to outsource social services:
WHAT: Call centers and new eligibility system
COST: $899 million for a five-year contract
PRECEDENT: Some. About 60 percent of the money is for new privatization. The rest reflects computer and children's health insurance call-center duties formerly performed by other vendors.
WHO: Texas Access Alliance, led by Accenture Ltd.'s U.S. subsidiary
WHEN: Awarded in June 2005
PROGRESS: Uneven. Delays in the rollout have cost the alliance $50 million in variable fees, state officials say. The vendor says it expects to make that up with higher program enrollments than the state projects. The state is weighing penalties for poor performance.
WHAT: Processing of payroll, benefits, job applications and performance reviews for the state's five health and human services agencies and their 46,000 employees
COST: $85 million for a five-year contract
WHO: Convergys Corp. of Cincinnati
WHEN: Awarded in October 2004
PROGRESS: Uneven. Though 95 percent of employees have gone online to perform self-service transactions, many middle managers who now must track subordinates' time have complained that the system is unwieldy and that they can't get help and weren't trained properly. Convergys says fixes will be complete by July. Delays last fall cost it $535,000 in fees.
WHAT: State care of abused and neglected children removed from their homes
PRECEDENT: While Child Protective Services previously had outsourced most foster home recruitment and adoption placement, it plans to eliminate by 2011 the jobs of about 1,000 conservatorship caseworkers. Management of children's therapies and work with families seeking reunification will be handed off to private agencies.
WHO: There probably will be multiple contractors.
WHEN: The first contract, to oversee the San Antonio region, is expected to be issued by Sept. 30, 2007.
PROGRESS: The state sought bids on May 1. (Can't wait to see the fallout when kids get lost in the Foster Care system)
SOURCE: Dallas Morning News research
Sunday, May 28, 2006
Sneak preview the all-new Yahoo.com. It's not radically different. Just radically better.
One of the fallouts of the number of vacancies in the local offices is scheduling. For those who are not on the 'inside'- a Food Stamp application is not supposed to be scheduled any later than 20 days after the date the application is filed. The reason? Because we only have 30 days to actually take action on an application (unlike TAA which has, evidently, anywhere between 2-6 months) and we have to give the client 10 days (at least) to provide any information that is needed to complete the case.
One of the problems that offices faced some years back was when QC (Quality Control) called a case in error if someone was eligible for 'emergency food stamps' and was not certified within 7 days of the date of the application. This led many offices statewide to play catch up and get any and all Food Stamp applications scheduled within 7 days.
Some offices aren't able to get a client scheduled until 30 days after application was filed. There aren't enough workers to do it.
I mean, I suppose we could schedule appointments every 7 minutes (the length of time that TAA claimed it would take to do an interview with their 'new system'- ha!) and see about 40 people per day- but the quality would take a dive and there is no guarantee that clients would be getting the correct amount of benefits.
How do we solve this? I mean, the State can hire all the temps it wants, and we are glad to have them-but, it is just unfair to the temp workers that they are expected to know everything as soon as they land in their local office. As I've stated before- this job is not something you can 'learn' overnight. Matter of fact, 'back in the day' new workers went to BJST (Basic Job Skills Training) and were in a training environment for up to SIX months. I mean, we are dealing with many aspects of Policy here- Federal Policy for Food Stamps and State Policy for TANF (cash assistance) and Medicaid. Now? New workers are 'fast trained' in a matter of WEEKS and expected to come into the field and be able to offer substantial support to the local offices. They don't. Even in the old days- with 12 weeks of training- it still took a trainee a good YEAR to get really GOOD at what they did. We (I) am in no way putting this off on the Trainees-quite the contrary.
This brings us back to the scheduling problem. If local offices - due to vacancies - are starting to get to a point where they are delinquent before they even get the client scheduled- we are in serious trouble. This increases workloads (Of course), workers in the field feeling very overwhelmed (because unlike TAA -evidently- we, in the field, are still held accountable on our evaluations for delinquencies *we can ask for exceptions when they are not our fault, but that takes more time and more work to do as well*), we aren't following Federal Food Stamp policy and clients are highly frustrated. Local office clients are not USED to having to wait 4 weeks for an appointment. Before too long, it will only increase- which increases complaints, which further overwhelms office staff, which causes more people to quit, which leads to the hiring of temps who are not adequately trained, which leads to all of it all over again....let's not even talk about QC error rates- which, if they get to high, rather than the State receiving Enhanced Funding - they will be paying fines and penalties to the Feds. Sounds fun, doesn't it?
If HHSC is going to give bonuses to stick around this summer, they better get to it.
Comment added today (Monday):
I started working for Department of Human Services as a Texas Works Advisor Trainee in February 2003. We were the last BJST class before the in-famous TIERS started to roll-out.
