Ramblings of an HHSC Employee amidst chaos

Happy New Year!

2012-01-09T00:49:00.000-06:00

Just wanted to pop in and say "Happy New Year" to my fellow HHSC'ers. Here's to hoping 2012 is full of blessings and peace for you and your families/loved ones.

Rollout is done- and whether we like it or not (or approve or not) TIERS is here. Period. So, I think maybe (and listen, I'm in the field, so I speak this to myself as well) it's time to STOP and reflect on what we do. You know, it's easy to get caught up and "hate" this job. The naysayers who hate it, maybe it's time to go. Many of us who have YEARS of tenure here aren't going anywhere. At least I hope not. We suffered, as an agency, in 05 when jsap happened. We really did- it's taken a LONG time to even come CLOSE to where we need to be.

I say, change at this point needs to come from some other places- long and short of it? workers aren't the problem. In some offices, it is incompetent supervisors and pm's. Maybe they promoted too fast, maybe they knew the right people. I don't understand why administration doesn't consider the fact that a GOOD leader will have GOOD staff. It's very frustrating to read comments about the bullying that goes on. Good supervisors get rid of bad workers/clerks. This makes it better for everyone.

But we never need to lose focus on WHO is really important- and that is the client that you serve each day. Our issues within our job are ours- and we go home and can decompress. Client's issues are theres ALL THE TIME. Never ever forget that. So decide each day- it's going to be a good day, or a bad day. Only you can make that choice. (after all, it could be US having to beg for help, ya know?)

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Rollout done?

2011-12-13T18:58:00.001-06:00

So, how's it going out there?

Wanted to talk a little bit about the horrible incident in Laredo.

Our agency and it's workers are being vilified in comments sections of major news stories (abcnews.com and huffingtonpost.com for example).....

We work hard.

We work long hours.

We have lazy workers (just like every other job on earth).

We have super workers that truly do believe in what they do everyday.

We have many workers trying as hard as they can to make a difference in the lives of Texans.

Obviously, this family had alot going on. I see in comments in other places that we should have gone to her home and "see" how she was living. It does not and will not ever have a bearing on eligibility.

Joe Public needs to make up their minds- either you want people to have to go through a process for the benefits, or you want us to just arbitrarily hand out benefits based on what they "look like". You cannot have it BOTH ways.

To all my fellow workers out there- what you do is important. It's hard. It's time consuming. You miss family time and work long hours. But know at the end of everyday you are ensuring a family has food to eat.

God Bless.

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Test

2011-12-13T18:52:00.001-06:00

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I'm still here!

2011-04-17T20:20:00.002-05:00

Just been extremely busy! So, to get back in the groove - what's been going on out there? Rollout full steam ahead- the "Valley" region rolled out this weekend- I guess that's why TIERS was at a snail's crawl all week last week. Very hard to get work done when the system is moving too slow. When it takes 2 hours to get ONE case done in TIERS, that's a problem And if you had any delinquencies because of this, sucks to be you Mr. Caseworker- it's still your fault.

Links

2010-07-01T19:09:00.001-05:00

Links about the Sanctions:

Feds Fine Texas Over Food Stamps; Legal Aid Groups Say "We Told You So"

Off the Kuff has THIS to say.......

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Texas hit with fine for food stamp errors

2010-07-01T18:58:00.001-05:00

Corrie MacLaggan
Austin American Statesman
Monday, June 28, 2010

Federal officials have fined Texas $3.96 million for errors in issuing food stamp benefits, according to a letter to House Speaker Joe Straus.

The penalty is for a high rate of overpayments or underpayments two years in a row, said the letter from U.S. Department of Agriculture Undersecretary Kevin Concannon.

Among the four states hit with penalties, Texas was fined the most. Also fined were Indiana ($1.2 million), Maryland ($742,238) and Iowa ($205,730), federal officials said.

Texas plans to appeal, said Geoff Wool, a spokesman for the state Health and Human Services Commission. He said the commission learned of the fine on Friday.

Wool said Texas' appeal will focus on the fact that the number of food stamp recipients in Texas spiked after Hurricane Ike in 2008, increasing 26 percent in the year that followed.

"The effect of the hurricane is certainly something that has disrupted our ability to process applications," Wool said. "We've also seen an increase overall in the number of applications and recipients" because of the economic downturn.

There are 3.56 million Texans now on food stamps. The federal government pays for the food, and federal and state governments split administrative costs.

Wool said that Louisiana successfully appealed a fine after Hurricane Katrina. "We feel like that's a precedent," he said.

In 2009, Texas' "payment error rate," based on overpayments and underpayments, was 6.9 percent, compared with a national average of 4.36 percent, the letter said.

That's the type of error that triggered the fine. The letter also said that Texas performed worse than the national average on a measurement called the "negative error rate," which measures the frequency of improper denials. Texas' negative error rate in 2009 was 14.82 percent, compared with the national average of 9.41 percent.

Wool said that Texas' payment error rate and negative error rate are now below the national average.

Texas has the option of investing half the amount of the fine to improve its food stamp system, the letter said. If the state were to improve, it wouldn't have to pay the other half.

Texas also may pay the fine in full, the letter said.

Meanwhile, federal officials are distributing $30 million to 10 states (plus Guam) for excellence in administering the food stamp program, Agriculture Secretary Tom Vilsack announced last week.

Texas received such awards for years. From 1998 through 2004, the state got a bonus each year, Wool said. In 2004, Texas' $7.4 million bonus for accuracy was more than any other state's, according to a commission news release from the time.

The most recent fine the commission has a record of is from 1994, when the agency was fined about $10 million, Wool said.

In recent years, the state has struggled to process applications because the commission lost workers in advance of an outsourcing effort and then was hit with Hurricane Ike and the economic downturn, state officials have said.

Celia Hagert, a senior policy analyst at the Center for Public Policy Priorities, said the recent fine should concern lawmakers "because we used to do a really good job in this area."

"The message this should send to the Legislature is it's important to have an adequately funded and staffed system," said Hagert, whose organization is an advocate for middle- and low-income Texans. "Otherwise, you're going to make mistakes and waste taxpayer money."

In addition to miscalculating benefits, the state has had trouble processing applications within the 30 days required by the federal and state governments. To address an application backlog that hit 42,000 applications last fall, the state has added 850 workers since September.

In December, Texas RioGrande Legal Aid sued the commission in state district court in Travis County over the backlog. The group expanded its lawsuit in June, adding more plaintiffs and arguing that the entire food stamp system is purposely dissuading people from participating.

But Wool said, "We feel that because this is a federal program governed by federal rules, the state court is limited in its ability to provide relief." The state is seeking to get the case dismissed, arguing in a June 22 court filing that food stamp processing deadlines aren't mandatory.

"That," said Cynthia Martinez of Texas RioGrande Legal Aid, "is about as ridiculous as it sounds. This is an attempt for them to avoid accountability by making the argument that the king can do no wrong because he is the king."

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And the rollout is back on

2010-05-05T14:21:00.001-05:00

So at cutoff this month (May) Region 1 (?) rolls out into TIERS. After that is ElPaso.

So, CCC (Customer Care Centers) is already THOUSANDS of case actions behind on changes, but we are going to add even MORE people to TIERS? This makes absolutely NO SENSE WHATSOEVER.

So what happens to the changes? What happens when someone reports the loss of a job (or a new job) in March, and that change isn't TOUCHED for months? Do we, as taxpayers, want to issue benefits to someone incorrectly?

Not to mention that regardless of fault, if we overpay a client (who reported a new job timely, for example) because the AGENCY does not work it timely....is that fair?

None of this makes sense. TIERS still doesn't do everything it is supposed to.....we are paying millions for this.

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Complete Insanity

2010-04-02T21:57:00.001-05:00

Exclusive: State privatization champion gets contract to help clear up welfare mess

11:59 PM CST on Saturday, March 13, 2010

By ROBERT T. GARRETT / The Dallas Morning News
rtgarrett@dallasnews.com

AUSTIN – A former state official who played a major role in the state's biggest privatization fiasco is now making money trying to help Texas fix the problems that resulted.

Gregg Phillips was the state's No. 2 social services official several years ago, and he led a push to hire a private company to evaluate applications for public assistance.

Now his Austin-based company, AutoGov Inc., has received $207,500 since November to help the state eliminate errors in deciding whether an applicant gets food stamps or other aid and how much recipients get. AutoGov was hired without other companies having a chance to bid for the work.

Health and Human Services Commission spokeswoman Stephanie Goodman said that the agency's commissioner, Tom Suehs, and his predecessor, Albert Hawkins, agreed that the company's software might alleviate the problem.

"They both faced the same problem – high error rates – and thought it offered a potential solution," Goodman said.

State laws on former employees lobbying or contracting with agencies would not prohibit such an arrangement, given that Phillips had been off the state's payroll for several years. But critics of the deal say it's troubling that a former employee is getting paid to try to fix problems spawned by an idea he helped hatch.

A leader of a state employees union complained that Hawkins and Suehs – both appointees of Gov. Rick Perry – again have sought high-tech, low-cost fixes for the loss of experienced state workers.

Mike Gross, vice president of the Texas State Employees Union, also said he's troubled that Hawkins approved a vendor subcontract with two of his former aides – Phillips and AutoGov's chief executive, Rose A. Hayden, Hawkins' former chief of staff. The company is paid as a subcontractor to the larger firm that the state hired to run the system.

