Privatization lessons learned-Austin American Statesman
Undoing the damage-Texas Health and Human Services acknowledges the shortcomings of its privatization plan - Houston Chronicle
Texas scales back plan to privatize its social services
By LIZ AUSTIN PETERSON-Associated Press
Blogs commenting on the "mess":
HHSC Reverses Course on Welfare Privatization - Fr. John Whiteford
More Privatization Tales - Eye on Williamson County
State finally cuts bait on Accenture - OfftheKuff
Wasn't Such a Good Idea to Privatize Social Services with Accenture (Remember them? Used to be Arthur Anderson Before ENRON!) - Somervell County Salon
Accenture gets the Clear Lake Axe - Bay Area Houston
Saturday, December 30, 2006
Friday, December 29, 2006
Full Speed Ahead into 2007!
Remember when I posted a reader's letter to many reps/state officials regarding the Women's Health Program?
Well, that reader has received ANOTHER response...this time from the Comptroller's Office...it was posted in the comments, but I feel it's worthy of being on the blog itself so no one misses it:
This was from the Comptroller's office:
Well, that reader has received ANOTHER response...this time from the Comptroller's Office...it was posted in the comments, but I feel it's worthy of being on the blog itself so no one misses it:
This was from the Comptroller's office:
Dear (worker):
Comptroller Strayhorn has received your e-mail regarding Medicaid's new
Women's Health Program, its potential negative impact on the troubled TIERS
system and potential problems that could result for families receiving other
types of financial assistance.
She has asked me to respond to you. We are forwarding a copy of your e-mail
without your name to the attention of Anne Heiligenstein, Deputy Executive
Commissioner for Program Services, Health and Human Services Commission. Alert local employees are often the first to realize potential problems and issues
involved in the application of new policies, programs and procedures within the
context of complex systems.It is important for staff to stand up and be heard so that unforeseen negative consequences can be avoided. We applaud you for having the courage to do so. We are confident that Ms. Heiligenstein will investigate your concerns and make any appropriate changes in the Commission's plans so that the new program can proceed without creating additional problems for our state's neediest families.
If you need further assistance, please contact me by e-mail at vicki.anderson@cpa.state.tx.us.
Sincerely,
Vicki AndersonLet this response serve as a reminder to all of
us "in the field"- your voice CAN be heard. I encourage everyone willing to email whoever you can as much as you think possible to get the word out. We do have a voice, and we WILL be heard.--hhscemployee
Saturday, December 23, 2006
Merry Christmas!
I'm going to take a break from all things HHSC for the Holidays, but let me say to anyone reading here that I wish you a VERY MERRY CHRISTMAS and a GREAT 2007!
To my fellow workers: The work you do for the people in the State of Texas means something. You continue to work under very pressured conditions, yet somehow we are able to help those who need us. Because of the work we do, there are families in Texas who will be able to have a little hope for the holidays and the New Year. No matter the pressure we feel from those "in charge"- what you do is important. We are feeding children, keeping kids covered under Medicaid so they can get medical care, and we are helping those who need us make a better life for themselves and their families. Don't let anyone "out there" make you feel like you aren't in the business of HELPING OTHERS. We are. We can make this agency what it once was. We just must continue on trying to get others to see the same things we do.
To my fellow workers: The work you do for the people in the State of Texas means something. You continue to work under very pressured conditions, yet somehow we are able to help those who need us. Because of the work we do, there are families in Texas who will be able to have a little hope for the holidays and the New Year. No matter the pressure we feel from those "in charge"- what you do is important. We are feeding children, keeping kids covered under Medicaid so they can get medical care, and we are helping those who need us make a better life for themselves and their families. Don't let anyone "out there" make you feel like you aren't in the business of HELPING OTHERS. We are. We can make this agency what it once was. We just must continue on trying to get others to see the same things we do.
In the News
Of course, we all know HHSC has been in the news quite a bit for the last few days...rather than link every article, you can check them out by clicking HERE.
Women's Health Program
I got this from someone who sent the following to all his/her reps......it would be great if any and everyone could take this letter and send it to their reps as well:
I sent this email or a little longer version to all the State representatives and Senators (also dewhurst) I may not be working by the end of the week, but I will get heard..
Dear Representative whoever:
Let me start by introducing myself. My name is Worker (used my real name and Town in the emails) and I am a Texas Works Advisor in Whereeveryouare, TX. As you most likely know by now, HHSC has been trying to push to get privatization for the issuance of State benefits (Food Stamps, Medicaid and TANF) for quite some time now, and have had limited success to say the least. The Feds have put a hold on any further rolling out of the system until HHSC can show that the system works.
HHSC is going to start a new Medicaid program on January 1st, called "The Women's Health Program." It is explained in Texas Works Bulletin 07-05 (http://www.dads.state.tx.us/handbooks/TexasWorks/res/Bulletins/index.htm) In theory, it sounds like it could benefit a lot of women in Texas, but there are a couple of issues that I am concerned with.
The program is designed to help women between the ages of 18 through 44 who meet the eligibility criteria. This limited benefit Medicaid program provides health screenings and risk assessment exams for preventable conditions. It also provides family planning counseling and contraceptives to eligible women. The problems that I have with the program have really started to bother me:
1.) It is not a full coverage Medicaid program. The women that would qualify for this program are probably not going to be able to get any treatment for problems that are found…It provides coverage for gynecological exams, related screenings, and birth control. If during any of the exams or screenings a problem is found, they have no medical coverage to pay for any related treatments or medications. They are probably over the income limit for adult Medicaid and TANF, or they would more than likely be on one of those programs already. It doesn't make sense to me to cover someone for a diagnosis, but then not let them be helped for treatment.
