Saturday, March 31, 2007

What Hawkins Knew

What Hawkins Knew

The State's Health Czar is Blaming Accenture for a program he was told would likely fail
by Dave Mann

In a misguided, poorly executed effort to let the private sector bring “efficiency” to Texas government, the state has squandered at least $100 million, cheated hundreds of thousands of needy Texans out of benefits, and now risks millions of dollars in federal fines for botching things up so badly.

This is not the promised land of free-market bounty that Republican lawmakers and right-wing think tanks described in 2003, when they convinced the Legislature to enact one of the most ambitious privatization plans any state has ever attempted. Back then, the talk was of how wonderful life would be as projections of $600 million in savings danced a lively jig through committee rooms and onto the House and Senate floors.

Now that the music has stopped, state officials are risking serious physical injury rushing to blame the debacle on Accenture Ltd., the private consulting giant that won the $899 million contract to set up call centers to help Texans get government benefits like food stamps, welfare, and Medicaid.

But many of those same officials—particularly Albert Hawkins, head of the state’s Health and Human Services Commission—were warned repeatedly that the program was being rushed, was never properly tested, and risked failure. The project plunged ahead anyway. An Observer review of thousands of pages of state documents reveals that while Accenture certainly made mistakes, it was Hawkins who relentlessly pushed the program toward launch on January 20, 2006—what HHSC described as the “go-live” date—despite numerous warnings from federal officials, Accenture, and his own auditor that the network of call centers wasn’t ready. HHSC officials also intentionally scaled back tests they knew the system would fail. And Hawkins moved the call-center project forward at two separate stages without obtaining prior federal approval—despite repeated warnings from the feds—actions that cost the state millions in federal funds.

“There were red flags,” says state Rep. Abel Herrero, a Corpus Christi Democrat who’s leading the legislative committee investigating the Accenture debacle. “There’s deep concern why the agency would proceed with an aggressive schedule with a program that was known to be deficient.”

The consequences of HHSC’s mismanagement are clear. The anticipated five-year savings of more than $600 million from the call-center plan haven’t materialized. In fact, the Accenture contract ran over budget. The state has already spent $30 million cleaning up the mess.

Moreover, thousands of eligible families mistakenly were dropped from government programs such as Medicaid and the Children’s Health Insurance Program—gaffes that cost the state tens of millions in federal matching funds. HHSC’s inability to enroll eligible families for benefits risks further fines and sanctions of up to $30 million from the federal government.

As head of the state’s five health and human service agencies, Hawkins is perhaps Texas’ most powerful unelected official. He remained a driving force behind the call-center plan even after former state Rep. Arlene Wohlgemuth, the Burleson Republican who drafted it, left state government to run unsuccessfully for Congress. His hunger to enact call centers has puzzled some observers in the Capitol. Appointed by Gov. Rick Perry in early 2003, Hawkins is a former budget director under then-Gov. George W. Bush. He’s an ace numbers man respected by lawmakers of both parties. While conservative politically, he’s not known as a rigid ideologue. All of which makes his mishandling of the call-center implementation peculiar. (Hawkins declined an interview request for this story.)

Perry has reappointed Hawkins to a new term. But the state Senate has thus far withheld his confirmation. It remains to be seen whether he’ll stay in his post, though there is no apparent attempt to oust him over the costly fiasco.

It began as a grand experiment to graft the principles of the free market and the private sector onto Texas’ system for screening and enrolling poor families in government benefit programs. In the past, those wanting to sign up for Medicaid or food stamps or welfare had to visit the nearest state office. A state employee would assess their needs, verify income, and proffer the proper forms for signing.

Under the new model, the state planned to close dozens of local offices, fire thousands of state workers, and replace them with four call centers run by a private company. Texans would access the social safety net much the same way they complain to the cable company about poor service. No state had ever outsourced such a core government function. But Republican lawmakers pitched their plan as the vanguard of a new movement, and in June 2005, Texas inked the largest contract in state history, awarding Accenture $899 million to run the show.

It never worked, and just 20 months later the great experiment was in ruins. After four months of dismal reports on Accenture’s continuing inability to make its call centers function, the HHSC tore up the contract on March 13. In the days after the massive deal came to an inglorious end, HHSC officials made clear in numerous statements that they put the blame on Accenture. Hawkins told a legislative committee that Accenture had assured him the call-center system was ready.

He was not telling the whole truth and nothing but, the Observer document review shows.

Hawkins and HHSC were, in fact, warned that the system was likely not ready. On two separate occasions, Hawkins failed to get federal approval for the plan despite repeated warnings from federal officials that prior authorization was needed to access federal money. Because Texas was attempting a radical reform that no state had ever tried, the feds had a keen interest: Several federal agencies would have to give their blessings at every major stage, or Texas would risk losing federal funds. This was particularly true of the food stamp program, which has slightly more stringent enrollment requirements.

The federal Food and Nutrition Service warned HHSC, according to memos, that Washington needed to approve the call-center plan before HHSC put out a call for private bidders. Yet HHSC published its request for proposals without federal approval on July 22, 2004. Four days later, the nutrition service wrote HHSC, “Please be advised that, pending our approval of your RFP, you are proceeding at your own risk and that no federal funding for this initiative can be provided ... until we have fully approved it.” FNS eventually approved the funds.

Trouble arose again in early 2005 as HHSC began negotiations with Accenture. FNS warned Hawkins that it had to approve the final contract before it was signed and that FNS needed 60 days to do that. Despite early and repeated warnings, HHSC gave the feds a lead time of exactly one day. The state submitted the Accenture contract for federal review on June 28, 2005, according to agency documents. On June 29, 2005, HHSC signed its deal with Accenture. The feds seemed baffled. “If Texas had followed the normal course of events, the State would have secured the approvals. ... Since the contract was signed before obtaining our approval, the funds that are expended now must be State funds and may not be reimbursed,” FNS wrote on July 14, 2005.