"The whole thing smells very bad," Gross said. "We're now hiring the guy who got us in the mess in the first place. It is absolutely stunning."

Call not returned

Phillips couldn't be reached by phone or e-mail to answer questions about the contract. A receptionist at AutoGov said Hayden was in a meeting and would not be able to return a call.

Hawkins said AutoGov was the right choice because it had experience doing similar work for the Texas Youth Commission and in other states' social programs. He said he saw no conflict of interest or appearance problem.

"Both of them had been gone from the agency, what, four or five years?" Hawkins said. "So I certainly didn't perceive it as being any kind of conflict-of-interest concern."

Hawkins said he didn't put the work up for competitive bidding because "it was within the scope of a contract that was already in place."

He was referring to an interim deal under which Texas pays Reston, Va.-based Maximus Inc. $134 million a year to run eligibility-screening call centers, enroll youngsters in the Children's Health Insurance Program, and assign them a doctor.

It's unclear whether the state could have found a better deal by seeking bids for a contract. Hawkins suggested that had he tried, Maximus might have sued the commission. When pressed, he said: "It at least would have required some contract discussions with Maximus."

Lisa Miles, vice president for investor relations for Maximus, declined to discuss the company's hiring of AutoGov. She referred all questions to Goodman, the state spokeswoman.

Goodman said Suehs, who formally approved Maximus' hiring of AutoGov as a subcontractor on Nov. 10, showed no favoritism toward his former colleagues.

"Played no role in the decision," she said in an e-mail.

Phillips, a former Mississippi state official, served under Hawkins in 2003-04. He headed Perry's 2004 investigation of ineptitude at Adult Protective Services before resigning for health reasons in September 2004.

Hayden was Hawkins' $125,000-a-year chief of staff at the commission and played a role in the agency's help with legislation in 2003, Hawkins said. Earlier, the two were colleagues in Gov. George W. Bush's budget office and at the Legislative Budget Board. Hayden left the state in October 2004.

Phillips helped former Rep. Arlene Wohlgemuth, R-Burleson, fashion a 2003 legislative requirement that privately run call centers be used to help process applicants for Medicaid, CHIP, food stamps and cash assistance. He testified before lawmakers on the idea.

Hawkins says the state's key misstep came two years later, when lawmakers ordered a 40 percent reduction of state eligibility staff. But his critics have said he didn't stand up to the state's GOP leaders and demand enough money and time to adequately support and test the proposed public-private screening system.

It was launched in late 2005, after a large outsourcing company, Accenture, won an $899 million, five-year contract. But soon after the state notified its own workers that they might lose their jobs and shifted duties to Accenture – and its main subcontractor, Maximus – the project went sour.

Call centers were jammed, people were wrongfully cut from benefits, and it took months for services to begin once Texans applied.

Most infamously, applicants for a time were given a wrong fax number for sending pay stubs and other private documents. It belonged to a Seattle warehouse that had no part of the deal. That company shredded and threw away the paperwork after unsuccessfully trying for weeks to alert Texas that something was amiss.

By mutual agreement, the Accenture deal was terminated, state workers were rehired and Maximus mostly took over a scaled-down contract. In June, the commission tentatively chose Maximus' bid to continue the work. However, the two sides are still negotiating and haven't settled on a proposed three-year contract, Goodman said.

Delays continue

For Texans hammered by the recession, problems persist. Long processing delays for

food stamps and Medicaid have continued for a year.

A Feb. 25 report by the commission shows the state overpaid or underpaid food stamp recipients 7.3 percent of the time in August, compared with a national rate of 4.3 percent. And it wrongly denied people benefits in 14.3 percent of cases that month, while the nationwide error rate was 8.2 percent.

Celia Hagert, a social programs analyst at the Center for Public Policy Priorities, which advocates for low- and middle-income Texans, said that between 1999 and 2005, Texas received federal bonuses each year for having low error rates in food stamp processing.

She called it "ironic" that Phillips has re-emerged as fix-it man.

His computer software, no matter how good it may be, is no substitute for hiring back enough state workers "who know what they're doing," Hagert said. "That's the key. The system we have now is neither accessible nor accurate."

Goodman stressed that the commission has no obligation to retain AutoGov if it doesn't meet expectations. The company has billed the state an additional $62,500 but hasn't yet been paid.

"There's no obligation for additional payments beyond those if the tool isn't proven effective during testing," Goodman said.

She said that the commission is exploring whether "similar services are available through DCS," a vendor that checks industrial payroll databases and automobile ownership records to spot applicants who make too much or own too much property to qualify.

Meanwhile, a March 4 AutoGov news release suggested that Phillips and Hayden intend to take their software to terrain even more troubled than Texas.

It said the company recently won contracts from the University of Miami's Project Medishare and the U.S. Centers for Disease Control and Prevention to "implement the software in Haiti's central plateau."

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Hello!!

2010-02-27T19:27:00.002-06:00

So sorry to have not been posting lately- have been very busy in both my personal and business life!

However, I'm here now and have some interesting info...

Evidently, the state has hired Stanley Stewart from Michigan for "consulting" to help get Texas back on track. FNS is likely breathing down the new Commissioner's neck while he tries to clean up the mess made by Albert Hawkins.

Anyway, so TIERS rollout is back ON. Region 1- Lubbock/Abilene area is next to roll out in May. After that, from what I've heard, ElPaso area is after that then SAN ANTONIO! It will be very interesting to see what rollout does to TIERS and it's ability to maintain the caseload.

As it is now, TIERS still has issues where it slows down so much that it's difficult to get a case done quickly. ESPECIALLY at the end of the month, when all recertifications are due.

It's also interesting that the State saw fit to take away local office's "On Site Support" staff who offered technical support to local office staff for TIERS. Now, ART (Assistance Response Team) helps troubleshoot, but that's not really what the state needs. ART has many "bad habits" and to share those with local office staff just makes a case having issues even worse.

So I've heard that it's Mr. Stewart that is advising to do an aggresive rollout and have the whole state in TIERS within a year.

I want to be optimistic about this, and hope it will work and that TIERS does not crash all around us, but I have to be realistic also.

Any gossip out there? Put it in comments.

Letter to the Editor regarding "Bridges"- the computer system in Michigan that's similar to TIERS that Stanley Stewart rolled out in Michigan...

DPHHS contract: In Michigan, Deloitte did all work in-state (Deloitte? As in the same Deloitte that Texas contracts with? Interesting)

Official: Texas Has Worst-Ranked Food Stamp Program

TIERS

2009-11-10T20:22:00.001-06:00

Got this comment today on a fairly old post...wanted to respond. First, the comment:

Anonymous has left a new comment on your post "Texas health and human services chief to retire th...":

You fail to mention the abomination titled TIERS that is behind the entire crisis being experienced by the Agency. The Internet based program is far from user friendly and has caused much of the huge backlog of cases. I had planned to work an additional year or two but took retirement early in March of this year due to the stress brought on by a program that would not allow cases to be proceessed and even the "experts" could not clear. I had a call from the Agency today asking me to return to work. I told them to give me a call when the state decides to trash TIERS and return to the old, but functional, SAVERR program.

To which I say, I've said this many MANY times on this blog. MANY. Several. Over and over and over again. To which I say, I totally 100% AGREE. In addition, it was ALSO Albert Hawkins that PUSHED the privatization scheme and TIERS. He was HIRED to do so. I'll never believe OTHERWISE.

And let's not forget, as I've mentioned before- TIERS is a MONEY MAKER for Deloitte. As long as the program doesn't work, then they make money....to "troubleshoot". Think about it.

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Food stamp woes grow with need

2009-11-05T21:58:00.002-06:00

Melissa Fletcher Stoeltje
San Antonio Express-News
11/5/2009

Despite efforts to improve the system, food stamp applicants continue to face long delays in assistance amid a recession-fueled surge in demand.

In Bexar County, the state processed 22,463 more applications from March to September than it did in 2008. More than 210,000 people received $26 million in food stamps in October in the county, with the average family getting $322 a month. In the vast majority of households receiving food assistance - 82 percent - at least one person is employed.

Many have had to wait six months for their first food stamps. "We're just not keeping up," said Stephanie Goodman, spokeswoman for the Texas Health and Human Services Commission. "We're processing more cases per month than we have before, but we just don't have enough workers. Our employees are ... exhausted and working extended hours. We need to give them a break, but there are still people lined up waiting for services."

State leaders recently said 250 more employees will be hired to process applications, with more to come. Goodman said she hoped to have 750 additional workers out in the field by next spring.
"We're planning to hire 150 to 250 per month, but of course all those additional people have to get desks, phones and computers. They all have to be trained, which takes time. So we probably won't be able to feel the affect until spring."

The backlog in qualifying people for food stamps has left many San Antonians frustrated. When Damian Perez and girlfriend Sandra Hernandez tried to get food stamps, they thought they had done everything right.

The application was arduous, requiring a raft of documents for verification. They brought in all the right forms. "Then they told us to come back on Monday," Perez said. They were asked for more documentation the next week, and the application was delayed several times. "The bottom line is it took us about six months to get the (Lone Star) card," said Perez, whose girlfriend since has found work. "All I want is for somebody to be accountable. I want somebody to say, 'We messed up.'"