2.) This program is being worked through the TIERS system. It has already been shown that this system is flawed, and the government has put a hold on any further rolling out of this system. All of these women between 18 and 44 that apply and are certified for this Medicaid program are going to be in the TIERS system, which means that all associated cases that they have (Food Stamps, Children's Medicaid, etc.) are going to be converted to TIERS cases, along with all other people on those associated cases. In my estimation, in any given week probably 40% to 60% of the women applying for Adult Medicaid in my office are doing so to get birth control. Being the pessimist that I am, I am seeing this program as a ploy to get more people into the TIERS system, so that if and when the powers that be realize that the system is too flawed and cannot save the state any money, there will be too many clients in the "new" system to just trash it and return t the "old" system (which is still working fine.) Once a person is taken off of the SAVERR system and put into TIERS, they can't be put back (although there used to be a way to correct mistakes that would put clients back into the SAVERR system.)If I were a woman between the ages of 18 and 45, and there was a program that would help me to get birth control plus medical screenings for women's problems, I think I would jump at it. If I knew anything about the problems with the TIERS system, and knew that I was going to have to have all of my cases worked through that system for the rest of time, I might think twice before applying. Couldn't this program be implemented through the SAVERR system? They have created more complex programs through this system before.What I am trying to say is that the public (and our government) need to be informed COMPLETELY about this program before it is implemented. Something has to be done to keep all of these clients from being converted to the TIERS system, or there may be more problems than anyone wants to deal with.Thank you for your time, and I apologize that I am sending this so late in the game. I am not a political activist; I just kinda go with the flow of things…usually.
This whole privatization issue has bothered me from the start, mainly because of the way that things were done, not the privatization itself, and I guess I have just gotten fed up. It seems that since HHSC has been stopped from rolling out anywhere else, they are going to virtually roll out with numbers of clients instead of with actual offices in areas.This privatization is adversely affecting workers, clients and it seems the general public now.
Please feel free to forward, cut & paste, or otherwise get this letter to whomsoever you see fit to inform them of the issue. I would rather be kept anonymous for obvious reasons, but if you need or want to, you may use my name and address as a source.
The sender then received a response to his/her letter which - with permission - is being posted below:
Dear Mr./Mrs. (Worker):
Thank you for your information regarding The Woman's Health Program. I understand your concerns with this issue, and it is something our office will research further. I agree with you about the problems associated with the Texas Integrated Eligibility Redesign System (TIERS).
In a report issued by the Texas Comptroller' s office in October, TIERS was credited with having many difficulties, such as not processing dates correctly, not distinguishing between eligible and ineligible members in a household, and failing to determine residency status.Thank you again for the additional information, we appreciate it.
If you have any questions in the future, please do not hesitate to contact our office again.
Thanks
Katherine
Katherine Frolow
State Representative
Pete P. Gallego
Texas State Capitol - 4S.5(o) 512-463-0566(Second e-mail)
One thing I found interesting was that in the Q&A last week (was it last week?) someone had asked about this:
According to Texas Works Bulletin 07-05, applications for the Women’s Health Program are to be processed by special Texas Works Advisors in TIERS. Does this mean the rollout has resumed? This will increase the workload for the workers who are trained in TIERS. Is the state looking at providing training for this program?
Applications for the Women’s Health Program, which begins Jan. 1, will be processed in TIERS by a new HHSC eligibility unit created just for this program. The new unit has 34 staff, including 25 eligibility advisors, who will process all Women’s Health Program applications statewide. These employees are receiving training in TIERS and the new program and will be ready to process applications Jan. 1. The rollout of the new eligibility system remains on hold.
Of course, you realize the Q&A did NOT address the fact that once a client is certified for this program, all cases will convert to TIERS which means LOCAL ART WORKERS will be the ones having to process those applications and reviews. The "new unit" will only certify someone for the WHP, not have to deal with overflow that will occur when this client's other cases end up in TIERS.
I sent this email or a little longer version to all the State representatives and Senators (also dewhurst) I may not be working by the end of the week, but I will get heard..
Dear Representative whoever:
Let me start by introducing myself. My name is Worker (used my real name and Town in the emails) and I am a Texas Works Advisor in Whereeveryouare, TX. As you most likely know by now, HHSC has been trying to push to get privatization for the issuance of State benefits (Food Stamps, Medicaid and TANF) for quite some time now, and have had limited success to say the least. The Feds have put a hold on any further rolling out of the system until HHSC can show that the system works.
HHSC is going to start a new Medicaid program on January 1st, called "The Women's Health Program." It is explained in Texas Works Bulletin 07-05 (http://www.dads.state.tx.us/handbooks/TexasWorks/res/Bulletins/index.htm) In theory, it sounds like it could benefit a lot of women in Texas, but there are a couple of issues that I am concerned with.
The program is designed to help women between the ages of 18 through 44 who meet the eligibility criteria. This limited benefit Medicaid program provides health screenings and risk assessment exams for preventable conditions. It also provides family planning counseling and contraceptives to eligible women. The problems that I have with the program have really started to bother me:
1.) It is not a full coverage Medicaid program. The women that would qualify for this program are probably not going to be able to get any treatment for problems that are found…It provides coverage for gynecological exams, related screenings, and birth control. If during any of the exams or screenings a problem is found, they have no medical coverage to pay for any related treatments or medications. They are probably over the income limit for adult Medicaid and TANF, or they would more than likely be on one of those programs already. It doesn't make sense to me to cover someone for a diagnosis, but then not let them be helped for treatment.