FNS did approve the contract in November 2005. But in the intervening five months, HHSC lost about $12 million in federal funds, according to an agency spokesperson. (FNS so far has denied the state’s attempts to recoup that money.)

On March 7 of this year, Herrero, who heads the subcommittee of the House Committee on Human Services that is investigating the Accenture fiasco, asked Hawkins at a hearing why his agency brushed off the feds. “We still believe that all those elements do not require federal approval,” Hawkins said. “But that aside ... we have been in constant communication with the FNS. It’s not that they were unaware of the elements of the contract or how the state was moving forward. They had not finalized their approval on it.” He later claimed that the Accenture contract was the only part of the call-center project that didn’t gain prior federal approval. “The one that did not was the contract—not prior approval. There was for the RFP,” Hawkins said. That statement isn’t accurate, according to a review of FNS memos.

When the feds finally approved the Accenture contract, they did so with conditions: FNS granted federal funding for only the project’s first three months. The agency was concerned that HHSC was rushing out a system that would deny benefits to eligible families—a concern that would prove prophetic. “We continue to have concerns about the seemingly unrealistic time frames for implementation of the state’s plan,” the feds wrote to HHSC.

Indeed, the state was in a major rush. After signing the contract, HHSC gave Accenture just seven months to set up its call centers before the January 20, 2006, “go-live” deadline, when the centers would begin fielding calls from needy Texans in two Central Texas counties. HHSC wanted the call centers to handle all enrollment statewide by December 2006. Could HHSC and Accenture really transition all enrollment and eligibility for complex programs that serve millions of Texans in 11 months? The feds didn’t think so. “[FNS] had some real anxiety about the aggressive conversion schedule that the state had developed,” Hawkins recently conceded to Herrero’s subcommittee. “[FNS] did advise us that it should be slower.” He ignored their advice.
As the go-live date fast approached, HHSC received several more warnings of flaws in the system and admonitions that its rollout schedule was too ambitious. Two independent verification audits, one commissioned by HHSC and one by FNS, reported serious problems with the call-center system, according to a report issued last fall by the Texas Comptroller’s office. HHSC’s own inspector general’s office also warned Hawkins of flaws in the call center’s computer system. In late December 2005, Accenture warned HHSC of “red,” or critical, system failures. The company, formerly a division of Arthur Andersen LLP, a defunct accounting firm, had run into a serious technology problem.

An Accenture subcontractor planned to use computer software to record applicant information at call centers. Problem was, the contractor’s software couldn’t interface with the state’s computer system. The inability of the two systems to talk to each other would prove a critical obstacle. To make matters worse, the state software was new. HHSC was rolling out a new computer system, known as Texas Integrated Eligibility Redesign System (TIERS—pronounced “tears”). The complex system is aptly named: It has been a constant source of heartache for state officials since its botched creation by accounting firm Deloitte and Touche LLP. Texas has spent the past five years and tens of millions trying to fix TIERS, with intermittent success. It has been perhaps an even larger disaster than the call-center contract. Yet HHSC had decided to package the call-center system with TIERS and planned to roll them out together.

HHSC officials say Accenture promised them it could “work around” the software incompatibility problem. Accenture would hire more workers, at the company’s expense, to do “dual entry,” meaning tediously typing in the same information twice—once into each software program. It was an ironic solution since the call centers were supposed to make the whole process more efficient. The “work around” resulted in numerous bureaucratic errors. Anne Heiligenstein, a deputy commissioner at HHSC, recently told lawmakers that, “We went to pilot [stage] based on the ... information the vendor brought forward that there was a viable solution [to the technology problems]. We accepted that. They offered that, I’m sure, in good faith. It did not achieve what it needed to achieve.”

Taking Accenture’s assurances at face value, HHSC decided not to test how well the call centers’ technology functioned before the rollout. In the rush to launch the system, HHSC officials instructed Accenture to scale back several elements of its final readiness testing.

Accenture’s report on readiness testing in January 2006 reads, “Due to significant delays in testing for the rollout coupled with a decision to go live on January 20, 2006 without regard to actual results of the Readiness Assessment Tests, [Accenture] and HHSC agreed to a scaled back Readiness Assessment Test that would only test critical technical components.” In fact, components of the system that would later prove to be major flaws—staff levels, staff training, proper routing of calls, fraud prevention, and computer compatibility—were intentionally dropped from the readiness tests, according to Accenture documents. The software also wasn’t tested because HHSC officials already knew the computer systems couldn’t talk to each other and would fail the test, according to the HHSC. Agency officials say a test wasn’t needed because they believed Accenture’s promises that manual entry would solve the problem.

What about the other flaws omitted from the readiness tests? HHSC spokesperson Stephanie Goodman says that Accenture’s “Readiness Assessment Tests” were just one form of testing.

Whatever elements Accenture left out, she says, HHSC tested on its own before the rollout.
Still, problems were evident. Herrero says the call-center launch should have been delayed. “The standards and quality-assurance levels were lowered to meet the schedule set by the commission,” he says.

Despite the warnings, HHSC left itself without a backup plan. In late 2006, the agency notified nearly 3,000 state enrollment and eligibility workers that they would soon lose their jobs. Predictably, this led to an exodus. More than 800 veteran enrollment workers took jobs elsewhere in state government, and hundreds more simply walked out. The loss of institutional memory proved disastrous when the call-center plan failed, and HHSC found it needed the state workers, some of whom had done enrollment for decades. “What’s troubling to me is that the commission would encourage employees to go elsewhere before there was a successful, integrated eligibility program,” Herrero says. “There were problems. The go-live date was fast approaching, and despite that, [state] employees were advised that their jobs would no longer be needed.”

As the warnings had predicted, the call-center system became a mess. The failures are well documented. Once Accenture took over screening in two Central Texas counties, and screening for the Children’s Health Insurance Program statewide, enrollment in all benefit programs began to drop.

