Wednesday, May 03, 2006

Texas Facing Fundamental Change in Social Services System

Texas Facing Fundamental Change in Social Services System
Chad Vander Veen
Government Technology
Fundamentally changing how government programs operate is never easy -- and changing entitlement programs is nearly impossible. Such is the issue facing Texas.
The Texas Health and Human Services Commission (HHSC) is in the midst of a systemwide overhaul of its functionality, and one component of that effort is altering how the HHSC delivers social services.
As part of its overhaul, the HHSC eliminated nearly one-third of its brick-and-mortar human services offices in favor of four centralized call centers. These call centers are supposed to streamline the application process for Texans looking for state benefits.
The HHSC's decision to turn to call centers stirred debate and plenty of newspaper coverage. Central to the ongoing debate is the problem of public policy lagging technology.
No Dotted Line
Food stamps are one of the most commonly sought benefits, and the HHSC intended to create a fully integrated eligibility system Texans could use to apply for these benefits. The result is the Texas Integrated Eligibility Redesign System (TIERS), privately managed through a contract with technology consultant Accenture.
TIERS is a multiyear project designed to create an integrated, Web-based eligibility determination system for health and human services programs in Texas, the HHSC said, and eligibility workers at the call centers were to use TIERS to assess eligibility and deliver food, cash assistance, medical and community-care services to needy Texans.
With the call centers in place and TIERS operational, the HHSC had planned on Texans telephoning the call centers to apply for benefits. But that created a problem.
The Food Stamp Act of 1977 required that food stamp applications have a physical signature from the applicant -- which is impossible over the phone. Thus, an unanticipated controversy was created.
The U.S. Department of Agriculture's (USDA) Food and Nutrition Service (FNS), the agency responsible for issuing food stamps, said Texas must comply with the federal law. The HHSC, meanwhile, said it believes the law does not preclude the state from accepting a phone call in lieu of a physical signature.
Letter of the Law
The Food Stamp Act, like many laws, understandably failed to take into account uninvented technologies at the time of the law's passage. Both the FNS and the HHSC cited passages from the Food Stamp Act to support their case.
Section 11(e)(2)(B)(iv) reads that state agencies shall "consider an application that contains the name, address and signature of the applicant to be filed on the date the applicant submits the applications."
According to the FNS, oral consent does not constitute a signature.
The HHSC cited section 2020(e)(2)(C), which reads, "Nothing in this Act shall prohibit the use of signatures provided and maintained electronically, storage of records using automated retrieval systems only, or any other feature of a state agency's application system that does not rely exclusively on the collection and retention of paper applications or other records."
Texas claims this indicates that a phone call can replace a physical signature.
The disagreement stems from interpreting the law, according to HHSC Communications Director Stephanie Goodman.
"Our interpretation is the law would allow us to take a signature by phone, but the USDA disagrees," she said. "The idea was to speed the process as much as possible. Since the start of your benefits would track to your application date, if we could take the signature by phone -- which we think the law allows us to do -- then the onus is really on the state to process that application more quickly, and the benefits would start that date."
The HHSC claims that giving a telephone call the same faculty as an actual signature, or even an e-signature, would significantly improve needy Texans' ability to get aid. Under the traditional method, food stamp application benefits don't start until a person has received an application, correctly fills out, signs and returns it to the state.
According to Jean Daniel, a spokeswoman for the USDA, the FNS is open to helping the HHSC offer better access.
"This is a matter of the law catching up with technology," she said. "We at the federal government are open to innovative strategies to more efficiently serve clients. We've been working in partnership with the state on this."
But the USDA says the law is clear.
"Under the new call-center model, when people call in for food stamps, there must be a signature on the application," she said.
This means call centers can't actually accept a phone call in place of an applicant's signature, and must instead refer callers to other application methods.
"When people call in now," Daniel continued, "the application is sent to them, they fill it out, they send it [back], and when the application is returned to the state, the timetable for processing applications starts."
Forging Ahead
Despite the debate, the HHSC rolled out the new call centers and TIERS after modifying its original food stamp application processes. The fix, however, doesn't really make applying for food stamps any easier. In fact some say the change makes it even more difficult to get food stamps than before.
By rolling out TIERS without resolving the signature issue, those applying for food stamps run into a problem.
To remedy the situation while the issue is being ironed out, the HHSC is taking the process of emergency food stamp applications -- which can be granted in days instead of weeks -- and using that for standard applicants, according to Goodman. The trouble is that it requires an applicant to either apply online, via mail or fax, or the most common method, at a local office -- many of which no longer exist due to consolidation.
According to a comprehensive Feb. 7, 2006, report conducted by the Austin-based Center for Public Policy Priority -- a self-described "nonpartisan, nonprofit 501(c)(3) research organization committed to improving public policies and private practices to better the economic and social conditions of low- and moderate-income Texans" -- the temporary fix Goodman spoke of doesn't help at all.
"The call centers will not accept applications for food stamps over the phone," the report reads. "Instead, they will direct applicants to apply online, via the mail/fax or at a local office. This is likely to cause a delay in the filing date for many families who don't have access to the Internet and can't get to a local office. Any delay in the filing date also means a cut in benefits for these families in the first month," the report continued, highlighting the fact that applicants get retroactive benefits from the date of application, which the phone call was supposed to substitute.
Meanwhile, the FNS will observe and monitor the remaining test phase of the call center/TIERS rollout. Currently operating in only two counties -- Travis and Hays -- the launch date was Jan. 20, 2006, with statewide rollout expected in six months.
Whether the phone call controversy will be resolved remains unclear. However, both the state and federal government are attempting to work together and toward improving access, though neither side was able or willing to explain if, how, or when the situation will be resolved.
"Since Jan. 20 through Tuesday [Feb. 14], we've gotten 36,500 calls, and we've also had more than 300 Internet applications come in," said Goodman. "Especially for the working poor, we felt it was really important to give them options other than eight to five on how they could apply for services. When they're not at work, they're generally not getting paid, so it's a real hardship."
On the federal side, Daniel expressed hopefulness that they can resolve things.
"We've certainly continued our partnership with the state. We have walked them through what is needed to start the application process at the time of the phone call," she said. "We continue to work in partnership with them."

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Anonymous said...

I have a memo from Denise Moore saying that HHSC staff will have to work applications "from TAA." I'm assuming that state employees will be doing the work that TAA couldn't do. Does anyone know how many cases have been sent back to HHSC to be worked? The memo says that some of these applications are dated January 2006

hhscsurvivalist said...

Those apps that are being returned from TAA are already delinquent! File dates as far back as Feb. My understanding is that the clients had mailed these apps to TAA in error and they are just now returning it. (That's their story and they're sticking to it...). What I would like to know is, why didn't they look at them when they received them in Feb???? Do you think we at the local office would get away with leaving an app sitting around for 30 plus days?!?!

Anonymous said...

ANYBODY HEARD ANY RUMORS TODAY...regarding accenture wanting out of the contract?
Word is they are thinking about scrapping tiers and going back to saverr...
any ideas?
have yall heard anything about thousands of applications being lost? they were never imaged...sounds like trouble between the mail room and imaging room...
Our unit rec'd some of those delinquent guy had turned in two via the internet.
I told my supervisor, they should have had some kind of program onthe internet application that when the zip code was put in it kicked it back out and told them where to go and apply.