The BJST started February 3rd, 2003 until May 5th 2003. This was just for Food Stamps and Medicaid training. We then went back in June for a month and a week or two to train for TANF. I then returned to my office and interviewed 2 cases a day. That alone was so difficult because of the complex policies and procedures. I was very thankful that I was in a smaller office with about 6 workers who were ALL very tenured workers. And, my mentor who was assigned to me for 6 months was great. If I had not been in a small office (most workers aren't) I am sure that they would have not had enough time to dedicate to me. You are suppose to slowly get moved up from 2 cases a day up to 6 max per day for a whole year. I was pretty good at the casework and wanted to help out so, I got moved up pretty fast. But, normally the supervisors are suppose to follow a strict schedule. You are suppose to get increased a case each month you are there until you reach the 6 limit. Once I reached 6 cases a day it started to get very over-whelming.
There is so much policy and so many things that go wrong. That, only a tenured worker (and sometimes they don't know the answer) would know the way around the problem. It would get very frustrating but because of the tenured workers there, it made it alot easier than it normally would be in a larger office. The workers would tell me it takes at least a full year to understand the whole picture of how everything works. That is very true!!!!
Alot of the other workers I trained with were in large offices (TIERS pilot area)and I heard about their trials and tribulations everyday. Especially once TIERS rolled out a few months AFTER they were trained on the old system. Out of about 20 workers that were in my training class about 9 were left after the year passed. Most were in the TIERS roll-out pilot area. And, the ones that were left were hanging on by the grace of God. It was seriously that bad and cudos for the one worker who is still there! I left the agency in February 2006. I was actually placed for a job with HHSC and was not going to be laid off. But, as each step progressed in that call center being started. I sensed the urgency to get out of there! By this time our supervisor left, our Worker IV was now our supervisor. One of our Worker III's was now our Worker IV, and we were half staffed. We were all able to deal with it (was not easy at all) because we all worked together (for the most part). We did have to see 30 minute appointments before I left. That is 12 in one day! That was in order for us to not have any delinquent Food Stamp cases over 30 days.
But, I knew that if one more person left it was going to start a huge decline in the office and all hell was going to break loose! And, it did. I left, another worker was transferred to her new job within HHSC. A temp left the agency. So, there is only one worker and one temp worker left (who only interviews food stamps) They do not care about timeliness now. The clients are pretty lucky just to get interviewed.
Anyway, my sister is now working for the agency and she is a temp worker. She only had 2 weeks of medicaid training. She goes to food stamp training soon and is only going to be trained for a month. And, probably the same with TANF for a month. I went to training for roughgly 4 1/2 months for all programs. She is going to be trained for 2 1/2 months. And, then 'thrown to the dogs' as we called it in a majorly short staffed office.Do the people running HHSC understand the complexity of what they are trying to do? Do they think they can throw in 7 dollar an hour employees with little or no education into a call center to answer questions on policy? Do they understand that even in local offices staffed by state employees had high turn-over rates and that the call centers staffed by 7 dollar an hour employees the turnover rate is going to be higher? Where is the quality of service going to go then? You barely got it in a full-staffed office because of the work-load. You think the people of Texas are going to get the quality of service with 7 dollar an hour employees are going to be answering the phones? 7 dollar an hour employees who are also receiving food stamps? Staff the call centers with all of these state employees you are going to lay off. You probably would still have problems. But, not as many as you would have with the 7 dollar an hour employees answering the phones. Let the tenured state workers answer the phones and work the cases. That is going to be the only answer to your problems.
Friday, May 26, 2006
Capitol Annex has some info about HHSC as does Dallas Blog. Check them out- the more the word gets out about what is REALLY going on, the more difference it can make.
Anyone want to join this blog as a contributor? I'd like to see every Region in the State represented here......email me......the process is very easy and doesn't even hurt a little!
Web Posted: 05/26/2006 12:00 AM CDT
Express-News Staff Writer
The state is considering financial sanctions against a contractor that is key to privatizing the screening of welfare applications, a senior health and human services official said Thursday.
A host of computer problems and poor training of contractor employees, resulting in misinformation to applicants and improperly filled out forms, has caused Health and Human Services Commissioner Albert Hawkins to indefinitely postpone the plan.
In addition, Hawkins has canceled the planned furlough of thousands of state workers and relieved the contractor of some of its duties.
It is not clear how much the state is considering penalizing Bermuda-based Accenture LLP, with which it signed a five-year, $889 million contract last summer.
It marks the first time the state has said publicly that its dissatisfaction with the contractor's performance may draw sanctions.
The firm did not return calls seeking comment.