2.) This program is being worked through the TIERS system. It has already been shown that this system is flawed, and the government has put a hold on any further rolling out of this system. All of these women between 18 and 44 that apply and are certified for this Medicaid program are going to be in the TIERS system, which means that all associated cases that they have (Food Stamps, Children's Medicaid, etc.) are going to be converted to TIERS cases, along with all other people on those associated cases. In my estimation, in any given week probably 40% to 60% of the women applying for Adult Medicaid in my office are doing so to get birth control. Being the pessimist that I am, I am seeing this program as a ploy to get more people into the TIERS system, so that if and when the powers that be realize that the system is too flawed and cannot save the state any money, there will be too many clients in the "new" system to just trash it and return t the "old" system (which is still working fine.) Once a person is taken off of the SAVERR system and put into TIERS, they can't be put back (although there used to be a way to correct mistakes that would put clients back into the SAVERR system.)If I were a woman between the ages of 18 and 45, and there was a program that would help me to get birth control plus medical screenings for women's problems, I think I would jump at it. If I knew anything about the problems with the TIERS system, and knew that I was going to have to have all of my cases worked through that system for the rest of time, I might think twice before applying. Couldn't this program be implemented through the SAVERR system? They have created more complex programs through this system before.What I am trying to say is that the public (and our government) need to be informed COMPLETELY about this program before it is implemented. Something has to be done to keep all of these clients from being converted to the TIERS system, or there may be more problems than anyone wants to deal with.Thank you for your time, and I apologize that I am sending this so late in the game. I am not a political activist; I just kinda go with the flow of things…usually.
This whole privatization issue has bothered me from the start, mainly because of the way that things were done, not the privatization itself, and I guess I have just gotten fed up. It seems that since HHSC has been stopped from rolling out anywhere else, they are going to virtually roll out with numbers of clients instead of with actual offices in areas.This privatization is adversely affecting workers, clients and it seems the general public now.
Please feel free to forward, cut & paste, or otherwise get this letter to whomsoever you see fit to inform them of the issue. I would rather be kept anonymous for obvious reasons, but if you need or want to, you may use my name and address as a source.
The sender then received a response to his/her letter which - with permission - is being posted below:
Dear Mr./Mrs. (Worker):
Thank you for your information regarding The Woman's Health Program. I understand your concerns with this issue, and it is something our office will research further. I agree with you about the problems associated with the Texas Integrated Eligibility Redesign System (TIERS).
In a report issued by the Texas Comptroller' s office in October, TIERS was credited with having many difficulties, such as not processing dates correctly, not distinguishing between eligible and ineligible members in a household, and failing to determine residency status.Thank you again for the additional information, we appreciate it.
If you have any questions in the future, please do not hesitate to contact our office again.
Thanks
Katherine
Katherine Frolow
State Representative
Pete P. Gallego
Texas State Capitol - 4S.5(o) 512-463-0566(Second e-mail)
One thing I found interesting was that in the Q&A last week (was it last week?) someone had asked about this:
According to Texas Works Bulletin 07-05, applications for the Women’s Health Program are to be processed by special Texas Works Advisors in TIERS. Does this mean the rollout has resumed? This will increase the workload for the workers who are trained in TIERS. Is the state looking at providing training for this program?
Applications for the Women’s Health Program, which begins Jan. 1, will be processed in TIERS by a new HHSC eligibility unit created just for this program. The new unit has 34 staff, including 25 eligibility advisors, who will process all Women’s Health Program applications statewide. These employees are receiving training in TIERS and the new program and will be ready to process applications Jan. 1. The rollout of the new eligibility system remains on hold.
Of course, you realize the Q&A did NOT address the fact that once a client is certified for this program, all cases will convert to TIERS which means LOCAL ART WORKERS will be the ones having to process those applications and reviews. The "new unit" will only certify someone for the WHP, not have to deal with overflow that will occur when this client's other cases end up in TIERS.
Thursday, December 21, 2006
Other Links/News
Eye on Williamson County has a post up today regarding fraud within HHSC.....
Dig Deeper Texas has a post up (kinda late in posting this, sorry) regarding Albert Hawkin's involvement with the Texas Health Institute.
****************************************************
TEXAS STATE EMPLOYEES UNION
EMAIL BROADCAST UPDATE TO MEMBERS
VICTORY FOR TSEU, TEXANS
HHSC announces partial cancellation of IEES/Accenture project
"New Strategy" could be beginning of the end for failed experiment
HHSC will announce publically later today a "new strategy" on its call center experiment and the Accenture contract. In a tacit acknowledgment that the experiment is a failure, HHSC will
* Drop most plans for Accenture to do eligibility work. The HHSC announcement says that in the "rebalanced model" Accenture will scan the case documents into the system, run data-broker checks, and report the information to state staff, who will proceed with the case.
* The JSAP system put in place to decide who will get state jobs under the new system will be scrapped.
* 900 Texas Works positions that are currently considered temporary positions will be converted to regular full-time positions
* Cut the contract by $356 million (about 30%) and end it in 2008 instead of 2010
* Accenture will take over direct operation of CHIP eligibility from Maximus. (This is probably the result of Maximus' plans to reduce its participation in the IEES project after losing nearly $50 million on the "Texas Project" in 2006)
* No further roll-out with Accenture. The pilot in Travis, Hays, and Williamson counties will be resumed "after a rigorous readiness review" and "with a more limited role for the vendor". No other roll-out will be attempted before the contract ends in 2008.
* The HHSC announcement also says that TIERS will be rolled out statewide over about 18 months beginning in January 2007.
TSEU'S POSITION:
It's a good start. Now, cancel the contract, rebuild eligibility, look hard at TIERS.
The announced changes are a welcome sign that HHSC is moving in the right direction in managing this failed experiment, but the $543 million that will still go to Accenture will be wasted, and the time from now to the end of 2008 will be wasted trying to keep a failed experiment on life support.
* The contract with Accenture should be cancelled. Several provisions allow the state to cancel at any time. We have already paid Accenture over $120 million and there is no indication that the State of Texas will get any value from this contract: the remaining $543 million will be throwing good money after bad.
* We should start right away on rebuilding our capacity to provide human services eligibility to the people of Texas . Converting the temporary positions to regular status is a start, but we need to hire an additional 1000 or more staff, and rebuild our capacity to train them.
