Wednesday, May 17, 2006

Albert Hawkins, guest column: Privatizing will pay off

Albert Hawkins, guest column: Privatizing will pay off

*I've added more comments than were originally on here the first time I posted this.....*
Wednesday, May 17, 2006
AUSTIN — Remember banking in the 1960s and ’70s? For virtually any service, you went to your local bank and waited in line. If a bank still operated that way — with no phone, Internet or ATM service — would you bank there?
I also know that as a consumer, I have choices when it comes to banking needs- if we really want to go there. I can always choose another bank if I don't like the one I'm with. Our clients have no choice. Oh sure, they can choose to not apply for Food Stamps I suppose, but it's not as though they can choose somewhere else to certify them for benefits. How about those clients who are in TIERS who have practically begged local office staff to PLEASE put them back in the 'old system' so that they can get their benefits timely. They have no options, do they?
Today, a person can pay bills or renew a driver’s license on the Internet or over the phone.
Those things are not them giving US Federal and State benefits, is it? We, as citizens- PAY for our bills and PAY to renew our Driver's License. Don't you think the taxpayers want the State to be good stewards of their money? Don't you think that overall the general public that pays taxes are not at all bothered by the State verifying information, requesting proof of income, having clients sacrifice up to an hour of their time every six months to come into a local office so that we can assure that the benefits we give them are correct? Don't you think that I, as a taxpayer, don't want to ensure that the benefits really do go to those who are eligible? Do you really believe that this can all be accomplished with a phone call?
But Texans continue to apply for Medicaid, food stamps and many state services much as they did decades ago, by going to a state office and waiting for an interview.
There was always a standard. They had to be seen for an interview within a certain period of time. In the 'old world' system, you never heard of clients waiting MONTHS to get help. Never. It would have never been tolerated. There is such a misconception about this whole 'waiting for an interview'- Turn in application on May 1. Case will be finished- one way or another- in 30 days. Old world? The client had an interview by May 7th. If they had a phone interview, they would most certainly be pended for more information and the case could be delayed (would be delayed).....but if the client came in, and had all their information- they would be certified the SAME DAY. If a client didn't want to wait 7 days for an interview, in the 'old world'- they could come into a local office and sit on 'standby' and wait for someone else to miss their appointment to take that slot. More often than not- when it was not all phone interviews- local offices could get standbys in to be seen. Now? With 211? That hasn't happened. Local offices are so understaffed, that applications are pushing getting scheduled by the 30th day- the technical date the case is due- because there is not enough staff in the local offices to actually see the clients. 15 cannot do the work of 30.
Earlier this year, the state began begin phasing in a new system that finally allows Texans to choose the application method most convenient for them — in person, through the Internet, over the phone and by fax or mail.
Woo Hoo! Those clients sure are lucky, aren't they!? They can call TAA and do an application on the phone! Wow! Only, TAA then has to send them the application to sign- OH WAIT! What if TAA sends the client someone else's application?! Does that delay the case even further (and yes, clients have been sent other folks applications).....then, when they sign the application and return it- then it might be 4-5 months before they have any benefits. Oh WAIT! TAA will just tell the client to come into the local office, DO ANOTHER application and have local office staff FAX the application to their 'Expedited Food Stamps' fax number so that someone can see them the same day. If that happens, then a worker will call them for an interview- and the client will have to COME BACK to the local office AGAIN for their lone star card. How convenient! (Nevermind that as my own little experiment, I requested an application through the website over two weeks ago- in my dog's name- and it has YET to arrive at my convenient for me!)
The biggest advantage of the new model will be easier access to state services for the working poor, for people who lack transportation and for others who have difficulty traveling.
What about people who don't have a phone or have internet? I'm sure there are plenty of TIERS clients who would disagree with you about it being 'easier'. Let's not play word games here- this is all rhetoric talking- it SOUNDS really great- doesn't it? Just call! No problem! Only, there are problems, many.
The project is not without its share of critics. Some, including editorial writers, philosophically oppose outsourcing state functions to the private sector [John Young, May 14, “Texas’ super-privatizing machine throws sprocket”].
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.
So is it efficient for the State of Texas to lose Federal Funding because cases aren't meeting Federal requirements? Is it efficient to pay a BERMUDA BASED COMPANY millions of dollars to run a social service program that issues out FEDERAL AND STATE benefits? What interest, I would like to know, does any private company have in this business? Where is their profit coming from? Off the backs of the poor due to substandard services.
In the case of call centers, our analysis found that contracting for those services would save taxpayers more over five years when compared to state-run call centers.
Hasn't saved a dime yet, has it? Yes, I suppose it will if the end goal is to get people to give up and not get benefits. I suppose that would work.
All four call centers will be located in Texas, and the contract includes strict performance standards to ensure that the state doesn’t pay for services that aren’t delivered.