Their experience is far from a quirk in the system: About 40 percent of Texans who apply for food stamp assistance aren't certified within the 30 days required by federal law.

Some go hungry "It's a humongous problem," said Renee Trevino, an attorney and group coordinator for public benefits with the Texas Rio Grande Legal Aid, which helps people experiencing food stamp delays. "We've had clients who have just given up because it takes months and months for them to even get an interview."

In the absence of food assistance, she said, low-income people rely on food pantries or forgo paying rent or utilities. Sometimes, they go hungry.

Cyrus Orozco, who makes $100 a week washing dishes, was struggling to buy a $13 can of powdered milk to feed the youngest of his three children. When he applied for food stamps, he was told it would be six months before he could receive assistance.

"I just couldn't wait that long," he said. "My children had to be fed." He sought help from the Advocates Social Services of San Antonio, whose volunteers are experts at navigating the food stamp application. Within two days, he had his food stamp card.

Carlos Mata, head of the agency, said he sees about 100 clients a month who have found their food stamp application delayed or derailed. He said the average wait is three to four months. He claims some 3,700 Bexar County families are being unjustly delayed from getting food stamps.

Food bank depleted In the meantime, people seek help from places such as the San Antonio Food Bank, not only for emergency food but for assistance in applying for food stamps.

Eric Cooper, the food bank's executive director, said last month his organization processed about 3,500 applications. When there are delays, applicants come back to him for groceries.

"Our resources are being depleted at a much more rapid rate because of delays," he said. "Food banks across the state have felt this tidal wave of need. ... This business-as-usual approach has created a significant backlog."

Houston's state Rep. Jessica Farrar, chairwoman of the House Democratic Caucus, said complaints about the food stamp program make up the chief reason for calls to her office. She blames an attitude among some lawmakers that if you starve the program, the problem will go away.

"This is symptomatic not just of the food stamp program but mental health, children's health insurance, welfare," she said. "If you don't spend the money, then the problem doesn't exist. In Texas, we consistently turn away money that then goes to other states. That needs to change. We need to take care of Texans in need."

The food stamp program has been in trouble since the 1990s, said Celia Hagert, senior policy analyst for the Center of Public Policy Priorities, a group that helps low-income people. She said that in 2006, the state sought to privatize the food stamp program, a move that triggered a massive exodus of workers.

"We lost about a third of the work force, maybe closer to half," she said. The privatization program was put on hold, but the dearth in workers remained. "The system became overwhelmed, and since then we haven't met the federal standard," she said.

Food stamp workers share frustrations

2009-11-05T21:56:00.002-06:00

Corrie MacLaggan
Austin American-Statesman
11/5/2009

When the new head of the agency responsible for the state's backlogged food stamp applications sent an e-mail to employees asking for feedback about the agency, he got it.

About 500 state workers replied to Health and Human Services Executive Commissioner Tom Suehs, telling him about low morale and low pay, poor management, technology problems, insufficient training, long hours away from their families. They wrote about feeling frazzled, crying on the drive to work and actively looking for other jobs.

"I have been with the agency 21 years and I have never seen it this bad," wrote Linda Perez, a supervisor in San Benito. "We can't work like this anymore. Morale is low but we come to work every day with the hope that things will get better."

The commission has struggled since experienced state employees started leaving in advance of a major privatization effort in 2005. And the current economic downturn has led to a sharp increase in applications, resulting in the longest wait times agency officials can remember - families routinely wait months - and drawing warnings from the federal government that if Texas doesn't start meeting 30-day processing deadlines, the state's food stamp aid will be in jeopardy.

To work through the backlog, many of the nearly 7,700 state employees known as eligibility workers are staying at the office into the evenings and coming in on weekends, putting in an average of 13 hours of overtime a week. In some cases, the overtime is mandatory.

"That is not sustainable," said state Sen. Judith Zaffirini, D-Laredo, who met with Suehs last week about the situation. Zaffirini, one of two senators tapped by Lt. Gov. David Dewhurst to monitor food stamps, added: "I didn't know that the eligibility staff are working 8 to 8 and on Saturdays. Well, of course there's a morale issue, and of course there's a turnover issue."

I'm sorry, but did she say she didn't know eligibility staff were working 8 to 8 and weekends? How can that BE? We've been doing that since jsap- 2005! This isn't new. Way to stay in touch.

Suehs spokeswoman Stephanie Goodman said the commissioner was aware of employees' concerns but that their e-mails "helped us really understand the human toll."

"We know we have to reduce the backlog; we know we have to deliver services faster," Goodman said. "But we cannot continue to do this to our employees."

No lie. It took someone other than ALBERT HAWKINS to actually care- but you can't say that no one knew the toll. You all see the overtime numbers, so it's not like you didn't know the amt of overtime that was being worked in the field. How do you THINK someone is working 20-30 hours in overtime PER WEEK? I know people who work from 7:30 a.m. until 8 p.m. (11.5 hours PER DAY) and then another 8-10 hours on Saturdays.

In his original message to employees, Suehs wrote that the agency is hiring 750 new workers by filling vacant positions, adding positions recently approved by state elected officials and hiring in advance of anticipated vacancies.

"Help is on the way, but you and I both know that it will take some time to get those new employees on board and trained," Suehs wrote in his Oct. 21 e-mail. "We're facing a crisis today, and I need your help. ... I welcome your ideas, and I need your suggestions."

Marni Chancellor of Athens replied to say she is averaging 85 hours a month of overtime and is "praying there is an end in sight."

In September, the state spent $2 million on overtime for eligibility workers, who earn an average salary of $30,321, according to Goodman. That month, eligibility staffers, including supervisors - who earn comp time, not paid overtime - put in an extra 227,000 hours, Goodman said.

Midland worker Kristin Davison told the commissioner that she spends several mornings a week crying on the way to work because she knows she won't see her 5-year-old until after the girl is in bed. Without full weekends off to eat dinner with family, do laundry and go to church, employees are "overworked, frazzled, tangled, frustrated, angry and guilt ridden."

This is what the public does not realize, and to some extent upper management. We don't work all these hours for the money...contrary to what those on the outside may think. We do it because we have an obligation not just to the agency, but to the clients we serve. The workers are in the middle of all this and have been the forgotten ones. Add to that when you are unable to take any decent time OFF- and it spirals. I just hope that the commissioner's email is not in vain, that the suggestions were asked for and still nothing gets done. Time will tell.

"Our clients are hurting because we cannot possibly handle the amount of work that is given to us daily," she wrote. Several employees in the Houston area told Suehs that they are not allowed to take any vacation this month or in December. Goodman said the agency is clarifying to Houston-area managers that there is no such ban.

Please, this isn't new either. Leave moratorium? We've had those much of the time. Not allowed more than 1-2 days off without "special permission"? Nothing new about that.

Goodman said the agency is considering changes, such as worker bonuses and temporarily hiring retired employees to help with the backlog. Also on the table, she said, is asking for a federal waiver that would allow workers to deny applications from families whose applications clearly show they don't qualify (now, employees have to schedule interviews for such families).

I have a newsflash for you- you can pay bonuses and hire back retirees all day long- but for longterm help- start training new workers the way us tenured were trained back in the "good old days"- 2 week trainings won't solve the problem. 3 week training won't solve the problem. You have to develop staff so that they know what they are doing and therefore STAY. All it seems is done now is new workers are just "thrown" out there, and they either stay and muddle through, or they quit from the sheer magnitude of what is expected of them. Ask any tenured worker if 2 weeks is enough, and see what they say.

Meanwhile, tens of thousands of families are waiting for decisions on past-due applications. "It's just unacceptable to be so far behind," Zaffirini said.

Dismissed

2009-10-16T20:27:00.001-05:00

Lawsuit over Texas food stamp delays dismissed

It may have been dismissed, but it accomplished what it set out to do- shine a spotlight on what we, in the field, knew would eventually would become an issue. Let's just hope that our new Commish and his staff don't take this out on the workers who are doing all they can.

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More...

2009-10-15T22:19:00.001-05:00

Ok, here are more:

Editorial: Food Stamp Crisis Dallas Morning News - ‎Oct 13, 2009‎

Food Stamp Asset Test not State Law Austin American-Statesman

Food Stamp Applicants Growing in Number KFDA

Two Senators to Monitor Food Stamp Problems Austin American-Statesman - Corrie MacLaggan - ‎Oct 9, 2009‎

Feds Warn State: Speed Up Food Stamp Process Marshall News Messenger - ‎Sep 26, 2009‎

One thing I WILL say, is regions are going to 10 day Food Stamp training classes for new workers. Now, while I understand the need to get workers in the field as soon as possible (because we need the help!), I also have been around long enough to know that 1 of 2 things will happen when you do not devote enough time up front into training staff adequately (and this isn't a slam on trainers either- they are just doing what they are told):

1- they will become overwhelmed very fast - this is a complex job, even though "the public" thinks all we do is whip out the proverbial state checkbook, and because of the overwhelming nature of the job- they will quit.

or:

2- we will have inadequately trained workers (through no fault of their own, mind you) who stay, and do cases inaccurately (again, through no fault of their own) that will lead to higher QC errors- and add to the growing sanctions Texas is going to pay.

It's a no win situation.