Enrollment in CHIP declined by as much as 27,000 kids in early 2006. (It’s difficult to determine how much of the CHIP shrinkage was caused by the call-center failure; the program had been declining for several years before the Accenture deal.) The children’s Medicaid program had expanded for years prior to the call-center debacle. After the go-live date and the loss of state workers, 118,000 children lost Medicaid coverage in just nine months. Denying these CHIP and Medicaid benefits deprived the state of at least $50 million in federal matching funds.

In the end, the call centers were overwhelmed by the number of calls, inadequate and poorly trained staff, and malfunctioning technology (Accenture’s “dual entry” solution was far too mistake prone and inefficient). Wait times and backlogs of applications swelled. Accenture sent out renewal letters dated May 8 that informed clients their deadline for reapplying for benefits was April 15. One Accenture fax number mistakenly routed benefit applications to Seattle.
After four months, HHSC halted the call-center rollout on May 10, 2006. It never resumed.

HHSC scrambled for a backup plan, rehiring thousands of state workers and paying out “retention bonuses” to keep temporary screeners. Cleaning up the Accenture fiasco cost the state $30 million, according to HHSC, money it still hopes to recoup from Accenture.

For now, state employees once again are handling screening and enrollment. But with the loss of so many longtime enrollment workers, a system that functioned well before the call-center experiment has suffered permanent damage. Texas used to routinely earn good-performance bonuses from the food stamp program for its mistake-free enrollment system. In 2004, for instance, the feds paid the state $150 million in bonuses. Now it’s the opposite. For the first time in years, Texas’ food stamp enrollment error rate—the number of applications the state botches—exceeded the national average in 2006. If the error rate breaks the national average again this year, Texas will face penalties and sanctions from the federal government that could approach $30 million.

In a recent hearing, Herrero asked Hawkins why HHSC didn’t heed warnings from the federal government, auditors, and the agency’s own contractors. “I thought it better to follow the direction of the Legislature,” he said, “and to achieve the savings [from the call-center plan] ... to fit within the [HHSC] budget.” In other words, he ignored the warnings so his agency could realize the estimated savings. It was an ironic answer since the call-center rollout ended up costing the state millions.

I say: In any other business anywhere else, if this happened, Hawkins would have been fired. Heads would roll in the State Office Corridors. We certainly know that if a worker(s) were the cause of this much money being flushed down the drain, they'd have CERTAINLY been fired. If QC read cases on Worker A who gave out millions in error- that worker would be GONE. Virtually IMMEDIATELY. Yet, Hawkins, in whatever quest he's on - is still the "head" of this and still hasn't been asked to leave. This is one of the #1 articles I've ever read and/or posted. Forward this to everyone you know- even folks not associated with this and tell them this is their TAX MONEY going down the drain.......word needs to get out about this. It's not JUST ABOUT HHSC anymore- it's not just about the "poor". It's about Texans paying taxes to a state who is so very loose with their money.

Sunday, March 25, 2007

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Friday, March 23, 2007

Open Thread

Leave a comment about whatever- rumors, opinions, what's going on in your office, anything you want.

Thursday, March 22, 2007

Accenture BRAGS

Accenture Clients Win Best of Texas Award Two Years Running

Best of Texas 2006 Award for Best Application Serving the Public: TexKat Web-based Evacuee Assistance Program, Texas Health and Human Services Commission
**I wonder if Accenture is going to post about their great "success" with the call centers too?

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Pretty old but interesting

Article done when Bush was still the Gov- and there was talk of privatizing us THEN.....

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Follow the Accenture money

It's a sad day when the economics department is teaching it's graduate students to draw lazy, obtuse conclusions instead of conducting rigorous research. Garth Huetel's column ("Learning from failed privatization," March 20) seems to pull its ideas from a couple front-page stories and Google searches instead of doing what should be second-nature to a student of economics: following the money.

If he'd dug a little deeper, he'd have discovered that the Accenture deal tanked not because of "political zealotry," but because of a hopelessly flawed bidding process where Accenture was hand-picked over vastly more qualified competitors. He'd have found a web of cronyism that revealed that the authors of HB 2292, Gregg Phillips and Chris Britton, were subsequently hired by Accenture to win the contract for work mandated by a bill that they helped write. And that former Gov. Rick Perry staffer Ray Sullivan and some former Gov. George W. Bush staffers also found work with Accenture. And that Accenture had a long, embarrassing track record working with government agencies spanning almost a decade in Nebraska, Virginia, Ohio, New Brunswick, New York, Ontario and other places, where they engaged in a pattern of cost overruns and poor service, prompting the Nebraska treasurer to say that dealing with Accenture was like "pouring money down a deep, dark hole."

Unfortunately, the bidding process at HHSC and other state agencies, with their governor-appointed directors/cronies, is just like that deep, dark hole. If you really want to explore why privatization fails in Texas, start talking about transparency.

Marc Duchen
UT alum
March 20, 2007

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Monday, March 19, 2007

Good one....

Fr. John Whiteford gives a good commentary about the "Bittersweet Vindication of Carlos Guerra" given the fact that he called the demise of the contract (as did we) a LONG time ago.

Go check it out HERE.