Same standards that the State Employees are currently held to? I can guarantee, as I've said before that had I processed every application given to me past 30 days, and was 100% delinquent 100% of the time, I'd have been terminated. Period. Field staff are STILL being held to that standard, yet BERMUDA BASED ACCENTURE is not?
We are still in the early phases of this project, but we have identified several areas where improvements must be made. In the meantime, we have delayed the rollout of
the system — a move that has cost the contractor $50 million to date.
I guess Bermuda based Accenture LLC can afford that given their tax exempt status by being
based outside the UNITED STATES OF AMERICA. Several areas? So is there improvement to be made out of the San Antonio call center where they have over 11,000 case actions pending in the Portal? That is potentially 11,000 cases - families- who are waiting either to get certified, have a change worked, get their address changed on their cases, etc etc etc. How about those things should have been explored BEFORE rolling out AT ALL. Everyone knew TIERS didn't work in the Pilot area before all this started.
A recent survey of more than 1,000 Texans enrolled in Medicaid and other programs found that these clients are ready for a change: 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.
Years ago, our local offices stayed open one day per week until 7. The hours between 5-7 p.m. were deadtime. Again, there is nothing wrong with making the programs more accessible to the clients we serve. BUT, given the amount of clients who have been directly affected by lost applications, long wait times on hold, going without Food Stamps, Medicaid and/or TANF- I'm sure they weren't really thinking THAT was the kind of change that was needed.
We recognize that many clients also like the security of having a state office nearby.
We will maintain more than 200 offices, and caseworkers will continue to be stationed in about 300 Texas hospitals and other medical facilities. By way of comparison, there are 71 Social Security offices and 233 full-time drivers’ license offices in Texas.
When did people have to start reapplying for the Social Security every six months? How about Driver's Licenses.....I have to go every 6 months for that? No. I can PAY my own money and renew my license and it's good for 6 years. If everyone had to renew their license every six to 12 months, I can almost bet there would be far more than 233 full time DL offices. I can't believe this comparison is even being made.
These changes will allow Texans to choose the application method that works best for them. This approach has proved effective in other states.
They may be able to apply by phone, but so far actually GETTING any benefits has proved to be far harder than it was when they walked into a local office, saw an actual caseworker, and oftentimes walked out certified.
In Pennsylvania, a Web-based system receives more than half of its applications outside of normal business hours, and an Idaho system is most heavily used on Sundays.
I'm curious- how many Food Stamps does Pennsylvania issue monthly as a whole? I bet Harris County alone issues more. What about Idaho? You think they come anywhere close to the numbers Texas does? How do we compare Texas to these states? Are you kidding me?
We’re seeing similar results in Texas. The new system debuted in Travis and Hays counties in late January. Since that time, it has received more than 250,000 calls, including 18,000 calls and 1,600 Internet applications after normal business hours.
You received a lot of calls that either weren't answered ever, or they are repeat callers because the information provided by the call center employees was oftentimes INCORRECT or the client was simply put off and told to contact the local office.
We can provide better government at a better price. We at the Health and Human Services Commission are listening to our clients and responding with a system that offers greater access for Texans in need. It’s a common-sense approach that is long overdue.
You listened to clients say what they wanted, but did you listen to the people that do and have been doing this job for years and understand the population we actually serve? Who knows better what the needs are that our clients have? You, Mr Hawkins? I'm not sure I've ever read where you were once a worker in a local field office. Who really understands what services our clients seek? You think that with this new system- that the clients are in the offices less? No. They are now there more. Some, everyday. Faxing to TAA. Getting told TAA can't help them.
Glad to hear that you have so much respect for the actual employees who are out there trying to fix the mess that TAA has made for so many cases. I'm glad you are giving the proverbial pat on the back to those who have not 'jumped ship' and have stayed behind in offices that have lost over half of their staff- but none of their workload. I'm glad you are recognizing the staff that are still around, working late, working weekends- not for YOU Mr. Hawkins. Not to make YOU look good...oh no sir- it's to help the clients. Oh, and to keep those stats up- because we are still held accountable.
Albert Hawkins is Texas Health and Human Services Executive Commissioner



Anonymous said...

Isn't he reworking an old article he's used before? I know I've seen that thing about "banks" somewhere before now. How unoriginal of him. And AMEN to your comment about needing more driver's license offices if that required renewal every 6 months!

hhscsurvivalist said...

Very well said!

I was going to counter this on HHSC Survivalist but don't see how I could possibly have said it better!

The Feds have said that a phone call does not a signed application make. Therefore, Accenture cannot take these applications in the mail. They are back to doing Children's Medicaid only and they can't even get that part right! (KMO's - Kids Medicaid Only - is the EASIEST eligibility program to process.......)

"In the case of call centers, our analysis found that contracting for those services would save taxpayers more over five years when compared to state-run call centers."

Notice he said "our analysis"... that's because the Comptroller's Office's analysis could prove no savings. CPPP could not show any savings. I wonder if Hawkins and Accenture have learned W's "funny math".