Do this- take the time to train adequately correctly. Us in the field would much rather do with the vacancies an extra couple of weeks or even an extra month if that means the new hires come into the field actually able to do the job. New hires will now come into the field having been CRAMMED full of information, and the staff in the office are going to be too busy to adequately help them, which will lead to frustrations. I know that while I know what I'm doing, I'm not so sure 2 weeks of training (with GWS training, mind you- along with policy)- would have been enough and I can see myself having given up years ago had I been thrown into this mess with that much under my belt.

Pay up front now, or pay later.

Stop paying Deloitte all this money on TIERS- think of the number of workers you could hire and take the time to train with all that money instead going to Deloitte to continue with the mess that is TIERS. You know, the more issues TIERS has, the more money Deloitte makes. TIERS does not even correctly figure benefits right- even when income is entered correctly. You have benefits being issued INCORRECTLY due to the SYSTEM. SAVERR has it's issues, we all know this- but it at least knew how to project income! Scrap these call centers- and do whatever you can to bring our tenured staff back. All the vendor does is refer clients back to the local offices ANYWAY! And we are PAYING them for this! Part of our timeliness issue in TIERS comes from the vendor scheduling untimely. WAKE UP! Albert Hawkins left before he could be put out- and look at the fine mess he's left us in.

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article

2009-10-15T21:58:00.001-05:00

I haven't had much time to post- but HERE is one article...if you see anymore, post the link in comments.

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Legislative Budget Board nixes more HHSC staff; Texas warned it could lose federal food stamp funds- from TSEU

2009-09-30T20:02:00.002-05:00

Legislative Budget Board nixes more HHSC staff; Texas warned it could lose federal food stamp funds

. . . The Legislative Budget Board (LBB) has turned down an HHSC request for funds to hire about 650 new eligibility workers the same week HHSC was warned of a possible cutoff of federal funds due to case delays.

. . . In a letter last week, the U.S. Department of Agriculture Regional Administrator William Ludwig warned Texas officials that future funding for the food stamp program (SNAP) could be suspended if the state does not comply with federal timeliness standards (95%). Currently, nearly 40% of applications are missing the deadline. Federal funding is essential to the SNAP program. Last year, the feds provided more than $3 billion of food stamps to eligible Texans.

. . . The stern USDA warning comes the same week that the Legislative Budget Board (LBB) denied a request from HHSC’s commissioner to hire about 650 state eligibility workers to help address application backlogs and processing errors. An LBB staffer sent an e-mail reading, “This notice is to inform you that the (staffing request) is disapproved. We will continue to work with you to further understand the agency’s needs and to address them in a timely manner.”

. . . The LBB decision seemingly ignores the crisis in HHSC eligibility programs. SNAP participation is up nearly 11% in the last year and the state’s ability to process cases has continued to decline. A class action lawsuit has been brought against HHSC on behalf of clients whose benefits have been delayed. “We’re working as hard as we can work but the volume of staff doesn’t come close to meeting the needs of the clients walking in the door,” said Lynn Moore, TSEU member and Region 8 Program Manager.

. . . Given the crisis in services, the LBB's decision is dead wrong. We need those additional staff right now to handle the flood of new clients and long-delayed cases. The LBB needs to approve HHSC’s request for new staff immediately.

. . . The increased number of applicants is not the only reason for the delays. Ongoing problems with the TIERS program, which processes cases slower than SAVERR, drag down local offices. Also, the state has continued to dump resources into the failed privatization project. Over $100 million per year is being spent on the Maximus contract for “eligibility support services”. Maximus receives over 15% of all eligibility funds, but the private company only does approximately 5% of all eligibility work. With the money being given to Maximus, HHSC could hire 1200-1600 additional caseworkers.

The services crisis has a solution. The LBB and HHSC need to put every available resource into rebuilding a functional eligibility system:

Hire and train at least 1000 new eligibility staff

Cancel the contract with Maximus and use the money being spent on the failed privatization plan to hire an additional thousand state workers.

Delay any further TIERS rollout (no new cases, regions, or programs) until TIERS operates as efficiently as SAVERR

WHAT TO DO NOW:

Call your state legislators in the House and Senate and ask them to tell the members of the Legislative Budget Board to approve HHSC’s request for 650 additional eligibility staff now. The over 38,000 SNAP applicants whose cases are currently overdue can’t afford for us to delay any longer.

Another article

2009-09-28T20:10:00.001-05:00

Off the Kuff speaks to the Feds Article- go comment!! Click HERE

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Feds: Texas must speed up food stamp processing

2009-09-28T19:29:00.002-05:00

Corrie MacLaggan
Austin American-Statesman
9/26/2009

Texas must process food stamp applications more quickly or risk losing federal funds, U.S. officials warned this week. This comes the same week as the state's Legislative Budget Board denied a request from the Texas Health and Human Services Commission to hire about 650 state workers to help address application backlogs and processing errors.

"The current status of (food stamp) administration in Texas is unacceptable and actions must be taken immediately," says a letter to Executive Commissioner Tom Suehs from the U.S.
Agriculture Department's Food and Nutrition Service, which oversees the food stamp program.
The letter from William Ludwig, a food stamp regional administrator, says that the state is out of compliance with federal law. The federal government requires applications to be processed within 30 days, but the state is failing to process more than a third of applications by the deadline, according to state data. At the end of last month, 38,000 new applicants were waiting for approval even though the deadline had passed, state officials have said.

Celia Hagert of the Center for Public Policy Priorities, which is an advocate for low- and middle-income Texans, called the federal letter "a warning sterner than we've ever seen before."
The letter says that commission officials must produce a corrective action plan within 60 days, and commission spokeswoman Stephanie Goodman said the agency will work swiftly to do so.
"We do know that Texans do need and deserve better service now," Goodman said. About 2.8 million Texans are in the food stamp program, now called the Supplemental Nutrition Assistance Program. That's an increase of 11 percent compared with last year, and the economy-related surge comes as the agency is struggling with backlogs and errors. One in every six food stamp applications is incorrectly processed by state workers, according to state data. In some cases, that means eligible families are denied benefits.

"How disgusting that we find ourselves in this situation," said state Sen. Judith Zaffirini, D-Laredo. "This pressure from the federal government should serve to motivate the state and the new commissioner to correct things."

Former Executive Commissioner Albert Hawkins, who retired Aug. 31, told Gov. Rick Perry and the budget board in an Aug. 13 letter that hiring additional workers would reduce caseloads. That "would improve timeliness of case processing, and should improve quality and accuracy," Hawkins wrote. There are now about 7,700 enrollment workers and more than 300 vacancies, Goodman said.

Even if the requested workers were added and a similar number were hired in 2011, the state would have about 1,000 fewer enrollment workers than it did a decade ago, when caseloads were significantly lower, Hagert said.

Under a provision in the state budget, this week was the deadline for the budget board or the governor to answer Hawkins' request; if they had done nothing, the request would have been automatically approved.

In an e-mail Thursday, budget board senior analyst Melitta Berger wrote to commission officials: "This notice is to inform you that (the staffing request) is disapproved. We will continue to work with you to further understand the agency's needs and to address them in a timely manner."

The 10-member Legislative Budget Board is made up of the lieutenant governor, House speaker and members of the House and Senate.

Rich Parsons, a spokesman for Lt. Gov. David Dewhurst, said that the decision to deny the request was made by board staff members rather than elected officials and that Dewhurst's office is working with the commission on a plan for the food stamp enrollment system.

Parsons said that simply approving the new workers would not necessarily address the problems and that denying the request now will allow officials to come up with a plan.

Zaffirini, a budget board member, said she supports the commission's request for more staff and wishes that she had been able to weigh in on it.

Goodman called the e-mail "more of a clock-stopping move" than a denial. The request "could still be approved," Goodman said. "We're still working with (the budget board) and other leaders to make sure they have the information they need to fully analyze our request for more staff."

But Hagert called the e-mail "stunning" and said that not hiring now is unfair to families waiting for food stamps. "We have hundreds of thousands of Texans needing help affording food and caring for their families," said Hagert, a senior policy analyst at the center.

Katherine Cesinger, a spokeswoman for Perry, declined to say whether the governor thinks the staffing request should be approved.

"This is an important issue that still needs to be addressed, and we'll continue to work with the leadership and the (budget board) on this," Cesinger said.

Backlog, processing errors bedevil food stamp program

2009-09-28T19:27:00.002-05:00

Corrie MacLaggan
Austin American-Statesman
9/24/2009

Tens of thousands of Texas families are waiting as long as several months for food stamps as a surge in applications lands on an already strained system.

And when state workers do process the applications, they often do it wrong. One out of every six food stamp applications is incorrectly processed by state workers, according to state data. In some cases, that means eligible families are being denied benefits.

That error rate has skyrocketed since 2004, rising from 2.8 percent to 21.4 percent last year. For the first half of this year, the error rate fell to 17.4 percent.

This comes as Texas is struggling with a food stamp application backlog, failing to process more than a third of applications within the 30 days required by the federal government.

At the end of last month, 38,000 new applicants were still waiting for approval even though the federal deadline had passed, state officials said. Families sometimes wait three months for benefits, officials said.

It's also a problem for longtime recipients who must renew, such as Bexar County resident Mary Bidwell. After years of receiving food stamps, Bidwell was surprised when she didn't receive benefits in August, she said.

