Wednesday, May 10, 2006

State takes back aid task

My comments in RED.
 
State takes back aid task
Web Posted: 05/10/2006 12:00 AM CDT
Guillermo X. Garcia
Express-News Staff Writer
 
Effective immediately, state workers again will be responsible for processing applications for assistance programs such as food stamps and Medicaid after myriad problems resulted with the private company hired to do the job.
 
(Surprise, Surprise......how many of us in HHSC knew this was going to happen?)
 
Bermuda-based Accenture LLP won an $899 million, five-year contract early last year to take over the state's public assistance eligibility system.
The switch comes about as state Health and Human Services officials acknowledge flaws with several components of the system, which is supposed to help applicants compile the information that's used to determine eligibility for public assistance programs.
 
State workers will continue to make the determination of whether an applicant qualifies.
 
Advocates for children and the poor have been critical of Accenture's work, attributing to the company a steep decline in the rolls of the Children's Health Insurance Program and a drop in the number of children covered by Medicaid.
 
The commission says the problems must be addressed and corrected, although it doesn't have a time frame by which it expects the problems to be fixed.
 
Among the problems:
 
Accenture workers have inadequate training and as a result are giving erroneous or contradictory information to applicants.
 
(Training to learn Food Stamp, TANF, and Medicaid Policy is more than just getting a quick tips handout.  The policy is involved, complicated, and different for each program.  What is done in Food Stamps is not necessarily what is done in TANF or Medcaid....)
 
 
Program software is incompatible, causing delays in application processing and forcing workers to manually input information.
 
State eligibility offices are understaffed because of the departure of thousands of state workers who feared they would lose their jobs when Accenture took over.
 
(And what's funny is that HHSC encouraged its staff to go to CPS.  All these agreements were made to place HHSC staff, etc....and now look at the condition of local offices....a mess.)
 
Those understaffed state offices now will be required to deal with thousands of cases that are to be transferred out of Accenture's control.
 
(Lovely.  I know I'm not looking forward to getting work back that I could have had finished months ago if the process had just been left alone.)
 
"If the contractor is not able to do the job it promised it could do, (the task) is going to again fall on state workers, who are already working in understaffed offices ... which means their already unmanageable caseloads just got bigger, which means more (people) will suffer or not get the benefits they are entitled to," said Celia Hagert of the Center for Public Policy Priorities, an Austin-based nonprofit agency that researches issues affecting low-income Texans.
 
(Exactly.  Say I have 100 cases pending.  Timely applications.  Not delinquent.  I get an assignment of say, 100 more to do from TAA that are already delinquent.  Now, all of them will be done late, because it's too much.)
 
It is another unusual step in a controversy-filled project that began with the state's goal of streamlining a system that Health and Human Services officials said was inefficient and bloated.
 
In 2003, state officials said they wanted to revamp the entire eligibility system to allow applicants more options when they applied for public assistance. The Legislature that year passed HB 2292, a massive bill that reorganized the state's health care system.
A cornerstone of the legislation allowed HHSC to determine if privatization would suit the state's needs.
 
A debate has ensued, pitting advocates for the poor against the state's health care bureaucracy and Accenture, the multinational private company that now operates the system.
 
State officials said they wanted to do away with long waiting lines at state welfare offices, so Accenture launched a program that would replace the face-to-face application process with one available over the Internet or the phone.
 
(Long waiting lines?  Maybe in the big urban offices. But middle sized offices/cities and smaller cities didn't experience that.  Long waiting lines often came from staffing issues- due to turnover in large cities......not the 'process' by which to get benefits.....phone interview do NOT speed the process- if anything, it delays it.)
 
But the transfer to a privately run operator has been far from smooth, state officials acknowledge.
 
Citing numerous operational problems, HHSC twice in recent months postponed rolling out its highly touted electronic eligibility system, which it said was projected to save Texas about $390 million over five years.
 
"We have no expectations about when we move forward, but the delay will continue until we see improvements. We know adjustments need to be made, and they will be," HHSC spokeswoman Stephanie Goodman said Tuesday.
 
Beginning in meetings with senior agency staff last Friday and continuing with meetings with lower level supervisors and front line agency workers Monday, word leaked out about the changes that are expected to be formally announced today.
 
The system operated by Accenture includes four privately run call centers around the state that eventually will replace hundreds of local offices staffed by state workers.
 
Already, the San Antonio call center, which is to serve a large swath of South Texas, has become the largest in the state, employing more than 500 workers.
 
It is not clear what other tasks the private workers will be performing because the jobs they were supposed to do will now be done by public employees.
 
More than 5,000 cases that had caused a backlog at the Midland call center also will be turned over to state workers for disposition.
 
Those cases have been pending for months.
 
Some of the cases being transferred from Midland have been pending since January, months past the time frame required by federal rules, state employee union officials said.
 
(yes, we have seen applicants who applied in January who are STILL without benefits-this type of delay would have been UNHEARD OF in the local offices before call centers- UNHEARD OF.  Workers have always been held accountable for this type of problem as have their supervisors- and I can assure you that had a caseworker with HHSC consistently not gotten applications done in 30 days, they'd have been TERMINATED.)
 
Those officials and veteran Health and Human Services employees say dealing with the backlog is only going to aggravate a morale problem for what they say are already overworked state employees.
 
(Bonuses are nice and all- but at the rate we are going, all of us will have to use the bonuses for stress management and therapy.)
 
The state planned to save money by having Accenture compile and screen applications, a task previously handled by state caseworkers. Health and Human Services officials said that by having private employees do the job faster and more efficiently through use of more advanced computer technology, the state could reduce the number of state workers on its rolls.
 
But because of the persistent problems, the agency's plan has been put on indefinite hold.
 
"We know we need to make adjustments, and with a program of this size, that is not a minor effort," spokeswoman Goodman said. "This is a (problem) with short-term impact, but it is a good system and a good program that works, and we will continue with it."
 
(A good program?  When?  A short term impact?  When clients go without Food assistance and Medical assistance for MONTHS- that is not short-term to THEM, is it?.......I'm glad HHSC continues to paint rosy pictures.......) 

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