Anne Heiligenstein, deputy executive commissioner for social services, said the agency is reviewing options for recovering unexpected costs and delays in its Integrated Eligibility system, which determines who qualifies for food stamps and the Children's Health Insurance Program, among others.
But if the commission decides to impose financial sanctions, it could be months before a specific dollar figure is negotiated.
The eligibility program was scheduled to roll out statewide later this year after an initial pilot program in Austin and San Marcos.
The new process was to have debuted in San Antonio this summer but was suspended after state officials raised concerns about Accenture.
The rollout delay will likely negate some of the $646 million the commission told the Legislature it expected to save by outsourcing to the company.
Thursday, May 25, 2006
From: Annie Landmann_HC [mailto:Annie.Landmann_HC@house.state.tx.us]
Sent: Monday, May 15, 2006 3:36 PM
To: email@example.com; Muth,Stephanie
Cc: Katherine Yoder
Subject: Eligibility System Concern
I would like to begin by expressing my appreciation for the eligibility oversight synopsis that I received by e-mail this afternoon. It is very encouraging, as always, to know that HHSC is reviewing better performance and system improvements and keeping us continually informed.
*it is encouraging, yes- that the bad press that HHSC gets is causing them to review better performance and system improvements, but for many local offices- this is too little, too late.*
With that said, I have been getting some discouraging feedback regarding the local offices. (I'm willing to bet a paycheck it's not as much discouraging feedback that we've gotten regarding TAA.) Many constituents have called my office in frustration, criticizing the application process for Medicaid and food stamps, whether it be their first time applying or when filing for an extension. (Before the call centers, did you get those calls? I doubt it.) The criticism is one and the same; the client walks into the local office to apply, or file an extension, or make an appointment, etc. and they are turned away, given a pamphlet, and told to call 2-1-1 . (*local office staff has been DIRECTED to tell clients to call 2-1-1 if they are TIERS. They also call 2-1-1 if they want referral services for their community) Not only is this becoming a redundant complaint in the committee office, but this was briefly discussed as a rising problem among my committee members' staff at a recent meeting as well. The call centers were made to serve clients as a convenient and uncomplicated option in the application process. (*it is not the local office staff's fault that we are now severly short staffed and that the call centers are anything BUT convenient and uncomplicated- why are state staff being blamed?) We were told, however, that if the client chooses to continue to go to the local office and speak with state staff, they can, and should never be turned away. (*this works only if there is staff in the local office who can help them. We are not on TIERS- and while we do have ART workers in the local offices that we can go to for questions, etc when clients come into the office, if they direct staff to have the client call 2-1-1, then what else are we supposed to do? Make up some information for the client so they won't call their representatives? This is, unfortunately, the cost of trying to rush to privatization without the concept being tested in a highly controlled environment before rolling out.)
It seems that staff in the local offices are under a false impression that they aren't in the business of assisting clients anymore. (This is the most offensive thing I've read or heard in a long while. Staff in local offices are doing all they can with very limited resources to help the clients- but again, there is only so much that we can do. To actually say outloud that it is PRESUMED that local staff believe they aren't in the business of assisting clients is outrageous and insulting. I'm sorry Ms. Landmann, but you don't speak for me, and cannot presume to know what my impressions are. Nor, I believe, can you speak for anyone else that is working in a local office. Mind you, many local offices are running at 50% of the staff they had just 6 months ago, they are being asked to work evenings and weekends just to stay caught up. They are being asked to do all jobs- be a worker, be a clerk, be a supervisor, whatever- and for anyone on the 'outside' to PRESUME to know what local staff is thinking is BEYOND good reason. This is the precise reason people are leaving. No support.) There is a common misconception among staff and we are hearing it through your frustrated clients. Whatever the resolution may be, it needs to be made quickly. Because of your efforts to fix the glitches in the new eligibility system, I know you are as truly concerned as we are when we hear that "clients" are being turned away when they should be helped. (Did anything go out to TAA when THEY were refusing to help clients on the phone? Were they getting a good stern email telling THEM to fix the problem quickly when THEY were giving out wrong information, and telling clients that they needed to get help at the local offices, when THEY are being paid to help them? I doubt it. Again, let's put it all back on those State Employees that are not only holding it together to do THEIR jobs, but are now also in a position of having to work the returned applications from TAA. Double work, no double pay, and THIS is what we get in return?)
Thank you for your attention in this matter and please don't hesitate to contact me with any questions.