"It made me so mad, I couldn't go to sleep," said Bidwell, 67, a retiree who said she can't afford to buy fresh fruits and vegetables without food stamps. "I thought, 'Well, hey, here comes the beans and tortillas again.' "

Stephanie Goodman, a spokeswoman for the Texas Health and Human Services Commission, said, "Right now, our focus is on reducing the backlog, but then we also know we have to tackle these error rate issues."

She attributed the errors to the lack of experienced staff - more than half of state enrollment workers, as of June, had less than two years' experience, compared with 8.4 percent in 2004 - and the pressure of an increased workload.

There are about 2.8 million Texans enrolled in the food stamps program, an increase of about 11 percent since last year. Benefits offices across Texas are struggling to answer and return calls about food stamps and other programs because of what Goodman said is "a combination of volume and really old phone lines."

The commission has asked Gov. Rick Perry and the Legislative Budget Board for permission to hire about 650 more workers.

"We've received their request, and our budget staff is analyzing it," said Perry spokeswoman Katherine Cesinger. Goodman said that to cut down on errors, the state tried giving workers more time to process cases, but that wasn't practical because of the backlog. To address the timeliness problem, she said, the agency is making changes such as assigning senior employees who normally review others' work to process emergency food stamp cases.

In July, the commission was sued in U.S. District Court over the timeliness issue by the Texas Legal Services Center and the National Center for Law and Economic Justice.

The timeliness problem started several years ago when the agency lost workers in advance of an outsourcing effort. Goodman said the problem was complicated by a surge of applications following Hurricane Ike last year and another surge this year as the economy soured.
"We've been hit by a number of various kinds of storms, some literal, some figurative," Goodman said. Some advocates for low-income Texans say the food stamp program - now officially called the Supplemental Nutrition Assistance Program - is in a crisis that could have been avoided. Celia Hagert of the Center for Public Policy Priorities said the program is supposed to be readily available during an economic downturn. A family of four earning up to $2,915 a month might qualify for food stamps, Goodman said.

"The state has simply failed to administer it in a way that gets help to people who need it, and that was an entirely preventable situation," Hagert said.

She said the situation could have been avoided by keeping the agency adequately staffed. State Rep. Elliott Naishtat, D-Austin, said Perry and the budget board should immediately approve the request, and he suggested that the state extend the food stamp enrollment period from six months to a year, which would not require legislative approval.

That's one of several possibilities that the commission is discussing with federal officials, Goodman said. "As stewards of taxpayer dollars," Naishtat said, "we need to make sure we're not spending taxpayers' money on a system that either does not or cannot perform as it should."
The backlog is especially large in the Dallas and Houston areas, where less than half the applications were processed on time in August. The Austin area did better - 87.8 percent of applications were processed on time that month - but didn't meet the federal standard of 95 percent.

Bidwell, who said her benefits dropped from $111 a month to $0 in August, e-mailed everyone she could think of - from the office of the San Antonio mayor to the U.S. Department of Agriculture, which oversees food stamps. One of her e-mails ended: "HELP!!!!!"

A few days later, she said, her benefits were reinstated. She said she's relieved but worried about others who depend on food stamps.

"Worst comes to worst, I could go eat at my daughter's. I don't want to, but I probably could," she said. "Probably a lot of people are in worse shape than I am."

Hmmm?

2009-09-01T19:43:00.001-05:00

Check this out....thoughts?

http://www.rfpdb.com/view/document/id/15897

...The Health and Human Services Commission (HHSC), State of Texas, invites all interested and qualified Proposers to submit proposals to provide Software Development and Technical Support Services for the maintenance and ongoing support of the Texas Integrated Eligibility Redesign System (TIERS) for S...

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Searches

2009-08-29T20:02:00.001-05:00

Blog Search regarding Thomas Suehs HERE

News Search regarding Thomas Suehs HERE

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Gov. Perry Names Suehs Executive Commissioner of Health and Human Services

2009-08-29T19:57:00.001-05:00

AUSTIN – Gov. Rick Perry has named Thomas Suehs of Austin executive commissioner of Health and Human Services effective Sept. 1, 2009, for a term to expire Feb. 1, 2011.

The Health and Human Services Commission provides leadership and strategic direction to the health and human services system in Texas, and the executive commissioner oversees the operations of the five health and human services agencies, including more than 50,000 employees and combined annual budgets of $30 billion.

"Whether managing the monumental reorganization of Texas' health and human services system beginning in 2003, or helping to coordinate the sheltering of special needs evacuees from hurricanes Katrina, Rita and Ike, Texas has successfully taken on these enormous challenges thanks to the outstanding leadership of Albert Hawkins as commissioner of Health and Human Services, and I thank him for his years of service to the state," Gov. Perry said. "As we move forward, I am confident that Tom will continue the trend of outstanding health and human services vision and expertise, and I am proud to welcome him to his new role as commissioner."

Suehs has served as deputy executive commissioner for financial services at the Health and Human Services Commission since 2003. His responsibilities include providing administrative leadership, oversight and direction for the financial management of all five Health and Human Services agencies. He is past executive director of the Texas Health Care Association, past deputy commissioner of the Texas Department of Mental Health and Mental Retardation, past president of the American Society of State Health Care Executives, and former special advisor to the Texas Indigent Health Care Task Force. He is also a past member of the Texas Society of Association Executives and American College of Health Care Administrators. Suehs received a bachelor's degree from Texas State University and Master of Business Administration from the University of Texas.

Governor's Website Announcement

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To feed hungry Texans-Houston Chronicle

2009-08-16T11:46:00.000-05:00

When it comes to federal programs, food stamps come close to being a freebie. Simply by providing half the costs of administering eligibility requirements, Texas and other states guarantee their low-income folks — primarily children and the elderly — crucial access to basic nutrition.

What the federal government asks in return is that states process 95 percent of food-stamp applications within 30 days. After all, hunger cannot be put on hold while bureaucrats dither.

Texas, which has had difficulty meeting that requirement for years, is getting worse. With the recession prompting rising requests for food assistance, the Lone Star rate of noncompliance rose from 19.2 percent in January to 37.2 percent last month. That failure has prompted a federal class action lawsuit by two citizen advocacy groups to force the Texas Health and Human Services Commission to put the eligibility process on the mandated federal schedule.

In recent years the commission has pushed through ill-considered privatization schemes that resulted in increased delays to processing applications for the Children's Health Insurance Program and other state-supervised federal programs. It has failed to hire an adequate number of workers to handle the growing food-stamp applicant backlog, even though the Legislature approved funding for an additional 656 positions. An HHS spokeswoman said approval for the hires has not been cleared with state leaders.

Harris County is at the center of the crisis, with more than 364,000 residents receiving food
stamps. The average family gets $324 in monthly food assistance.

Houston state Rep. Garnet Coleman, a Democrat, says top Texas leaders have shown a callous disregard for the needs of poor constituents.

“When the people in charge don't like the government to provide services, whether it be health care or food, they just do a very poor job of providing the service,” says Coleman.

Texas must do better in processing food assistance to its neediest in a timely manner. It shouldn't take a federal judge to remind state officials of their responsibilities.

Watchdog: As Texas bureaucracy flounders over food stamp applications, a couple settles for potatoes

2009-08-16T11:33:00.002-05:00

Watchdog: As Texas bureaucracy flounders over food stamp applications, a couple settles for potatoes

By DAVE LIEBER
watchdog@star-telegram.com

Unlike everybody else who contacts The Watchdog, Bob of Fort Worth doesn’t want my help. He only wants everyone to understand the horrible state of Texas’ food stamp program.

Bob, who doesn’t want his last name used because he is afraid of getting into a fight with the government, is 78 and lives with his wife on $500 a month from Social Security.

Two years ago, they qualified for food stamps. But the credits on his state-provided electronic debit card — worth about $200 a month — ran out in May.

So what does he do?

"Potatoes are like a dollar for 5 pounds," he said. "So we eat a lot of potatoes. If they’ve got a sale on something — for instance, if regular lettuce is a dollar and a half a head, and they have a sale for 75 cents, we’ll make salads out of lettuce. We find the bargains on something and we’ll eat that this week."

Since May, Bob has been trying to get ahold of someone at the state Health and Human Services office on East Lancaster Avenue in Fort Worth to help him re-qualify for the Supplemental Nutrition Assistance Program — a requirement to make sure recipients still need it.

"We sent all our papers, and we kept calling, and they kept putting us off. You couldn’t get anybody down there. Nobody answers the telephone. They had about a dozen people working down there helping people, checking and rechecking them.

"And a woman says, 'Well, we’re planning on getting a new system so it will be about a week.’ And then you don’t get anything. Then finally, a week or so later, they got a recording on their phone. I guess everybody was not getting anything. The recording said, 'If you’re really needing help, if you’re really out of food, call 211 and they’ll get you some food.’ "

The Texas 211 help-line folks told him that he could go to a food bank, but Bob, a military veteran, doesn’t want to do that: "I have to be careful what I eat. I had colon cancer and diabetes. I’m a mess."

Nobody knows how many Bobs there are in Texas. State officials say they believe that one-third of all food stamp applications processed in July were past the 30-day limit allowed by federal law.

That’s 45,000 families like Bob’s that waited more than a month for help, for a phone call back, for a letter, anything. Bob’s wait is three months. How many more are out there waiting?
A spokeswoman for state health services, Stephanie Goodman, says the state doesn’t really know.