Letter to the Editor

Re: "Texas terminating deal with main social services contractor – Medicaid, food stamp duties going back to state; official defends system, admits flaws," Wednesday news story.
The North Texas Food Bank applauds the decision by state Health and Human Services Commissioner Albert Hawkins to end the contract that outsourced the food stamp program.
Now it's up to the Legislature to make sure the Health and Human Services Commission gets the staff and funding it needs to fix the problems privatization created.
The complicated food stamp program requires an adequate number of trained staff to run. If privatization had resulted in a more effective and efficient program, we would acknowledge that. But it only made things worse, delaying services to thousands of hungry North Texans.
The population served by this important program is our most vulnerable – the hungry, the poor, the elderly and our children. We cannot afford to try to get it right.
Jan Pruitt, CEO, North Texas Food Bank, Dallas

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House panel seeks answers on Accenture

House panel seeks answers on Accenture

Hawkins details next steps

Friday, March 16, 2007

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Editorial: State learns lesson about privatization

Editorial: State learns lesson about privatization

San Antonio Express-News
Perhaps the best lesson to be gleaned from the experience of the Texas Health and Human Services Commission with Accenture LLP is this: Modernization of the state's public services is not necessarily synonymous with privatization.
Privatization has been a mantra of Gov. Rick Perry and the GOP leadership in Austin . In 2005, the state awarded a five-year, $899 million contract to a consortium of companies led by Accenture to run a pilot program for the Texas Integrated Eligibility and Enrollment Services.
The program covered eligibility and enrollment for the Children's Health Insurance Program, food stamps, Medicaid and Temporary Assistance for Needy Families. But the privatized effort has been fraught with problems.
A report last year from the Center for Public Policy Priorities found that more than a third of people trying to call the eligibility centers were abandoned. The average wait for phone calls was 22 minutes. The consortium's computer system didn't interface with the state's system. And there's a good chance that rather than saving money, this experiment may end up costing Texas taxpayers.
This week, the state and Accenture agreed to cancel the contract. It was the right decision.
The Health and Human Services Commission still needs to modernize the delivery of its services. And a billion-dollar bureaucracy is bound to suffer from waste and inefficiencies that some degree of privatization can help cure.
The pilot program for integrated eligibility ought to offer some practical experience about which functions private contractors can perform and which state workers should perform. A looming question: How much will the terminated contract cost the state?
As the Legislature considers even greater privatization - for Child Protective Services - it should take this experience and the costs of privatization to heart.

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Roper: Privatizing welfare services would put profit above children

Roper: Privatizing welfare services would put profit above children
Austin American-Statesman
Texas recently announced the termination of its contract with Accenture, the private company the state hired to enroll Texans in health care, food stamps, and other social services. Though privatization was supposed to save the state money and improve services for families, thousands of the most vulnerable Texans were wrongly denied benefits and the state didn't save a dime.
Despite the failure of this privatization experiment, legislation is still in the works to privatize another essential state service - Child Protective Services, the child welfare arm of the Texas Department of Family and Protective Services. CPS investigates reports of child abuse and neglect and works to protect these children.
The first opportunity for the Legislature to discuss what to do about privatization will be this week when the Senate Health and Human Services Committee considers Senate Bill 758 by Chairwoman Jane Nelson, R-Lewisville. The bill calls for less privatization, but still moves Texas toward a privatized CPS system.
Historically an underfunded agency, there is no question that CPS needs more funding to hire additional staff and improve services for families. For 10 years, I represented CPS as a prosecutor and children in the foster care system as an attorney ad litem. I saw CPS' challenges firsthand. However, privatization won't solve the problem any more than it helped enroll Texans in public benefits.
A few weeks ago, I went on a fact-finding mission to Florida , which privatized its child welfare system over the past 10 years.
I talked with many of the people who are directly involved in the system, including lawyers, judges, service providers, community-based care agencies, state agency staff members and the guardians ad litem appointed to represent the best interests of the children in foster care. It became clear that privatization is not the solution.
For one thing, privatization is costly. In Florida , child welfare costs have risen. And despite the fact that the private companies promised more competition, better and more innovative services for children and families, more community involvement, more accountability and better outcomes for children, Florida has not seen substantial improvements. In fact, the rate of re-abuse after children have been returned home has risen since private entities took over.
In addition, privatization has failed to prevent the same problems in Florida that plague Texas ' current child welfare system - high caseworker turnover and caseloads as well as inadequate resources for services for families. I heard many stories of inexperienced caseworkers who don't know what they are doing and who don't return phone calls. Even some initial proponents of privatization admitted to me that Florida has made a huge mistake.
Privatization in Florida also has resulted in conflicts of interest. Back here in Texas , pressure to reform CPS by privatizing isn't coming from child advocacy groups or even CPS itself, but from those in the private sector who would make more money in a privatized system.
Inevitably, the desire to make the most money will lead to financial decisions that could trump the best interests of children.
Privatization is risky business. There are no guaranteed results - which is dangerous in a child welfare system that makes life or death decisions regarding children. Decisions made by CPS - whether abuse has occurred, whether to take a child from a parent, whether to return a child to a parent or whether to place the child with a relative or in foster care - should be made by public employees who don't have a conflict of interest.
Those in the child welfare system are the victims of bad choices made by grownups. Texas must make careful, thoughtful choices in the best interest of the children in the state's care. Privatization isn't one of them.

Sunday, March 18, 2007

Ah, privatization: Texas provides case study of failure - Daily Kos

FSSA preps for privatization:
Indianapolis - On Monday, more than a thousand state employees will begin working for a computer giant. It's part of the state's efforts to privatize Indiana's welfare system. (more...)

Here's to hoping INDIANA caseworkers/office personnel don't get to experience the same personal hell we have in Texas.

Valley leaders thrilled at canceling of Accenture contract

(My comments are in red at the bottom-HHSCEmployee)

Valley leaders thrilled at canceling of Accenture contract

March 17, 2007 - 4:11PM

AUSTIN — They said it wasn't working; now they say it's about time.

Leaders from the Rio Grande Valley praised the announcement last week that the state would phase out its contract with Accenture LLP, the company hired to help the state process eligibility applications for human-services benefits and oversee the Children's Health Insurance Program.

In 2005 the state entered into an $899 million contract with a group of companies led by Accenture. State leaders wanted to privatize the eligibility system for Medicaid and food stamps and let Accenture process CHIP applications.

The contract came after lawmakers in 2003 made cuts to the human-services budget.

But problems with the company's performance arose. Advocates of the working poor said families who applied for CHIP benefits found that the company lost and mishandled applications. CHIP enrollment dropped below 300,000 for the first time since the program started, but has since rebounded.