* Before we commit more resources or cases to TIERS, the whole system must be evaluated by competent staff who are not paid by HHSC. If the system can be fixed, it should be. If it cannot be fixed, it must be replaced
Dig Deeper Texas has a post up (kinda late in posting this, sorry) regarding Albert Hawkin's involvement with the Texas Health Institute.
****************************************************
TEXAS STATE EMPLOYEES UNION
EMAIL BROADCAST UPDATE TO MEMBERS
VICTORY FOR TSEU, TEXANS
HHSC announces partial cancellation of IEES/Accenture project
"New Strategy" could be beginning of the end for failed experiment
HHSC will announce publically later today a "new strategy" on its call center experiment and the Accenture contract. In a tacit acknowledgment that the experiment is a failure, HHSC will
* Drop most plans for Accenture to do eligibility work. The HHSC announcement says that in the "rebalanced model" Accenture will scan the case documents into the system, run data-broker checks, and report the information to state staff, who will proceed with the case.
* The JSAP system put in place to decide who will get state jobs under the new system will be scrapped.
* 900 Texas Works positions that are currently considered temporary positions will be converted to regular full-time positions
* Cut the contract by $356 million (about 30%) and end it in 2008 instead of 2010
* Accenture will take over direct operation of CHIP eligibility from Maximus. (This is probably the result of Maximus' plans to reduce its participation in the IEES project after losing nearly $50 million on the "Texas Project" in 2006)
* No further roll-out with Accenture. The pilot in Travis, Hays, and Williamson counties will be resumed "after a rigorous readiness review" and "with a more limited role for the vendor". No other roll-out will be attempted before the contract ends in 2008.
* The HHSC announcement also says that TIERS will be rolled out statewide over about 18 months beginning in January 2007.
TSEU'S POSITION:
It's a good start. Now, cancel the contract, rebuild eligibility, look hard at TIERS.
The announced changes are a welcome sign that HHSC is moving in the right direction in managing this failed experiment, but the $543 million that will still go to Accenture will be wasted, and the time from now to the end of 2008 will be wasted trying to keep a failed experiment on life support.
* The contract with Accenture should be cancelled. Several provisions allow the state to cancel at any time. We have already paid Accenture over $120 million and there is no indication that the State of Texas will get any value from this contract: the remaining $543 million will be throwing good money after bad.
* We should start right away on rebuilding our capacity to provide human services eligibility to the people of Texas . Converting the temporary positions to regular status is a start, but we need to hire an additional 1000 or more staff, and rebuild our capacity to train them.
* Before we commit more resources or cases to TIERS, the whole system must be evaluated by competent staff who are not paid by HHSC. If the system can be fixed, it should be. If it cannot be fixed, it must be replaced
News Release
NEWS RELEASE
Albert Hawkins
Executive Commissioner
Executive Commissioner
Date: Dec. 21, 2006
Contact: Stephanie Goodman or Ted Hughes, (512) 424-6951
Contact: Stephanie Goodman or Ted Hughes, (512) 424-6951
HHSC Announces New Strategy to Modernize Eligibility System
AUSTIN — The Texas Health and Human Services Commission (HHSC) today announced a new strategy to modernize the state’s eligibility system and make it easier for Texans to apply for services. Under the plan, the state will retain some functions originally envisioned to be performed by the private sector, reduce the terms of the contract, and change management of the Children’s Health Insurance Program (CHIP).
"We remain committed to implementing a system that works better for consumers and makes efficient use of taxpayer dollars," said Health and Human Services Executive Commissioner Albert Hawkins. "We have evaluated the results of our pilot and concluded that we need to take a different approach to achieve our goals."
Hawkins said the new strategy includes rebalancing the roles of the state and the private sector.
"Our goal from the beginning was to design a system that efficiently supports state workers and keeps complex decision-making in the hands of trained, experienced state employees," Hawkins said. "The pilot has shown us that we need to redraw the line between the state and private sector to clarify that the private sector is there to provide a support role to state staff."
In June 2005, HHSC concluded a competitive procurement process and entered into a contract with the Texas Access Alliance (TAA) for call center operations, CHIP processing and eligibility determination, maintenance of the TIERS computer system and enrollment broker services. Most of the functions, including CHIP processing, have long been performed by the private sector. The critical new elements in the contract included establishing call centers and moving some work currently performed by state eligibility workers to the private sector.
Under the original contract, for example, vendor staff image food stamp, Medicaid and TANF applications into the system and attempt to verify some information through independent sources. If an application lists no cars and the independent check indicates the household has a car, vendor staff attempt to resolve the discrepancy before sending the case to state staff. In the rebalanced model, vendor staff will image the case into the system, run the independent checks and submit all the information promptly to state staff who will decide how to proceed.
Within the contract, management of CHIP will change with Accenture taking over responsibilities previously handled by Maximus. CHIP eligibility determination, which is less complex than most other social service benefits, has been handled by a private contractor since the program’s inception in 2000. The state changed contractors in November 2005 and has noted several ongoing performance issues since that time. The most serious issue involved unnecessary letters to CHIP applicants requesting more information. A review found that in some of the cases, the requested information was either on the original application or had been received by the subcontractor and not attached to the case properly or within required timeframes. This issue led the state to implement manual checks to ensure that families were not inappropriately disenrolled.
Other elements of the state’s new strategy include:
Modernizing technology by converting cases statewide to the state’s new computer system. In early 2007, HHSC will begin a gradual conversion of 8 million food stamp, Medicaid and TANF clients to the Texas Integrated Eligibility Redesign System (TIERS). State workers will continue to process all cases, and all state benefits offices will remain open.
Recovering $30 million in state costs through service credits and discounts.