The computer system used to process food stamp applications is so outdated that they aren’t counted until they are actually entered into the system.

(Stephanie, really? "so outdated"? More spin from Austin to build TIERS up? Can you imagine if the Dallas area was IN TIERS? Can you? Because even YOU can't deny that a worker can work FAR MORE CASES in SAVERR, in a day, than in TIERS. And, we have no idea? What, the supervisors in Region 3 don't have to submit a lead time report? They have "no idea" how many apps there were waiting to be seen? Surely you jest.)

Applications "sitting on someone’s desk that we have not gotten to" are uncounted, she says.
For sure, there are tens of thousands more.

The problem is so bad that two groups filed a federal lawsuit in Austin last week demanding that the state comply with the 30-daylimit.

The lawsuit is designed to force the state to create a quick plan, says Randall Chapman, executive director of Texas Legal Services Center, which co-filed the suit on behalf of two Irving residents tired of waiting.

"Believe it or not, the two people named in that lawsuit were approved in less than 24 hours," Chapman said. "It was just magic. Their approval letters were hand-delivered to their homes."
Chapman offered his organization’s help to Bob. Goodman, the state official, would have checked into Bob’s case, too, had I asked her. Bob could have been fast-tracked and had food stamps hand-delivered to his door, too. But he told me not to do that. He was adamant.

Chapman said: "Some elderly people feel intimidated, or they don’t want their neighbors knowing they need help. That’s a real shame."

The state is trying to come up with solutions, shortcuts, hiring proposals, abbreviated training procedures, anything to get food to Texans. Next month, the state will begin hiring 656 workers to process applications.

For now, however, the bureaucrats simply cannot get it done.

"We’re processing more cases than ever," Goodman said. "We’ve got more people on the rolls. We’re just not simply keeping up with the increase in demand. . . . Our staff has been working weekends and long hours, but it’s still not enough. We’re not keeping up."

In Tarrant County, 150,000 people now receive food stamps, compared with 130,000 last year. There would be more if the system worked properly.

As a test, I called the phone number of the East Lancaster Avenue office where Bob keeps striking out. When you push zero for operator, you get this message: "Hi, you’ve reached the general delivery mailbox for the East Lancaster office. However, this mailbox is not set up to have return calls. Please do not leave a message. Press zero for operator so your call will be reverted to our operator. Have a nice day."

I hit zero, and got the same message again. Did it again and again and again.

Meanwhile, Texans are eating potatoes and lettuce and waiting for phone calls and letters that never seem to come.

Getting help

For food stamp problems, call the ombudsman’s office at the Texas Health and Human Services Commission at 877-787-8999.

THE WATCHDOG COLUMN APPEARS FRIDAYS AND SUNDAYS. DAVE LIEBER, 817-685-3830

Here's my only issue with all of this (aside from the comments that people leave on these types of articles- see the link if you want to read them) is that Region 3 (Metroplex) and Region 6 (Houston area) have had issues with timeliness forEVER. It took a LAWSUIT for anyone to take notice? This is NOTHING NEW. It's a SHAME is what it is.

More from the Texas Bloggers

2009-08-05T22:44:00.001-05:00

Off the Kuff has an article HERE which references OLDER articles- in other words, this lawsuit and the issues surrounding timeliness has been a LONG TIME COMING.

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All about the lawsuit

2009-08-04T19:27:00.001-05:00

Many articles- some the same (AP)- I know that I was emailed the one I posted yesterday- and have just now had a chance to sift through the "news" to see what else is out there:

Hard To Believe, But Texas Is Fouling Up The Process Of Distributing Food-Stamp Relief

Texas Health and Human Services Commission Sued for Failure to Meet Federal Food Stamp Timeliness Guidelines

Lawsuit alleges Texas broke food-stamp processing laws

Google Search (just click this sentence) for the Lawsuit news

And here begins the beating down of the local office worker, I'm afraid. You know, we - meaning us in the local offices- we, who used to do a FANTASTIC job in that we allowed for the State of Texas to receive enhanced funding several years in a row- money which, btw, went straight into the general fund, we knew that attempting to "outsource" and do "call centers" and take away the relationships that offices had with their clients- we KNEW this would lead up to THIS. A lawsuit on timeliness.

I guess it boils down to what I've been saying on this blog from day one- the workers in the field, the clerks, the local office supervisors- are doing ALL THEY CAN. Are there cracks? Of course! But if you have more clients/applications coming in than you have workers with the abilities to see many in a day, and do them CORRECTLY- then it snowballs. Into THIS- a lawsuit. I'm torn about how "I" personally feel about the lawsuit, given that I think it's time that Perry and Co. are going to have to be accountable to some extent- and for the USDA to see what's going on (although they know).....but at the same time, I know that whatever this lawsuit brings- will hurt the local office.

I know that "Joe Blow" doesn't care what we do- as I've said before. But Joe Blow also doesn't realize that we, as employees, have families and lives too. Most of us (MOST) care about what we do, and will work late, work weekends, etc- at the EXPENSE of OUR families- so that other families can eat. And have Medical care for their children. There's just so much one person can do. After the "fake layoffs" and after the offices sunk- THEN and only THEN did the state realize they had to hire more people- by then, the damage was done. You bring in new people and throw them to the wolves, so to speak, and they figure this was too much and they leave, and the process starts all over again.

Tenured staff that didn't "Jump Ship" (as it were) were depended on to do the jobs of 2 or 3. Yes, staff were paid overtime (I mean, think about it- if you are working 10-11 hours per day, and on weekends- without PAY, you aren't so apt to work those crazy hours- and furthermore-earning the overtime as leave is a joke when you can never take it off to regroup) and that made it easier to bear- but it just gets to be too much.

I forsee staff now (due to the lawsuit) having to work mandatory overtime and have to work cases for those areas that are so behind (Irving, for example, as these are where the clients are from from whom the lawsuit originated)...which will put those offices that are BARELY making it behind themselves....then the snowball starts back down the hill.

We had a system in place that worked. BEFORE tiers. BEFORE Accenture/Maximus. It WORKED. We proved it worked. And now? I just don't know how you fix something like this.

Thoughts?

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I'm shocked this hasn't happened before now.

2009-08-03T19:24:00.001-05:00

Texas Health and Human Services sued over food-stamp response times

By The Associated Press | Monday, August 3, 2009, 12:40 PM

Two advocacy groups are suing the Texas Health and Human Services Commission, accusing the agency of not processing food stamp applications within the time required by law.

The Texas Legal Services Center and the National Center for Law and Economic Justice filed the class action lawsuit Friday in federal court in Austin.

Federal law requires the state to decide on food stamp applications within 30 days, seven days for emergency food stamp applications for families without money for food or rent.

The lawsuit alleges Texas has failed to meet the time constraints for more than three years. It says that last month, Texas processed more than a third of all food-stamp applications late.

The Texas Health and Human Services Commission hasn't commented on the lawsuit and its allegations.

I'm just shocked it took this long.

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Article- HHSC in Daily Kos!

2009-07-21T19:55:00.001-05:00

Texas #HHSFails!

The Texas Health and Human Services Commission is a disaster. They fail to the needs of the people they are to serve, and indeed increase the pain and difficulty those people are having. There are so many problems with this agency that it is difficult to know where to start. But I'll start with my knowledge of problems in the administration of the Supplemental Nutrition Assistance Program (SNAP).

For the uninitiated, this is the program colloquially known as Food Stamps. They fail to process applications or renewals in accordance to laws and are having the people wait months for an interview. The agency is strikingly unresponsive. Now in July, they are making appointments to interview people in September that applied or should have been renewed and the Food Stamps delivered in June.

I agree that this is a travesty, but if there aren't enough workers, then what should the state do? Interview 24/7? I think they are doing what they can with what they have been given.

This is not what was intended when the Food and Nutrition Act of 2008 authorized USDA to award $5 million in grants for state and local government and private non-profit organization projects aimed at simplifying the SNAP application and eligibility systems or improving access to SNAP benefits by eligible households.

You may ask how am I qualified to berate the Health and Human Services Commission in the Great State of Texas. I have had to become familiar with Texas HHS and the nightmare that agency is. If you take a little bank fraud, employment outsourced to other countries, some health problems w/no insurance and reach the age where nobody wants to hire you, all you have to do is stir. You have the perfect recipe for personal financial disaster.

I moved to Houston because I had family here. Shortly after I moved here, my sister's husband was transferred, and now I'm the only one who can care for my 89-year-old mom.

This is my first diary, and I'm coming out of the Food-Stamp-Closet with this story in hopes that I can bring awareness to the problems faced by so many here. I petition anyone reading this to join me in bringing attention to the problems in that agency and to work towards making things better for the many who have no voice.

By my experience, I can tell you:

The public web site doesn't work- I called Information, 211, and they steered me to the Internet to apply for benefits. I did so, and two months later I spent days and dealt with people all over the state, looking for the status of my application. The application showed on the web as having been submitted, but no one could tell me the status. I spoke to people in Midland, several in Austin, and several in Houston. The final verdict was that my app must have gone into a black hole in their system, as the system didn't handle applications from Harris County, yet. Then why was I sent to this system? And why did this system accept my application when one of the first questions I answered was "County"? What kind system is built so that "records in" aren't tracked and accounted for? And if there is an error that the system is unable to process, why was three no error message and the requestor not notified?