"The continuous mishandling of documents has resulted in thousands of children being dropped from CHIP, Medicaid and other services," said the Rev. John Lasseigne, pastor of St. John the Baptist Parish in San Juan and a leader of Valley Interfaith. "This has not only produced a loss of federal funding, but more importantly has jeopardized the health of our children."

Responsibility for handling CHIP applications is slated to be gradually returned to state employees.

But the move toward modernizing the state's eligibility centers continues. State leaders heard for several years from angry clients that closing local offices in favor of phone and Internet processing was a burden on people in poor and remote areas.

"Our goal hasn't changed," said Albert Hawkins, Health and Human Services commissioner. "We want to make it easier for Texans to apply for services by modernizing technology and letting citizens choose how they want to submit an application, whether that's in person or by phone, mail, fax or Internet."

Some Valley lawmakers praised the news that the contract would be phased out.

"Unfortunately, decisions made in 2003 devalued some of our most loyal state employees by jeopardizing 2,500 positions, and the result has been disastrous," said Sen. Eddie Lucio, D-Brownsville.

Lucio and Sen. Juan "Chuy" Hinojosa, D-McAllen, both said the end of the contract was overdue and that state employees have benefits-handling expertise that private companies lack.

Hinojosa said it was high time to make the change.

"I called on state leaders last summer to cancel this contract because the private company was simply not getting the job done," he said.

Now that it's not spending the money on the Accenture contract, the state may have more money available in the long run to enroll more children in CHIP, said state Rep. Veronica Gonzales, D-McAllen, who sits on the House Committee on Public Health.

"When you spend $900 million, you better get your money's worth, and we definitely didn't get our money's worth with Accenture," Gonzales said.

Others argue the termination of the contract just goes to show that privatization works, because government can stop dealing with companies that don't meet expectations.

"If a private vendor fails to meet the agency's expectations, the state can hold that vendor accountable," Mary Katherine Stout, vice president of policy for the Texas Public Policy Foundation, said in a statement. "Government employees never face such scrutiny for similar failures."
(HHSCEmployee Comment:  Government employees never face such scrutiny for similar failures?  When?  Let's see, actually- the "Government Employees" were the ones that made it possible for Texas to receive MILLIONS of dollars in enhanced funding due to the accuracy and "correct" handling of cases from the Federal Government.  Not only that, if an employee is NOT meeting requirements, they do face scrutiny- which is called TERMINATION.  I realize that even responding to a comment made by Ms. Stout is a waste of time, given the "Think Tank" she works for...however, I felt it important that it's said.  Texas Access Alliance took on a job it could NOT handle.  Period.  This is about issuing MILLIONS of dollars in State and Federal Benefits.  TAX PAYER MONEY.  Accenture/TAA got in this deal TO MAKE MONEY.  And they DID- even though the results of this contract have been DISASTROUS to the people we serve. )

Elizabeth Pierson covers the state capital for Valley Freedom Newspapers. She is based in Austin and can be reached at (512) 323-0622.

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Saturday, March 17, 2007

More Texas Access Alliance "stuff"

All DabJab posts regarding Texas Access Alliance are HERE.......what's interesting are some of the posts have information that I've missed on this it might be worth looking at.

Friday, March 16, 2007

Search Words

I just wanted to note that today I had someone search for my blog with this:
Search Words disgruntled state employee blog
I just wanted to let anyone know who wasn't sure that contrary to what you may believe, I'm not disgruntled.  I care about the agency I work for.  I care about the clients that we serve.   If I didn't, I wouldn't care what was going on in the offices- and rather than try and do something about it, I'd sit around work and gripe about it- and that's not what I'm doing.
dis·grun·tle      [dis-gruhn-tl] Pronunciation Key - Show IPA Pronunciation
–verb (used with object), -tled, -tling.
to put into a state of sulky dissatisfaction; make discontent.
That's so not my goal here.
Just felt like I needed to clear that up!

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Human Services chief defends failed contract

AUSTIN — Lawmakers had some tough questions for the state's health and human services chief on Thursday about his decision to sever ties with a contractor hired to help make it easier for needy Texans to receive public benefits.
Members of the House human services committee wanted to know what went wrong with the state's $899 million contract with the Texas Access Alliance, a group of companies led by Bermuda-based Accenture LLP.
Albert Hawkins, head of the Texas Health and Human Services Commission, announced Tuesday the agency was cutting ties with the contractor after efforts to re-negotiate the troubled contract failed.
"I've been frustrated to hear Accenture's bad and I'll agree Accenture was bad," said Rep. Patrick Rose, the committee's chairman. "But then what comes after Accenture's bad has been: 'But everything's fine.' I don't think our contracting quality control is fine."
Hawkins defended the 2005 contract, saying it included strong performance measures that let the state hold Accenture accountable for technical and operational problems that arose over the past 14 months.
The Texas Access Alliance was hired to help run a new state computer system that would let people apply for benefits such as food stamps or Medicaid over the phone, online or in person.
The project debuted in Travis and Hays counties in early 2006 and was supposed to be implemented in all 254 Texas counties by the end of the year. But technical and operational problems forced Hawkins to indefinitely delay the rollout last spring.
Problems also cropped up when the Texas Access Alliance took over processing applications for the Children's Health Insurance Program, the state's low-cost health insurance program for the children of the working poor.
The problems were so serious that Hawkins announced in December he was slashing the contract by more than $350 million and curtailing the responsibilities given to the group's employees.
But the state and company couldn't agree on the terms of the new contract, he said.
The state plans to sign short-term contracts with Accenture subcontractors to do some of the work over the next two months. Meanwhile, officials will decide what jobs should be done by state workers and what jobs can be outsourced.
Rose, a Democrat from Dripping Springs, said his committee wants to be closely involved in that process. He asked Hawkins to give them a list of lessons learned from the contract's failures and regular updates on decisions about the project's future.
"I think it would be a mistake for us to think that the Legislature doesn't need a larger role in monitoring and overseeing and maintaining quality control over the process," he said.