Reducing the contract by $356 million. The original contract was valued at $899 million and expired at the end of fiscal year 2010. The revised contract is valued at $543 million and ends after fiscal year 2008.
Resuming the pilot in Travis, Hays and Williamson counties with a more limited role for the vendor in food stamp, Medicaid and TANF cases once the technology solutions are in place to support improved performance. The state will not expand the pilot beyond the current three counties during the current contract term.
Converting 900 temporary positions in eligibility offices to regular-status positions to help stabilize the state workforce.
"We recognize that modernizing a system of this size and complexity is never easy," Hawkins said. "But we remain focused on implementing a system that finally allows Texans to choose how they want to apply for services, is built on modern technology and makes the most of limited state resources."
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Just received this...hmmmmmmm
HHSC to make announcement about Accenture deal
By Staff | Thursday, December 21, 2006, 10:14 AM
Texas Health and Human Services Executive Commissioner Albert Hawkins will make an announcement this afternoon about the state’s controversial $800 million-plus deal with the Texas Access Alliance, a commission spokeswoman said. The Texas Access Alliance, led by Accenture LLP, was hired to run an enrollment system for food stamps, Medicaid and Temporary Assistance for Needy Families. The privatization of tasks formerly done by the state was supposed to save the state money and make it easier for Texans to enroll by allowing them to sign up via phone, Internet, fax, mail or in person instead of just in person.
But when the private group took over in Hays and Travis counties nearly a year ago, the system became plagued with problems. Some Texans eligible for public assistance were declared ineligible or received benefits late. Hawkins delayed statewide rollout of the new system, and some legislators have called on him to cancel the contract. Commission spokeswoman Stephanie Goodman did not say what the announcement will be, but she did say: "I promise you a headline." Stay tuned.
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Saturday, December 16, 2006
Spin
I've read and re-read the article that is linked below, and something kept standing out to me and that was the response from HHSC:
"Commission spokesman Ted Hughes said that, although officials are sensitive to the stress workers are under, the shift is part of the transition to a more automated system. In the long run, the changes should decrease workloads for eligibility workers, Hughes said. Plus, it has already allowed people to apply for benefits over the phone or through the Internet, he said."
So, in reading that I'm struck - it's kind of like that spokesman from Iraq that would constantly get on TV and tell his people that Iraq was winning when we first went over there- although obviously everything he said was absolutely false.
Officials are sensitive to the stress workers are under? Is that why pressure continues to be put on local office staff that they must maintain timeliness? Integrity in cases? How does one do that when workers are having to see upwards of 20 appointments per DAY? What about the stress the clients are under, and take out on staff? There are folks in Texas who are going without benefits Mr. Hughes. WITHOUT MEDICAID, WITHOUT FOOD STAMPS, WITHOUT CASH ASSISTANCE TO PAY THEIR BILLS. What Mr. Hughes fails to realize is that when clients go without, it's US in the local offices that bear the brunt of THEIR frustration. WE are the ones blamed because their child needs a prescription filled and the Medicaid isn't done yet. It's us they blame when they have to go to the local food bank for help because there aren't enough hours in a day to see 20 clients and finish all the cases that are ready to be finished. What about, Mr. Hughes, the stress workers' families are going through while mom/dad are having to work late evenings and every weekend? In the long run the changes are going to decrease workloads? When is that Mr. Hughes? When TIERS works? When TAA figures out how to do their jobs?
Are we still harping on the "applying by phone" and "internet" thing? Seriously? Again, let's remember that while a client can call 2-1-1 and apply for Food Stamps- or PARDON ME- can give their info to an operator who will basically complete an application for them, then MAIL the application to them for their SIGNATURE and then refer the client to their LOCAL office- this is not "applying by phone". Internet? Apparently, we are all forgetting the clients we serve. Sir, most of our clients don't have PHONES much less internet. Let's not forget also, that it serves little purpose to apply by phone when one must still have an interview to get certified. When it's taking over a month to get an interview scheduled and THEN pended for more information- how convenient is THAT? How about this- for all the workers reading here- when a client calls you to complain at how long it's taking to get an interview or get their cases finished, tell them that at least now they have the option to apply by phone and the internet and ISN'T THAT GREAT?! After you get screamed at and told that applying by phone doesn't get them what they need- then tell them that THAT is the stance that those in charge take- that it's busy, and the offices are understaffed- BUT BY GOD CLIENTS CAN NOW APPLY BY PHONE AND INTERNET. See how that goes over and refer them to Mr. Hughes.
I wish every office in the State of Texas got with the Union and staged their own rally. I think it's amazing. It's time to do something. It's time to stop letting the puppets in State Office continue to pile work on and then say it's all great and wonderful.
If enough news gets created- then maybe someone will start listening.
Thursday, December 14, 2006
Rally in Waco!
Thanks for the links and the heads up commenters-
There was a "Rally" in Waco Tuesday- workers who are evidently fed up and feeling like their voices are not being heard.
You can read the article HERE
and you can watch the TV Spot HERE.
I would imagine that if you are interested in doing something in your area, you'd contact the Union.
Wow. Just wow.
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Friday, December 08, 2006
Let's Shake things up!
We've got quite an audience reading here guys....it's time to shake some of this up before the session starts in January.
Email me your stories. I'm going to post them all on this blog- we are going to put this out there. I think so far, employees who "complain" are doing so because of our "jobs". We all know it's not that way.
Email me from an anonymous email address- I don't want to know your name. I just want your stories. The more, the better. This blog is being read by representatives across the STATE! Make your voices HEARD.
All I ask is that you tell me your tenure- or a figure around your TENURE.
You don't have an anonymous email address? It's easy to create one at Yahoo! or Hotmail.
Tell me what kind of support you are getting. How many appointments. We must do this y'all. We have to. It's time.
Forward my blog to all your co-workers. Tell them it's time to make a stand.
