Tuesday, July 15, 2008

Testimony of Derrick Osobase, Legislative Director, Texas State Employees Union

Testimony from TSEU:

Joint Committee on Oversight HHSC Eligibility System
July 14, 2008

My name is Derrick Osobase, I am here representing the Texas State Employees Union. We represent over 12, 000 state agency and university employees across Texas.

The Texas State Employees Union is very concerned for the future of services administered by the Health and Human Services Commission. We ask that the legislature continue to direct HHSC to rebuild the eligibility program that’s been plagued since HB 2292 with the dismantling of the Health and Human Services workforce, the use of a new eligibility system that has proven not ready for statewide rollout, and the use of costly and ineffective private call centers.

We acknowledge the effort that the Commission has put forth in attempting to rebuild the workforce and encourage them to continue. The legislature in the last session made great gains to stem some of the problems that agency was experiencing, such as giving the Commission the authority to hire 10% more staff above its FTE cap. We are pleased to hear that’s what the agency plans on doing. However 10% is not enough, rider 54 explicitly gives HHSC permission to hire additional state staff to replace work being done by private contractors. In light of past failures by private contractors and taxpayer money wasted on these endeavors, we believe that most efficient and reasonable course of action is to forgo private contracting and use the money rebuild state staff.

Currently, staffing levels are still clearly inadequate to properly administer services to Texans in need. Caseloads for eligibility workers have exploded in recent times; the average caseload before regional rollout of TIERS was about 150 to 250 cases per worker and now its 500 to 900 cases per worker. Customer service has been adversely affected by these high caseloads, which translate into clients not receiving their benefits. This is compounded by trying to navigate TIERS, which workers describe as “inefficient” and “cumbersome”. Many state employees are overwhelmed by their workload and see little indication that the situation will get better in the near future, so they leave, which contributes to 20.9% turnover rate statewide.

We have a major concern with the amount of time it takes to process TIERS cases. HHSC reports that 1914 state eligibility staff processed a Food Stamp case in the month of June. We know that there are approximately 4000 HHSC employees with the job title Texas Works Advisor. That suggests that nearly half of all staff worked at least one TIERS case last month. Some of those workers do all their cases in TIERS. Yet, according to HHSC, only 12% of all Food Stamp cases are in TIERS currently. This suggests that a significantly disproportionate amount of staff are working TIERS cases. Plus, the vast majority of cases worked by vendor staff are in TIERS. We would like to see an analysis of how much overall staff time is being spent on the entire TIERS caseload compared to the entire SAVERR caseload. Without this analysis and simply based on what we see right now, a statewide roll-out of TIERS would necessarily require one of two changes: TIERS would have to be much quicker or HHSC would have to hire significantly more staff.

The TIERS program continues to fall short of expectations. Timeliness of cases in TIERS for the month of May in the rollout region was 69 %, an improvement from 49% in February, but still well below federal timeliness standards. Recipient are experiencing delays and even the highly trained TIERS workers are having trouble processing cases within the 45-day time period. Recipients literally flood local state offices asking to be placed back into the older system.

Compared to SAVERR timeliness on average is about 92% statewide. This is not a call to get rid of TIERS, but before the State of Texas fully commits to a system on which the taxpayers have already spent 420 million dollars and counting, we need to be sure it works. We're asking this committee to direct HHSC to take the following steps to ensure that Texans continue to get the services that need in a timely fashion.

1. Stop putting new cases into TIERS until backlog is cleared. This means putting new women’s health, CHIP, and foster care cases into SAVERR, not TIERS.

2. Conduct an independent analysis of the TIERS system with an assessment of its strength and weaknesses compared to the SAVERR system. Also, explore the cost benefits to converting SAVERR to a web base system.

3. Get pilot area into compliance with Federal timeliness standards.

Finally, stop the continued use of privatized call centers for service delivery. Making recipients fax their documentation to a call center that is not connected with a state office in their area just places another obstacle in the way of getting services. Clients report many other problems such as lost paper work or paper work that was improperly scanned, which results in the eligibility worker essential redoing intake. The approach has been both very costly and has caused problems for recipients. It increases the number of people with whom the clients need to communicate and, as a result, delays the final disposition of the case. This notion that private call centers save taxpayers money and make access easier for clients is false.

The original authorization for call centers in HB 2292 required that HHSC make a convincing cost benefit analysis for call centers. In light of the lack of cost saving for private call centers and the frustration they cause our citizens, it is our position that private call centers should be abandoned. HHSC, under the direction of the legislature should plan and operate any facilities where applicants and recipients communicate by telephone. The successful children Medicaid center in El Paso is one example of a state run call center that is fully integrated into their program components.In conclusion, we ask that the committee and the legislature act quickly to stabilize the workload by hiring more staff, freezing further roll out until TIERS is fully ready, and making service delivery more unified and effective, by eliminating the role of vendors making contact with clients. The best way to insure accountable and timeliness would be to have one entity, HHSC, being responsible for all client contact with adequate staffing and a computer system that works.

Contact: Derrick Osobase, TSEU Legislative Director,
512-468-3018 or dosobase@cwa-tseu.org

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