If it helps, workers across the state knew back when our Commissioner and Governor wanted to "privatize" our work and have call centers- that this would be the outcome. They wouldn't listen to us.

They cannot process mail- An example of how poorly they handle any mail is a notice I have before me right now, (because I needed to reference it), And the envelope it came in. The notice was dated June 30th and it came in an envelope postmarked July 8th. Personally, I believe the postmark. I've learned to save the envelopes because I suspect this particular problem is a deliberate attempt to make applicants fail their response times. Clients have time limits to respond, and if it takes eight days for a notice to get from someone's out-box to the Post Office, the client can miss their deadlines and loose their benefits. I've also taken to sending mail Certified (this is a hefty cost to someone on food stamps). While they can't deny getting the mail when you have a receipt, I have found that it failed to speed delivery to the recipient (i.e., Post Office" signed for date" does not mean that the recipient got it (or the worker fibbed to me about when it got to their desk)), nor does sending it Certified have any time impact on having the contents processed.

Their phone system is a dreadful- Do you like to wade through a phone tree and wait for a long time listening to messages repeated, to be disconnected and have to start all over? How about when you finally get a person and explain your problem they transfer you to a line that asks for your FAX number to continue? (This was a new on for me. I've had a phone tree problem on other phone systems, but HHS's has been the only phone system I've encountered to throw me out because I didn't have a FAX number.) If you're wondering why phones are important, consider that Houston is a big place. I live in the North West area but I'm assigned to an office in the South East. This is equivalent to having someone in the Bronx go to Brooklyn or someone in Queens sent to Staten Island, except that New Yorkers have a Public Transportation system that Houstonians don't.

They do not send notices to claimants even when benefits are ending-. They don't follow normal business etiquette and provide information to clients by mail or phone when there is a major change and frequently don't reply to the clients at all. I sent one Certified Letter that never been replied to, at all. No letter. No call. Nada. I appealed a decision and got the same treatment: Nothing. I ask, " Is this any way to run a railroad?"

All certification letters for Food Stamps show the length of the certification (i.e. 7/1/09-12/31/09)

From the start, the experience is humiliating. If you can manage to get your application processed, you are fingerprinted and they share your personal data with law enforcement agencies.

This is a myth and is NOT TRUE. We have never EVER shared finger images with law enforcement as a practice. Never. The ONLY reason finger imaging is done is to prevent one person from having 15 identities and having 15 different cases. No one has 15 different finger prints, so we finger image. Hence, one case for each person. Law enforcement has to go through OUR Office of Inspector General (OIG) for information. We do not cross match with PD.

Barbara Ehrinreich from her Op-Ed A Homespun Safety Netpublished in the NYT, July 12, says this is making it hazardous for anyone who might have an outstanding warrant — for failing to show up for a court hearing on an unpaid debt, for example — to apply.

Not true.

Then they check and check and check. Everything you tell them they check. How many times do you have to submit your social security benefits statement and your apartment lease? The answer is: every time they as for it. The redundant paper is incredible.

It is. Unfortunately, the honest pay for the dishonest. We don't make the Food Stamp rules, the Feds do that (USDA). If the Feds mandate we verify your address each time you apply, then we do. It's our job to do so.

Right now, I'm trying to fix their failure to renew my case in June and this is a rerun of what happened last year. In December 2008, I mailed my renewal info, as requested, but my case was not processed. In January I started pleading for help, as my account was not credited. No notice. Nothing. Just no credit to the account, the same as this time. It took a while before I could get any action, and when I did, they cut my benefits greatly. I had just spent $11.31 in postage to send all the paper they demanded!

I appealed the reduction in benefits. And I suppose I lost. I said suppose, because after the insane "Hearing" by phone, which is a horrendous story by itself, I never received the result, which should have been sent by mail. I was told in a month or so. (I could go further into the appeal, but I'll limit my discussion here).

I'm fortunate in that I can tell the story and point the finger, because most of those in need cannot. Many of the people here have nowhere else to go except to the Texas HHS and have no voice at all. It's not like you can take your neediness to another agency. Poverty itself can deplete and strain entire social networks, leaving no one to turn to. When the poor get no help, they are forced in a further downward spiral, often falling for the rip-offs of 'payroll and quick auto loans' that they can never get paid off. They are the most vulnerable and the sufferer most from many scams. If they can't pay their credit card, the Banks slam them and their car insurance goes up. If they don't get their food stamps they may not have the cash for a haircut to go on the job interview they worked hard to get.

As the national recession persists and our National Government is striving to help people caught in it, Governor Perry and most of Texas' Republican lawmakers work overtime to set up barriers to any help that's made available. Texas Senator John Cornyn voted against the SCHIP program (health insurance for low-income children. I can never understand how the Republicans, who care so much for the unborn, have no heart when it comes to children who are here. Governor Rick Perry refused the federal assistance to the unemployed. He should be ashamed of his record and the punitive bureaucracy he is in charge of, but he's not.

It's true, Texans likes to brag. But for those who can face the truth, the quixotic becomes brutal. Eliot Shapleigh, a State Senator from El Paso, compiles a report each legislative session called

Texas on the Brink. Shapleigh's little book of horrors comes fully footnoted to avoid being attacked by partisans. His staff gathers data from the Census Bureau and Texas government agencies. Skimming it will provide more than enough data to show where the Republican leadership, which so proudly brags about its governance, has brought the state.

Here are a few of Shapleigh's tidbits about Texas that Rick Perry doesn't want the rest of the nation to know:

49th in teacher pay

1st in the percentage of people over 25 without a high school diploma

41st in high school graduation rate

46th in SAT scores

1st in percentage of uninsured children

1st in percentage of population uninsured

1st in percentage of non-elderly uninsured

3rd in percentage of people living below the poverty level

49th in average Women Infant and Children benefit payments

1st in teenage birth rate

50th in average credit scores for loan applicants

1st in air pollution emissions

1st in volume of volatile organic compounds released into the air

1st in amount of toxic chemicals released into water

1st in amount of recognized cancer-causing carcinogens released into air

1st in amount of carbon dioxide emissions

50th in homeowners' insurance affordability

50th in percentage of voting age population that votes

1st in annual number of executions

Given these numbers, need I explain?

There are a lot of Texans that need help.
If you qualify for food stamps you should be able to get them.
The State Government should be held accountable.

The Houston Chronicle reported that our lawmakers cleaned out the public schools' piggy bank so it could replace it with federal stimulus money in Stimulus, or better yet, status quo.

Note that Texas is last in voter participation of all the states. Now, try to square this with the fact that the Republicans spent much of their effort during the last State legislative session working on a bill to make voting more difficult, (to require Voter-Ids). Should they really work so hard to defend their position of dead last?

Sometimes you need a laugh.

Nick Anderson, editorial cartoonist for the Houston Chronicle, did one of his toons about it: He has a crossing guard stopping Traffic so that a Mother Duck and her little duckies can cross the road. While allowing a string of ducks to cross the road is normally a kind, humanitarian act to be admired, Nick's crossing guard is a big elephant, holding his hand up to stop Emergency Trucks "Children's Health Insurance", "Windstorm Insurance Reform" and "Unemployment Benefits", so that V (mamma duck) could lead the little ducklings o,t,e,r—I,d across the street.

In the same Off the Wall vein he did one of an angry looking Nancy Pelosi sitting behind a desk piled high with stacks of Budget, Health Care, Economy, etc. papers, saying," Beat it!", with Representative Sheila Jackson Lee in the background grandstanding a 'Congressional Resolution Honoring Michael Jackson', with her own portable spotlights.

In yet another, he has Perry slurping Stimulus Funds out of a straw while pushing an unemployed back with, "STOP, It's Tainted".

To quote Barbara Ehrinreich from the article cited above, "So far, despite some temporary expansions of food stamps and unemployment benefits by the Obama administration, the recession has done for the government safety net pretty much what Hurricane Katrina did for the Federal Emergency Management Agency: it's demonstrated that you can be clinging to your roof with the water rising, and no one may come to helicopter you out". Even the help that has been sent doesn't make it to the citizens of Texas. That's due to the State Government that undermines it and sets up roadblocks to its use. And if Texas doesn't address its Health and Human Services problems fast, things are going to get a lot worse.

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TIERS

2009-06-10T22:23:00.000-05:00

Anyone in Region 7 want to give some insight regarding "rollout" aka "expansion"- how's that going?

You can email- you will be anonymous.

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State of Neglect: Outsourcing enriches contractors, ex-legislators

2009-05-16T18:54:00.001-05:00

This isn't a new article, but a good one nonetheless:

By GREGG JONES / The Dallas Morning News
gjones@dallasnews.com

For the weak and the vulnerable, Texas has long been an especially hard place. Year after year, national surveys place the state at or near the bottom in such categories as assistance to poor children and the malnourished, treatment of the mentally ill and care of the disabled. This story is part of The Dallas Morning News' 'State of Neglect' series examining how the state determines whom it protects and whom it excludes – and how special interests and their lobbyists strongly influence the writing of laws and the workings of state government.

Texas will pay private companies billions of dollars this year to provide health and human services to its neediest residents. Contractors will coordinate care and process benefits, operate call centers for welfare applicants and cut checks for state health workers.