If you want to email me from your own email, and it has your name- know that I would never EVER under any circumstances EVER reveal where a story comes from.
Let's shake it up. We don't have long.
__________________________________________________
Do You Yahoo!?
Tired of spam? Yahoo! Mail has the best spam protection around
http://mail.yahoo.com
Wednesday, December 06, 2006
Interviews per day
I'd like advisors reading (or anyone else who knows the answer) to tell me how many appointments you are seeing a day.
Do you get a workday or any worktime at all?
Is your office mandating interviewing on Saturdays?
What can we, as the remaining HHSC employees, going to do to make our voices heard?
Is there anything we can do?
What would YOU be willing to do to make your voices heard?
Do we need to all flood our local representatives with emails telling them that they are not getting the full and true story about what is going on in the local offices if they are depending on THE POWERS THAT BE to give them the info?
If someone reading has a good blanket statement would could all send to our reps, would anyone do it?
If we come up with that, would you send the link of my blog to every coworker you have to get everyone on board?
WE MUST DO SOMETHING.
Want to start your own business? Learn how on Yahoo! Small Business.
Hits?
The blog has received many hits today from www.texasweekly.com.....
It's apparently accessible to paid "subscribers"- so I'm unable to see what everyone is coming here in reference to.
If you can shed some light, please email me!
__________________________________________________
Do You Yahoo!?
Tired of spam? Yahoo! Mail has the best spam protection around
http://mail.yahoo.com
Tuesday, December 05, 2006
Letter to the Editor: Private doesn't equal good
Austin American-Statesman
12/1/2006
Re: Nov. 15 article, "Foster care plan under review":
We must stop blindly believing that anything done by government can be done better by the private, for-profit sector.
Some activities (prisons, medical care, public schools, military supply and enrollment for state benefits, as examples) are done better by government workers - at a lower cost.
Most work previously done by government and contracted to for-profit companies ends up costing more and providing less. Business owners spend less on training, wages and health coverage to increase profits.
Chairwoman Jane Nelson, R-Lewisville, was "the only senator to attend" last week's meeting of the Senate Health and Human Services Committee.
Assuming there are other committee members, where in bloody blue blazes were they?
Mack Waldrip
Austin
12/1/2006
Re: Nov. 15 article, "Foster care plan under review":
We must stop blindly believing that anything done by government can be done better by the private, for-profit sector.
Some activities (prisons, medical care, public schools, military supply and enrollment for state benefits, as examples) are done better by government workers - at a lower cost.
Most work previously done by government and contracted to for-profit companies ends up costing more and providing less. Business owners spend less on training, wages and health coverage to increase profits.
Chairwoman Jane Nelson, R-Lewisville, was "the only senator to attend" last week's meeting of the Senate Health and Human Services Committee.
Assuming there are other committee members, where in bloody blue blazes were they?
Mack Waldrip
Austin
Opinion: Texas Medicaid seeks to improve women's health, save tax dollars
Staff EditorialHouston Chronicle12/5/2006
It's taken well over a decade. Other states have been doing it for years. But next month Texas will embark on an efficient plan to save as much as $430 million – and incalculable social costs – by averting unintended, Medicaid-paid pregnancies and many illnesses related to them.
Early in December, the federal government gave verbal approval to Texas ' request for a Medicaid waiver to give extensive health screenings and birth control to 1.5 million uninsured women. Under Texas ' five-year demonstration project, Medicaid will waive some of its ordinary eligibility rules.
In Texas , a single mother with two children can't make more than $308 a month and be eligible for Medicaid. That's about 14 percent of the federal poverty line. The new waiver allows women 18-44, who are at 185 percent of the FPL or less, to get a wide range of health screenings, family planning information and birth control.
The savings, both monetary and societal, should be enormous. In 2002, Medicaid paid for a staggering 52 percent of all Texas births. Each routine delivery cost about $9,000. Now consider this: In 2003, according to state officials, 45 percent of the documented 328,311 live births here were reported as unintended.
What if Texas Medicaid hadn't had to finance so many unplanned deliveries? What if the low-income mothers who gave birth to those unplanned infants had had counseling, information about birth spacing and contraception to keep their families the size they desired?
Finally, what if more Texans could be born into families — and a community — better able to care for them, emotionally, physically and financially?
This was the vision the 2005 Legislature pursued when it finally authorized the state to seek the Medicaid waiver. Lawmakers had tried to pass previous versions of the bill since 1993 without success. During that time, more than a dozen other states successfully took advantage of this expanded health care opportunity.
Now Texas will be on board, starting in January. It's strictly a demonstration project: The federal government will only renew it if Texas can satisfactorily answer a set of evaluating criteria. Among them is the $430 million question: "To what extent did the waiver reduce the number of unintended pregnancies resulting in live births for women who are at, or below, 185 percent of the poverty level?" *Now, does everyone realize that these cases are going to be worked in TIERS statewide? That any woman that applies for this benefit will then become a "TIERS client"- no matter her location in the State? By doing so, any case she has from that point forward- Food Stamps, Medicaid for her children- will then also be in TIERS. Which means they get to call the "call centers" for certification. In other words, if 50% of our cases locally have a woman in that age group who will qualify for the new program will then be in that convoluted system? Good luck with that.
The equation shouldn't have taken Texas so many years to add up. By finally taking advantage of this chance to improve women's health care, however, the Legislature will save Texas millions in Medicaid costs. What can't be quantified will be the corresponding benefit: families with fewer health problems and with children who are wanted, cared for and better prepared for adulthood.
It's taken well over a decade. Other states have been doing it for years. But next month Texas will embark on an efficient plan to save as much as $430 million – and incalculable social costs – by averting unintended, Medicaid-paid pregnancies and many illnesses related to them.
Early in December, the federal government gave verbal approval to Texas ' request for a Medicaid waiver to give extensive health screenings and birth control to 1.5 million uninsured women. Under Texas ' five-year demonstration project, Medicaid will waive some of its ordinary eligibility rules.