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Wednesday, March 14, 2007

Indiana Politics

Indiana is also in the throes (it appears) of's what was posted there:

Big Deal: Texas Ends Accenture Contract Early Amid Problems, Lack Of Savings

"'You suggest that this agency has not acted in good faith and has retreated from agreements we reached in December,' Health and Human Services Executive Commissioner Albert Hawkins wrote Monday in a letter to Accenture. 'This is incorrect. To the contrary, (the options Accenture offered) contradicted many of the agreements Accenture made with the state.'

"As the deal dissolves, Accenture spokesman Jim McAvoy said he doesn't expect either side to blame the other for what went wrong.

"'The state's position on funding wouldn't permit us to successfully operate the program,' McAvoy said.


Senators seek investigation of troubled social services contract
I'm going to copy pieces of the above linked article, so I can comment on it (what is below is NOT the full article, that can be found by clicking the link above)...I've taken the liberty of BOLDING that information out of the article that jumped out at me:
"Nearly every state senator has signed a letter asking the inspector general of the Texas Health and Human Services Commission to investigate the failed contract with the company hired to privatize the state's social services eligibility system. "
Good. I hope they do a thorough investigation into the relationships of those involved in this
mess. I'm telling you, as a "lay person" who has no inside information to any of this- SOMEONE is getting rich off this disaster.

The letter, signed by 30 of the 31 state senators, asks the inspector general to conduct an integrity review, and if warranted, a full-scale investigation of both the new computer system and the contract for running it.
I'd like to know which state senator DIDN'T sign the letter. If your DID- send him/her an email thanking them for doing what should have been done A LONG TIME AGO. A full scale investigation into TIERS ought to be quite eye opening to many people on the "outside". The amount of money spent on TIERS is beyond comprehension considering the product that is out there.
Accenture spokesman Jim McAvoy said the company will cooperate fully with the investigation. Commission spokeswoman Stephanie Goodman said the agency will provide any information that is requested.

"It's hard to imagine that there's a document in the building that hasn't already been provided to every losing candidate for governor, the employees union and IBM's attorneys, but we'll keep the copy machine warmed up and ready to go," she added.

Well, at least Stephanie Goodman is keeping her sense of humor. I mean, she WAS trying to be funny, right? "every losing candidate for governor"? Ha ha ha ha ha......I mean, I'm sure Rick
HairPerry asked for information too, didn't he? Oh? He didn't care? I'm sorry. Wait, and "the employees union and IBM attorneys"? Yeah, so when a union full of employees wants to know what's going on and uses their right to see documents to ensure that this scam is put
out there- and the HHSC spokesperson has jokes. That's great. I wonder if she believes her own rhetoric? It's amazing that the same employees that Anne H says have important ideas and input are the employees represented in the public via a spokesperson who is so professional.

Austin American Statesman

I noticed that the blog was getting quite a few hits from the Austin American Statesman website today- and found where it was can see it HERE. (It's nothing big, but increases exposure, which is necessary to continue on with the goal of getting HHSC back to the level it used to be).....

Yesterday was a big news day!

Some Links for Today

Accenture, Texas say adios to outsourcing contract - Washington Technology, DC

Texas to Wind Down Outsourcing Deal with Accenture - Computer Business Review

Accenture, Texas Health and Human Services Commission Agree to End.... - Trading Markets

State ends ACCESS contract -Odessa American,TX

Accenture-ating the Positive - Texas Observer Blog

**If you come across any articles today that need to be posted, put the link in the comments!

Another Search you can do

If you want to read some of the other bloggers out there talking about the failure of the Accenture deal, you can click HERE.

Link Update

If you read here and have a blog that is not linked in the sidebar, please either email me or leave your blog address in the comments and I'll get it linked ASAP!

Tuesday, March 13, 2007

TIERS reflections

I was going back and reading some archives from April of last year- and came across these gems:
These were found in THIS post (under comments):
1st, a comment that was left by an Accenture employee (what a difference a year makes, no?):
Folks, sorry to break up the lovefest but the "entry level" workers at the San Antonio office are doing you job better than you are with less training. The problem is not that the data entry people can not work cases as fast as you revered state workers can, it is that TIERS is a slow and most of the time monotonous program that requires lots of time. I have talked with many, many of the state workers who have come to observe. Many of them were critical or, at least, wary of all these entry level people doing the work.

After a few short days they commented to me at how great of a job they were doing and that the entry level staff had a greater grasp of policy in the few short months that had been working, than many of the people in the offices. No telling what these entry level people will be like once they get the hang of the process.

One state worker said that the problems people are having on the floor are the same problems experienced by state people. Lucky for us, we have state workers and former state workers who work on the floor to answer policy questions and bring everyone up to speed.

So, for all of you smart and intelligent state workers who seem to think that the world can not revolve without your knowledge, get over it.

This is a pilot program, once more, one that is only several months old. Everyone is still coming up to speed with the ungodly program of TIERS.

It will take TAA time to fix what you, the collect state worker, spent years screwing up. Why do you think they privatized it?
And then this comment left by Fr. John who explains alot about TIERS:
Fr. John Whiteford said...
TIERS was not screwed up by HHSC workers. I was on a TIERS advisory committee before they signed the contract to develope the piece of crap system that they now have. They had field staff from every region in the state to provide feedback on what we needed in a new system. Problem was, they already knew what we needed, and just presented their ideas to us. We provided feedback to the extent that we could, but they weren't really interested in what we had to say. Then, as soon as they signed the new contract, they disbanded this committee, and so we never had a chance to provide feedback based on how the actual program worked.

This program was supposed to have been rolled out in 2001, they spent 300 million dollars on it, and it is a piece of crap. SAVERR, for all of its problems, is still a far faster, and more reliable system.

