Spin by Center for Health Care Policy Studies at the Texas Public Policy Foundation

Opinion: Wait's Out of Welfare; Why Aren't Critics Happy?

Mary Katherine Stout
Special to the Houston Chronicle
7/29/2006

 

Texas has undertaken an ambitious plan to overhaul the way applications for government assistance are handled. But over the last six months the plan has taken a pummeling at the hands of state employees unions and advocates for bigger government; they have relished the bad news and missteps dominating news reports of the new system.

 

Like blacksmiths facing the advent of the automobile, critics hope to forestall progress.

 

**I know that in our local office, we have long held the belief that if this system could work, and work WELL- benefitting the clients as a whole- we'd be all for it. 

 

In 2003, lawmakers directed the Health and Human Services Commission to establish and outsource call centers for all assistance programs, "if cost-effective." The commission contracted with a coalition of firms, led by Accenture, which began work late last year. The new system, allowing one-stop access to all assistance programs, was to be gradually implemented.

 

By using modern tools that have become standard conveniences — such as the Internet and phone (Internet and phone that a majority of our clients do not even have, but ok) — the new system is designed to control costs, increase efficiency and improve client accessibility. Rather than relying primarily on in-person interviews in a field office (which helps to insure a case is done correctly, and accurately- as the client is RIGHT THERE WITH YOU- also preventing fraud in that you could verify who you were interviewing) with limited hours of operation (easily solved if you only extend office hours in local offices- oh wait!  We did that and the response was deadtime), the new system also allows applicants extended hours by phone, and 24-hour online access (they can call an automated line RIGHT NOW in the "old world" 24/7 to check the status of their case.  That has always been available).

 

Real and perceived problems have stalled implementation. Meanwhile, critics have promoted stories of miscues, such as claims applications were inappropriately faxed to a warehouse in Seattle. The commission found that incident resulted from accidental misdialing by applicants, yet those opposing the new system wrongly cling to it as evidence of malfeasance.

 

Critics claim the old way is best and should be rebuilt, while others believe privatization will modernize the system.

 

In early July, 30 Texas House members sent Health and Human Services Commissioner Albert Hawkins a letter, expressing support for the new system and its promise to "bring administration of human services programs in Texas into the 21st century."

 

Two days later, 60 other members of the House sent a different letter to Hawkins, urging him to cancel the contract. They asked him to "commit the remaining resources to rebuild the human services eligibility system that, as little as two years ago, was among the best in the country."

 

The contrast in positions could not be more stark.

 

Of course, the old system — "the best in the country" (best in the country which was proven by way of accuracy rates and ENHANCED FUNDING BONUSES PAID TO THE TEXAS GENERAL FUND)— still serves most recipients of state assistance, since the new system isn't available statewide. Critics pan the new system, holding a seemingly romanticized notion of the old ways. Perhaps they should consider what the "old" system was like.

 

In a recent visit to a field office outside the "pilot" area, I sat for two hours in a room with dozens of people, many of whom arrived long before me, and would remain long after I left. One man was in the same office the day before, only to be told that his application couldn't be finished that day and he would need to return the next. On day two he arrived 50 minutes early for an 11 o'clock appointment, but wasn't seen until after 4 p.m.

 

As one woman waited more than three hours for her appointment, she said the rule of thumb was to "pack a lunch." She later learned her name had been called while stepping outside, missing her "appointment." She was instructed to return the next day, despite protests she had other state-required appointments to keep and difficulty in finding transportation.

 

Considering her instructions to return the next day, perhaps she will also begin taking a sleeping bag.

 

The waiting room had no reading material, no information on finding a job, getting a degree, locating community resources, getting parenting guidance or child care. While waiting, some attended to their children; others talked on their cellular phones.

 

Most people spent hours just waiting — unproductively. (I would hope that you aren't making the broad generalizations based on a visit to one office.  I know that in the office I work in, I see upwards of 10-15 appointments everyday ON TIME.  I certify my clients timely.  I assure you that you would not find that to the be the case every single day in every single office.  To write about it based on that one experience is wrong.)

 

While many would argue this is the result of short-staffed offices (that is EXACTLY why this is happening across the state- some offices have lost anywhere from 20% to 80% of their staff!  What in the world can anyone expect? If the only grocery store in town lost 80% of its checkers, what kind of wait do you think that would cause?), the reality is that there is no excuse for a horse-and-buggy system when considering the technology now available (That horse and buggy system never had a client waiting MONTHS for their Food Stamp case to be completed.  Everyone involved with TIERS knows it does NOT WORK like SAVERR does). A system that treats people with such lack of dignity, and with no respect for their time, is simply indefensible. (Thank your local Congressmen and Albert Hawkins for that).

 

At one time many of the new system's critics would have agreed. For years they pointed to the inconvenience of going to a field office for in-person interviews (just FYI- but now that we are doing virtually ALL phone interviews, clients are realizing that coming in isn't that big of an inconvenience if that means their case could be finished the same day.  When doing interviews by phone, 99% of the cases must be delayed for futher information-information that the client may have had with them at the interview had it been a face to face interview), highlighting the virtues of one-stop shopping and demanding change based on client dissatisfaction. Dissatisfaction with the system they now claim is superior to all others. (Dissatisfaction with a system that actually got people CERTIFIED timely.  Clients are like anyone else- if you tell them you can make something easier, they are all for it- but in non-pilot areas- we are dealing with clients that are in the TIERS system that practically beg local office staff to please take them OUT of the "new and improved system" and let them stay in the old system....of course, we are 'told' that is not possible- even though everyone knows that it is).

 

Reports of real problems in the new system cannot be taken lightly, and taxpayers should demand efficiency for every tax dollar. But calls to end the project and return to the old way are simply insufficient. To ignore the opportunity to deliver services more efficiently for taxpayers and more conveniently for the recipients, despite having the resources to do so, is unacceptable.

 

The state must move forward using well-established technologies that deliver better efficiency for taxpayers, along with greater convenience for the recipients of state benefits.

 

Mary Katherine Stout is the director of the Center for Health Care Policy Studies at the Texas Public Policy Foundation, a nonprofit research institute based in Austin.

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