In Texas , a single mother with two children can't make more than $308 a month and be eligible for Medicaid. That's about 14 percent of the federal poverty line. The new waiver allows women 18-44, who are at 185 percent of the FPL or less, to get a wide range of health screenings, family planning information and birth control.
The savings, both monetary and societal, should be enormous. In 2002, Medicaid paid for a staggering 52 percent of all Texas births. Each routine delivery cost about $9,000. Now consider this: In 2003, according to state officials, 45 percent of the documented 328,311 live births here were reported as unintended.
What if Texas Medicaid hadn't had to finance so many unplanned deliveries? What if the low-income mothers who gave birth to those unplanned infants had had counseling, information about birth spacing and contraception to keep their families the size they desired?
Finally, what if more Texans could be born into families — and a community — better able to care for them, emotionally, physically and financially?
This was the vision the 2005 Legislature pursued when it finally authorized the state to seek the Medicaid waiver. Lawmakers had tried to pass previous versions of the bill since 1993 without success. During that time, more than a dozen other states successfully took advantage of this expanded health care opportunity.
Now Texas will be on board, starting in January. It's strictly a demonstration project: The federal government will only renew it if Texas can satisfactorily answer a set of evaluating criteria. Among them is the $430 million question: "To what extent did the waiver reduce the number of unintended pregnancies resulting in live births for women who are at, or below, 185 percent of the poverty level?" *Now, does everyone realize that these cases are going to be worked in TIERS statewide? That any woman that applies for this benefit will then become a "TIERS client"- no matter her location in the State? By doing so, any case she has from that point forward- Food Stamps, Medicaid for her children- will then also be in TIERS. Which means they get to call the "call centers" for certification. In other words, if 50% of our cases locally have a woman in that age group who will qualify for the new program will then be in that convoluted system? Good luck with that.
This will be a special challenge, as the Texas waiver does not include coverage of teens or emergency contraception, both of which could help the state meet its savings goal. Texas also has to keep the project budget neutral — for Washington and Texas both.
The equation shouldn't have taken Texas so many years to add up. By finally taking advantage of this chance to improve women's health care, however, the Legislature will save Texas millions in Medicaid costs. What can't be quantified will be the corresponding benefit: families with fewer health problems and with children who are wanted, cared for and better prepared for adulthood.
Group says kids were wrongly denied Medicaid
Group says kids were wrongly denied Medicaid
Elizabeth Pierson
Valley Freedom Newspapers
12/5/2006
AUSTIN — About 3,800 Texans, most of them children, were denied health care through Medicaid during the first three months of a new federal rule that requires proof of citizenship, according to an advocacy group for families.
Medicaid applicants since July 2006 have had to show proof they are U.S. citizens, whereas previously they had only to say they were citizens. The result has been that thousands of eligible citizens who qualify for Medicaid have been rejected because they can’t access their birth certificates in other states, or because state officials aren’t confirming their births in this one, said Anne Dunkelberg, associate director of the Austin-based Texas Center for Public Policy Priorities.
The data Dunkelberg received from the Texas Health and Human Services Commission do not confirm how many of the 3,800 rejected applications came from illegal immigrants. She can’t say with certainty that none were illegal immigrants, but experience tells her the number was at most very low, she said.
“After 20 years of policy work on health, we have a hard time getting just families of non-U.S. citizens to come in and try to qualify,” Dunkelberg said. “There have never been large numbers of people coming in and trying to fake out the Medicaid system.”
Medicaid is the federal-state health care program for low-income adults and children. It serves 1.9 million children in Texas , including more than 200,000 children in the Rio Grande Valley , as of May 2006, the latest data available.
Officials at the Texas Health and Human Services Commission are looking into the numbers brought to light by the CPPP, said spokesman Ted Hughes. “I don’t know for sure yet whether we have such a number, where we could definitively say, ‘These people were denied because they couldn’t prove citizenship,’” he said.
Dunkelberg said the data she received from the state did not separate the 3,800 people by geographic region. It did show that two-thirds were children and 200 were infants younger than 1 year old. State rules require speedy enrollment of qualified babies born in Texas . Dunkelberg thinks many who were denied would have qualified but couldn’t have their birth certificates sent promptly from another state, she said.
Others may be victims of recent downsizing of state eligibility workers. State workers who are left processing applications may not know they can search Texas ’ electronic database of birth certificates to confirm whether a child was born here, Dunkelberg said.
State workers routinely check the database, Hughes said. “It’s a standard practice to check that election database assuming there’s no other document offered,” he said.
Dunkelberg said the state has dealt well with the federal policy, for the most part. “I think they’ve done about as good a job that a state can do,” Dunkelberg said. “I think it’s an unfortunate federal policy that wasn’t well thought-out.”
Elizabeth Pierson
Valley Freedom Newspapers
12/5/2006
AUSTIN — About 3,800 Texans, most of them children, were denied health care through Medicaid during the first three months of a new federal rule that requires proof of citizenship, according to an advocacy group for families.
Medicaid applicants since July 2006 have had to show proof they are U.S. citizens, whereas previously they had only to say they were citizens. The result has been that thousands of eligible citizens who qualify for Medicaid have been rejected because they can’t access their birth certificates in other states, or because state officials aren’t confirming their births in this one, said Anne Dunkelberg, associate director of the Austin-based Texas Center for Public Policy Priorities.
The data Dunkelberg received from the Texas Health and Human Services Commission do not confirm how many of the 3,800 rejected applications came from illegal immigrants. She can’t say with certainty that none were illegal immigrants, but experience tells her the number was at most very low, she said.
“After 20 years of policy work on health, we have a hard time getting just families of non-U.S. citizens to come in and try to qualify,” Dunkelberg said. “There have never been large numbers of people coming in and trying to fake out the Medicaid system.”