Those of us who have taken issue with the Accenture contract have never blamed the staff at Accenture for the problem. The problem is with a system that cannot work. I don't care how good the staff at accenture are, or get, they will not be able to save the state money with this system, because too many cooks are involved in determining eligibility, and if you had ever done interviews from start to finish (from taking the application, to the point of issuing the benefits, and all points in between) you would know why it is always worse to have more than one person involved in the interview process. It is too difficult to figure out what the previous person saw or did not see, when you are trying to figure out what the next step should be. It is better to have one person interview the client, and then do the follow up steps.

When I was a worker, and had to finish a case another worker had started, I generally had to call the client, and practically do another interview to make sure that the previous person didn't miss something, because in the old system, whoever actually certified the case was ultimately responsible for the case, regardless of what mis-steps anyone else might have made.

How then can you expect a HHSC worker to take a case from someone that they have never seen, and do not know, and trust the case work that they did. Either the worker will end up re-doing that work, or they will simply rubber stamp what the Accenture worker did. Neither alternative is an improvement on the old system.

Also, anyone who has ever done interviews will tell you that doing a face to face interview gives you a lot more information than doing one over the phobe, because people are much more comfortable lying over the phone than they are looking someone in the face.

At the end of the day, if we want quality cases that give people what they are actually eligible for, we should be doing face to face interviews.

In fact, doing occassional home interviews (like we used to do back in the day) gives you even more information than an in office interview can.

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To All State Representatives

This is an open letter to ALL Texas State Representatives:

TIERS DOES NOT WORK.....GO TO YOUR LOCAL OFFICES IN YOUR DISTRICTS. TALK TO THE WORKERS WHO WORK IN THOSE OFFICES- ESPECIALLY THE ONES WHO WORK CASES ON THE SAVERR PROGRAM- ASK them if that program works. ASK them why they have stayed on amongst the turmoil. TALK to the clients in your area. FEEL their frustration.

TIERS should only be put in a highly controlled environment- not one where it literally affects clients and their families. TIERS is not what the Executive Commissioner and his cronies are telling you. IT is not the "end all, be all". ASK the people in the field who know.


What now?

We've been calling for this since it started, and now it's all beginning to unravel.  I attribute this cancellation (since Hawkins and Co. have proclaimed all this time how GREAT all this is) to the pressure the Union helped put on the Agency through their Legislative contacts.
Now, what will happen?
Potentially "re-bid" the job?  BAD IDEA.
Continue to rollout TIERS?  BAD IDEA.  Entirely TOO much money has been wasted on TIERS as it is.  Cut bait and run.  Convert all these cases back into SAVERR until a new system is "built" and WORKS.  Rebuild staffing.  Get rid of all these "chiefs" and let's get back to work  - with the quality that we used to have.  Re-vamp the "Upper Management" who refused to acknowledge the flaws until they were forced to.  Remember this- "Upper Management" have goals that do NOT include client services OR employees.  They do not care if you are or were a loyal employee.  They do not CARE that clients have gotten the shaft.  They do not CARE that the taxpayers in Texas have gotten this screw job.  Us, those in the front lines- those in the offices that have borne the brunt of this screwup from the beginning- WE do care. 
Write your local representative and tell them that this is NOT OVER.  Please!  There IS power in numbers.  The more attention we can bring to this the better.  Email reporters at various newspapers (maybe not in your town, if you are fearful)- OR, send ME your letter and where you want me to email it and I'll do it from MY "hhsc" email address.  Remember this fellow HHSC Employees- WE ARE ALL "HHSC EMPLOYEE".  We are the ONLY ones that can continue to push this.
And I've been waiting a long time to say this, but:

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More Links

Links about the Contract

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Monday, March 12, 2007

Breaking News from TSEU

Sources: announcement set for Tuesday, March 13

TSEU has received the word from several sources that Accenture and HHSC will jointly
announce on March 13 that the contract will be "unraveled", with each party "going its way."
The word is that Accenture is feeling pressure to do the job right including making the TIERS
system work and is balking at the cost.

Human Services might still not be on track

According to the sources, HHSC might put forward a plan to re-bid the contract rather than
concentrate on rebuilding the system we had, which actually worked until they started
dismantling it.

While this development goes a long way toward ending a wasteful and damaging boondoggle, it
does not by itself result in a restoration of quality human services eligibility. TSEU will continue
to call for implementation of our plan, which includes:

1. Terminate the Accenture contract.
2. Rebuild a functioning human services eligibility system.

A. Hire more staff: It would require less than 1000 additional positions to rebuild the staff
to the 2004 levels. Add these staff and re-evaluate staffing levels in 2009.

B. Rebuild a qualified staff:

1.) Create a program to bring skilled, tenured staff who have left back into the agency.
2.) Reverse the damage caused by the Job Search and Placement ( JSAP) program by
allowing all HHSC employees who accepted transfers under JSAP to return to their
original positions.
3.) Rebuild the training program for eligibility staff.
4.) Cancel the Convergys contract and rebuild effective human resources/personnel
services to support management and front-line staff.

C. Consider creative ways to enhance services. Ask front-line eligibility staff for ideas.

3. Integrate CHIP eligibility with children's Medicaid Eligibility in the state-operated
intake system.

HHSC already operates state-employee-staffed call centers in El Paso, Houston, Austin,
and San Antonio, and Dallas that do intake for Children's Medicaid. The CHIP and
Children's Medicaid programs are closely related: integrating eligibility would provide a
seamless, "one-stop" system in which a single qualified worker would directly enroll the
applicant in whichever program they are eligible for. This step would reduce costs and
increase accuracy and timeliness in providing these crucial services to Texas children.

4. Deploy a cost-effective, functional data system for human services eligibility.

A. Have a task force that is outside the HHSC structure and answerable to the Legislature
re-evaluate both the TIERS system and the SAVERR system to determine the systems'
present and potential functionality.