House Committee on Human Services
Got the following in comments after this was posted, and I felt like it was worthy of being posted on the main blog:
This just goes to show that we, as dedicated workers, need to strive to do our best to take up the slack from the TAA and Hawkins' sneaky ways. They send work back to the local offices that is three months old, and then we get the bad stats. They overload already overworked workers with cases where the client is already frustrated, and we get the complaints on us, not them. Ms Landman was probably directed to send this e-mail out as the beginning of another spin by Hawkins and his crew. I can read it now...."More calls recieved complaining about local offices now that they are handling the cases..." You can bet somebody is keeping tabs on all the calls that are coming in now. Hawkins and Accenture aren't going to give up without a fight, and it'll probably get dirty(er)Before the dust settles.If we want to keep our jobs, and serve our clients the way we were, we are going to have to really be on our toes, and try to get the job done now. Any failure in the old system will be exploited by "them"
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Wednesday, May 24, 2006
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Tuesday, May 23, 2006
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*more comments later.
Monday, May 22, 2006
Stop throwing good money after bad; fire Accenture,
rebuild health and human services at the local level
Austin- The Texas State Employees Union today called on the state Health and Human Services Commission to fire Accenture and to take immediate action rebuild the state's health and human service delivery network that has deteriorated so badly since HHSC awarded the $899 million call center contract to the Bermuda-based company.
The union made this call after the San Antonio Express News published an article by Guillermo Garcia today saying that HHSC has paid Accenture $91 million even though the agency admits that "the [call center] program is fraught with operational problems."
"HHSC should stop throwing good money after bad," said Mike Gross, TSEU vice-president. "The conservative and prudent thing to do would be to fire Accenture then use the money budgeted for the contract to improve services at the local level."
Because Accenture was performing so poorly, HHSC on May 10 returned most of the work that Accenture was doing back to state employees and announced that 1000 eligibility workers who had received layoff notices would keep their jobs.
Prior to May 10, thousands of cases were backlogged, some food stamp applications were taking three to four months to process, and frustrated clients were complaining to their legislators. During the four months that Accenture was processing CHIP and Medicaid applications, enrollment in these programs dropped substantially. In April CHIP enrollment dropped below 300,000 for the first time since 2001.
"HHSC made a bad decision when it chose to privatize services," said Gross. "It redeemed itself somewhat this month when it returned most of the work that Accenture was doing to state employees."
But HHSC's ability to deliver services is still hampered by its privatization decision. About 1000 employees who once worked in local eligibility offices have quit since July when HHSC awarded the call center contract to Accenture.
As a result many local offices are short staffed. One Houston office that used to have 40 employees is now down to 18 full-time staff. To make matters worse, state employees in local offices are working Accenture's backlog as well as their own caseload.
"HHSC should take the money that it planned to spend on the Accenture contract and re-invest it in its community-based offices," Gross said. "Community-based offices are where people can get face-to-face assistance from knowledgeable, professional state eligibility employees. You can't get the same kind of help from a faceless, call center operator."
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Sunday, May 21, 2006
Thursday, May 18, 2006
San Antonio Express-News5/18/2006
"Pay now or pay later" accurately describes the economics of delayed care, whether for cars, roofs ... or people's health and human needs. We will be paying heavily for the problems resulting from the legislative consolidation of 12 Texas health and human service agencies into one and by the privatization of those services.
Contracting the services to a company (Accenture) whose goal is to make a profit, not necessarily to serve the people of Texas well, has already proven to be a mistake. Aside from the financial losses, we will be paying inordinately for health and emotional problems resulting from lack of help for those deserving it.
It is critical that people are able to function effectively as students, workers, leaders ... and taxpayers. To do so requires a healthy body and emotional stability. Productivity and a sound economy are assured only if people can assume the requisite roles. It behooves us all to promote this.
Columnist Carlos Guerra has chronicled well the problems of this legislative endeavor to avoid "paying now" and predicting accurately the problems we are facing by assuming that "paying later" will be effective.
Ruth F. Stewart, RN
San Antonio Express-News5/18/2006
Thank you for Carlos Guerra's columns on the meltdown at the Health and Human Services Commission.
I worked for that agency for 13 years and was a supervisor until I left in August because things were already spinning out of control. I no longer had a job I could count on due to the planned layoff of more than half our staff.
I tried to get my elected representatives to listen to my warnings of where things were headed and ran into a brick wall.
Now these same representatives are beginning to ask what happened. What happened is that they pushed through a major overhaul of a state agency without listening to any of the people who were making that agency work, and now the state is suffering the consequences.
We have a $300 million computer system that was supposed to be rolled out in 2001 and still doesn't work. We have a call center privatized system that is a complete failure. We have local offices that have imploded and have almost no staff left. And we have people who are need help who are waiting six months to get a response when the law says they should have to wait only 30 days.
Guerra is the only writer in the mainstream media saying the things those of us who know what's happening up close would like to have said.
John Whiteford (He has a blog also, which is linked here!)
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