Medicaid is the federal-state health care program for low-income adults and children. It serves 1.9 million children in Texas , including more than 200,000 children in the Rio Grande Valley , as of May 2006, the latest data available.
Officials at the Texas Health and Human Services Commission are looking into the numbers brought to light by the CPPP, said spokesman Ted Hughes. “I don’t know for sure yet whether we have such a number, where we could definitively say, ‘These people were denied because they couldn’t prove citizenship,’” he said.
Dunkelberg said the data she received from the state did not separate the 3,800 people by geographic region. It did show that two-thirds were children and 200 were infants younger than 1 year old. State rules require speedy enrollment of qualified babies born in Texas . Dunkelberg thinks many who were denied would have qualified but couldn’t have their birth certificates sent promptly from another state, she said.
Others may be victims of recent downsizing of state eligibility workers. State workers who are left processing applications may not know they can search Texas ’ electronic database of birth certificates to confirm whether a child was born here, Dunkelberg said.
State workers routinely check the database, Hughes said. “It’s a standard practice to check that election database assuming there’s no other document offered,” he said.
Dunkelberg said the state has dealt well with the federal policy, for the most part. “I think they’ve done about as good a job that a state can do,” Dunkelberg said. “I think it’s an unfortunate federal policy that wasn’t well thought-out.”
Friday, December 01, 2006
Rant
It's been a while since I've "talked" about what's happening in the local offices.
I've noticed a few things lately. Namely, the first "wave" of people we lost (late last year, after the "pink emails" came out) were due to the layoff notice. Now, we are losing people who have TRIED to stick around but the workload and expectations have become too much.
Anyone, as I've said before, on the outside thinks that this job is easy. They think that all we do is push some paper around and give away all the taxpayer money while we sit back and laugh at all the money we make doing nothing.
Nothing, and I mean NOTHING could be further from the truth.
Sadly, the Agency that was DHS is gone- and the good work put out by said agency is gone as well. Quality is at an all time low. Let's not even talk about "timeliness". I'm sure if FNS came in and read a bunch of Food Stamp cases they'd find that most were probably wrong. Not because we all just don't care- but because we have people hired off the street, who have had 15% of the training that new hires USED to get and they are just flying by the seat of their pants. Tenured workers are getting loaded with more and more and more- and most of the TANF and it's just TOO. MUCH.
Clients are suffering. People are going WITHOUT basic needs because we don't have the staff to see anyone like we used to before. Our local office has 15% of the tenured workers we used to have. FIFTEEN PERCENT. The workload has NOT slowed down or stopped.
Sinking. Those who were trying to hold on are leaving now.
How scary.
I've noticed a few things lately. Namely, the first "wave" of people we lost (late last year, after the "pink emails" came out) were due to the layoff notice. Now, we are losing people who have TRIED to stick around but the workload and expectations have become too much.
Anyone, as I've said before, on the outside thinks that this job is easy. They think that all we do is push some paper around and give away all the taxpayer money while we sit back and laugh at all the money we make doing nothing.
Nothing, and I mean NOTHING could be further from the truth.
Sadly, the Agency that was DHS is gone- and the good work put out by said agency is gone as well. Quality is at an all time low. Let's not even talk about "timeliness". I'm sure if FNS came in and read a bunch of Food Stamp cases they'd find that most were probably wrong. Not because we all just don't care- but because we have people hired off the street, who have had 15% of the training that new hires USED to get and they are just flying by the seat of their pants. Tenured workers are getting loaded with more and more and more- and most of the TANF and it's just TOO. MUCH.
Clients are suffering. People are going WITHOUT basic needs because we don't have the staff to see anyone like we used to before. Our local office has 15% of the tenured workers we used to have. FIFTEEN PERCENT. The workload has NOT slowed down or stopped.
Sinking. Those who were trying to hold on are leaving now.
How scary.
Interesting
This was in comments, but I wanted to put on the blog so that more people might notice...any insight?
Actually, Albert is still lying. I did an open records request and have in
my possession the copy of the sole source justification dated 12/28/05 for over
1,000,000 dollars to the Texas Health Institute. I do not know why Al must
continue to lie, maybe because the truth in this case is not his friend.The sole
source justification essentially states--because we picked them to do it-- and
is unsigned.There is no RFP or award announcement that was ever made. It was a GIFT. A non-competitive retainer to pay this group to lobby for privatization.
The staff of this non-profit are mostly former staff to legislatos turned
lobbyist.BTW--the Chief Operating Officer at DSHS (Health) worked for Michael
Toomey(lobbyist for Philip Morris and Texans for Lawsuit Reform)and Maximus. In fact, he was in charge of the Maximus call-center project in California and came here to work during negotiations with Maximus for their contract for Texas call
centers at a 70,000 paycut. Interestingly, he worked here before as the CHIP
Bureau Chief, gave the CHIP eligibility contracts to Maximus, then went to
Maximus for a 75,000 raise. Cool.Really, they must not know that at the Texas Hospital Association or they would surely have corrected their website. BTW--the Board of this group is mainly made up of THA members, including the THA president and several HOSPAC members. People who get what they want from Al Hawkins. Like Jim Springfield, THI Board Member, HOSPAC Board Member, Texas Association of Health Plans Board Member, and Perry Appointee to the Department of State Health Services Council. Also, as a matter of fact, the President of Valley Baptist Health System and beneficiary of an HHSC application to the Federal Government to restrict all non-emergency inpatient healthcare services for Medicaid recipients in Cameron County to his hospital system. This from Al-the big proponent of competition and choice?I have done my research really well. The stories will continue to be more incriminating--and accurate. There is alot of corruption needing to be exposed and it will continue to be until Al is gone, arrested, or exposed as dishonest and in collusion with lobbyists.
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