B. Move decisively on the findings of the study to either complete the development of
TIERS or cancel the project; to implement an upgrade of SAVERR , or to pursue a new

C. Suspend all input or conversion of cases into TIERS until the future of the system has
been decided and, if it is decided to keep TIERS, until the system is fully functional.

D. Seek and accept the input of front-line human services staff as part of all decision-making
and developmental steps to deploy a functional system.


Here's another comment...which is in line with the crazy decision to continuing to rollout TIERS:
Guess what? The feds audited hhsc and said IEE and Tiers is not working. The report is on the sao web page. Look at page 127. TIERS, 07-13 on page 126/136 PDF.

The fish are biting.
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Comment that is deserving of being posted

I thought the following comment was worthy enough to be on the page itself so everyone sees it........provides interesting food for thought:
Topics for an interesting Albert Hawkins hearing:

1. What about ethics charges filed by Chris Bell regarding Albert Hawkins' membership on the board of Texas Health Institute and their non-competitive award of state Health and Human Service dollars? Is there an outcome?

2. What about OIG report stating public funds were paid to contractors at DSHS to lobby? Are these groups still funded? Has anyone had to pay back the money?

3. What about allegations by OIG that records were altered by DSHS and their contractors? Has there been follow-up on this serious criminal allegation in the OIG report?

4. What about allegations of inside info on bids shared between DFPS and Providence in the outsourcing of CPS services? Has this been thoroughly investigated?

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More TEARS to come as TIERS spreads further into the state.......

I'm sure everyone got this- but I'm posting it for those who read here that do not work for HHSC.  So it appears as though HHSC is going to continue rolling out TIERS which STILL does not perform in a way that it should.  I suppose this also means that the issues that TIERS has in relation to fraud (where cases are basically not prosecuted that have fraud because there's no way to verify/prove that TIERS didn't cause the overpayment)...will now be spread into even MORE counties.
So while HHSC tells the public that they are putting the contract with Accenture rollout on "hold"- they are still going to rollout the system that doesn't work.
Good luck to the following counties:
In April, we will begin a series of conversions over the spring and summer that will move more counties in Region 7 and a few in Region 8 to the new system. Each conversion will take place after cutoff for that month. Here's the schedule:
April          Bastrop , Burnet, Caldwell , Comal, Guadalupe, Lampasas and Llano counties
May          Bell County
June          Brazos , Burleson, Fayette, Grimes, Milam and Washington counties
July           McLennan County
August      Bosque, Coryell, Falls, Freestone, Hamilton, Hill, Lee, Leon, Limestone, Madison, Mills, Robertson and San Saba counties.
State workers will continue to process all cases, and all state offices will remain open. With each conversion, we will conduct thorough readiness assessments before reaching a final determination to move forward. We moved Williamson County cases to TIERS in November 2006, and we converted foster care cases in February of this year. Both those conversions went very well.
Staff in the conversion areas will begin receiving TIERS training, and ART workers will fill in at the offices while staff receive training. In addition, ART workers will be on hand in the offices to assist with each transition.
If you have questions or concerns, please let your supervisor know. One of the keys to any computer conversion is to identify and address issues quickly. You are on the front lines, and we need and value your input to make the transition successful.
Thank you for all your hard work and your commitment to our clients.
Anne Heiligenstein
Deputy Executive Commissioner for Social Services

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Sunday, March 11, 2007

Just some rambling

First off, sorry I've been away. I've not abandoned the blog (by any means)- work has been horribly busy and by the time I get home? I'm spent of all things HHSC.

I will say that with the session going on, there's no better time for those of us in the filed who are seeing the destruction that has become of this agency to SPEAK OUT! Write letters! Send your representative the link to this blog if you'd like- anything to get the word out.

I also want to do a post in the future of what the actual personal toll all this has taken on the actual employees. We all know the effects that the changes have had on our clients, but what about those of us who have served the agency and it's clients well for years- that have had to make huge personal changes due to what has gone on. Some have left the agency and taken a pay cut just to ensure they had a job (because they got a layoff notice). Some have sold homes, cars, cut out other various expenses (vacations, etc) because they thought they were losing their jobs. You have employees who, due to the stress, have developed medical problems that is directly due to the conditions under which they are now working. Stress kills. Then you have those employees that the agency really couldn't afford to lose, but have retired and NOT come back because it wasn't an agency they believed in anymore. Many of our offices are now short staffed with very few tenured workers left and the rest are temporary employees who are thrown into the fire and expected to be able to grasp the policy and see the full caseload with little or no protected plans in place. This overwhelms new people to the point that THEY then leave.

And now, they are expanding TIERS? So you will have small rural offices that have always been able to truly help their clients, see many appointments per day, etc- and now? With TIERS? That level of service will go way down. For HHSC "Powers that Be" to continue to act as though TIERS is the God-send of human services are just giving the public lip service. The amount of money that has been POURED into TIERS still has not produced the end product as promised. I'm sure most of us either work in TIERS already, or know a worker who is in ART and hears the stories of a "no show" taking an hour to process, or the simple procedure of correcting a case takes forever......this? this is client service? Insane.

So in offices that are seeing 15+ clients per day? What do they think will happen to the "almighty lead time" when the offices rollout into TIERS? If that office can only see 4-5 to account for the learning curve, it pushes the lead time even FURTHER. Which directly conflicts with Federal regulations. Is FNS doing anything at all?

Rumor has it that the Pilot area sees upwards of 17-18 appointments per day in TIERS. Can anyone verify? I've also heard that they are also getting massive amounts of overtime. So when those in charge point to the pilot area and how many they are seeing as the "model to follow"- they leave out the fact that it's not being done in an 8 hour day. How about those employees that have actual "lives" outside of the office? Are the rollout offices supposed to tell these employees that their families, their children, their outside responsibilities are no longer important? I guess they could, and more people could just quit.