The national economy may be collapsing, but it's another boom year in the state's effort to outsource functions it once performed.

Government outsourcing in Texas expanded dramatically with 2003 legislation that crunched 12 health and human services agencies into five, negotiated lower prices with drug companies and replaced state workers with private contractors to screen and administer welfare benefits. It has since grown to include such functions as data management across state agencies and payroll processing for state employees.

"Anytime state government can provide the same or better services more efficiently and cost-effectively, the citizens benefit," said Allison Castle, spokeswoman for Gov. Rick Perry.

Some have benefited more than others: Former Perry aides, state agency staff and legislators have gone to work for private companies that have profited from the outsourcing.

The architect of the landmark legislation, for example, has earned between $1 million and $2 million as a lobbyist specializing in health care over the past four years.

Former state Rep. Arlene Wohlgemuth said the result of her legislation, known as House Bill 2292, has been smaller government that still served the needs of vulnerable Texans.

"By reducing administrative costs, more money was available for social services programs, the benefits of the poor were protected and funding for foster-care programs actually increased," Wohlgemuth said.

The revolving door from public to private sector does more than enrich former public officials, critics contend.

"It undermines public faith in government when they see that kind of thing happening," said Andrew Wheat of Texans for Public Justice, a liberal group that tracks lobbying and campaign contributions. "It reconfirms the sense that these people are operating on the take and not in the public's best interest."

Policies and profits

The state Health and Human Services Commission reported more than $15.5 billion in contracts in fiscal year 2007, according to the most recent figures available from the Legislative Budget Board, the Legislature's fiscal and budgetary office. That was 58 percent of overall state spending on health and human services and an 11 percentage-

point increase over fiscal year 2003 contracting.

This year's health and human services budget is $29.3 billion. Commission spokeswoman Stephanie Goodman said nearly $25 billion was for contracts, including payments to doctors, pharmacies, hospitals and private companies.

The belief that outsourcing promotes efficiency and cost savings is one that conservative activists and corporate interests have promoted in Austin over the last decade. It shaped HB 2292.

Gregg Phillips had a foot in both the corporate and political worlds that produced the legislation. He was hired as a senior official at the Health and Human Services Commission just as Wohlgemuth was introducing the first draft of HB 2292.

As a deputy executive commissioner at Health and Human Services, Phillips played a leading role in shaping the legislation and promoting some of its more controversial elements. When state Rep. Brian McCall, a Plano Republican, expressed concerns about the plan to replace state welfare administrators with privately run call centers, Wohlgemuth arranged for him to tour an Austin call center that was handling applications for another state program. Phillips was his guide, McCall said.

Later, Phillips directed the agency's business case analysis, which predicted that the call centers would be cost-effective. (The call center program has cost taxpayers more than $250 million and is still not fully functional three years after its launch.)

Phillips was a former Republican Party fundraiser who presided over privatization initiatives as Mississippi's human services chief in the 1990s. A Mississippi legislative committee concluded in 1995 that Phillips had created "an appearance of impropriety" by going to work for a company after awarding it a $557,000 contract while in his state job.

From 1997 until August 2002, Phillips worked on health-care contracts for Deloitte Consulting LLP, a major government outsourcing firm, according to his state personnel file.

Chris Britton, a former Republican legislative aide who had worked for Wohlgemuth and had advised Perry on health and human service issues when he was lieutenant governor and governor, was also heavily involved in the legislation.

Just weeks after leaving the governor's staff in late 2002, Britton was hired by Wohlgemuth to perform budget and legislative policy analysis, Britton said in an e-mail response. State campaign finance records show Wohlgemuth paid him $10,000 from campaign funds in 2003. Britton now works for Accenture LLP, another big outsourcing firm that along with Deloitte won contracts with the state after the passage of HB 2292.

Deloitte and Accenture also may have been involved in discussions about the outsourcing legislation. Phillips' office calendar shows that he met repeatedly with representatives of the two companies during the time he was working on the legislation. The Houston Chronicle first reported those meetings in 2005.

In a recent telephone interview, Phillips told The Dallas Morning News that he had "a lot of interaction with a lot of folks" but could not remember whether he met with Deloitte and Accenture while working on the bill.

Deloitte spokeswoman Melissa Norcross Wolf said the company "had no involvement in the drafting of HB 2292."

Health and Human Services Executive Commissioner Albert Hawkins said Accenture and Deloitte were among many parties interested in HB 2292. He defended the involvement of private contractors in discussions regarding the legislation.

"There's all kind of input that is provided into the legislative process from people who have expertise or those that might be interested in some business opportunity down the road," he said.

Hawkins said he was confident that Deloitte and Accenture did not improperly influence the legislation.

"The drafting process is under the control of the Legislature," Hawkins said. "While we share information about it, it's up to the author and the legislative committees as to what to include in their bills."

In this case, Wohlgemuth and her colleagues included the prevailing orthodoxy on outsourcing state health services, including the use of call centers to process applications for Medicaid, food stamps and cash assistance.

Supporters said that would save time and millions of dollars by eliminating the jobs of thousands of state workers who accepted benefit applications in offices around Texas.

From March 11, 2003, when Wohlgemuth filed HB 2292 in the Texas House, until it was signed three months later, the bill grew from 20 pages to 300 pages, including more than 150 amendments.

Wohlgemuth told colleagues the bill would "cut out inefficient bureaucracy, streamline programs that belong together, delete the duplication of services provided by the state and make government more user-friendly to the citizens of Texas." It would also save the state $1.1 billion, she said.

That was an irresistible pitch for lawmakers facing a $10 billion budget shortfall.

Landing contracts

Once signed, the law set in motion another high-stakes competition as companies vied for contracts, drawing on well-established ties to key lawmakers.

Texas law bans contributions to lawmakers while the Legislature is in session and generally prohibits corporations and labor unions from directly contributing to politicians. But they are allowed to give money through political action committees, or PACs, registered groups set up by corporations, labor unions, professionals and others to accept and make campaign contributions.

The money given to officeholders by the Deloitte & Touche Texas Political Action

Committee typifies the sort of targeted contributions made to advance a corporation's interests in Austin.

Since 2002, the Deloitte PAC has contributed more than $270,000 to political candidates and causes in Texas, according to state records. The largest contributions typically go to top officeholders – it has contributed more than $30,000 to Perry since 2004 and $17,500 to House Speaker Tom Craddick, who wields vast influence over legislation. Dozens of other contributions have gone to lawmakers on committees that deal with issues and legislation of interest to Deloitte.

In July 2003, the first month that Deloitte could resume contributions to lawmakers following the end of the legislative session, the Deloitte PAC made only one donation: $1,000 to Wohlgemuth, at the time a member of the powerful House Appropriations Committee and chairwoman of its subcommittee on health and human services.

In September 2003, the Deloitte PAC contributed $1,000 to Rep. Dianne Delisi, then chairwoman of the State Health Care Expenditures Select Committee. She is also the mother-in-law of Deirdre Delisi, the governor's then-deputy chief of staff.

The next month, Deloitte Consulting won the first contract resulting from Wohlgemuth's legislation. The Health and Human Services Commission chose Deloitte as the lead consultant in the consolidation of agencies, a contract worth more than $1.8 million. A $1.2 million consulting contract went to Accenture. And Virginia-based Maximus Inc., another outsourcing firm that has since become a major player in Austin, won a $712,000 contract.

HB 2292's grand prize, however, was a contract to outsource the screening process for welfare benefits and to create call centers for accepting applications. The competition pitted outsourcing rivals Accenture and IBM, both of which hired a well-connected cast of lobbyists that included former legislators or executive branch staff.

In 2005, Health and Human Services awarded the $899 million call center contract to Accenture. IBM formally protested and later sued the state, alleging contract irregularities.

IBM later withdrew the lawsuit. It declined to discuss its decision with The News, and Hawkins said IBM's complaints "were unfounded."

About 16 months later, IBM won an $863 million contract to manage state data for Texas. Supporters said the contract would save the state $159 million over seven years. (In October, after the state had already fined IBM $900,000 for failing to complete timely backups, Perry suspended further data transfers to IBM.)

Delayed care

When Accenture's four call centers began taking social services applications in January 2006, delays immediately plagued the system. Thousands of applications piled up, and by May the state halted further rollout of the call centers.

In 2007, the state canceled the contract at Accenture's request. A report by the Health and Human Services inspector general later criticized the agency for a flawed bid evaluation and inadequate contract oversight. It also found the Deloitte-designed software was significantly slower than the old state-run system.

Hawkins had supported the call centers as a way to save $600 million over five years. But problems have indefinitely delayed the system's statewide rollout, and so "we didn't achieve the savings," agency spokeswoman Goodman said.

Instead, Texas spent $30 million dealing with various problems with the Accenture contract and another $10 million on retention bonuses to keep experienced staff from leaving. For less than two years of work on the project, Accenture and its subcontractors were paid about $210 million.

The state paid Deloitte $116.6 million before the company turned the new computer system over to Accenture in 2005, even though there were still more than 500 defects, the inspector general's office later noted. After Accenture gave up the call centers contract, the state hired Deloitte back and is paying the company $115.6 million to help maintain the system through 2010.

Texas hired Maximus to take over operation of the four call centers and to perform other health and human services work. It has paid Maximus $141..2 million over the last two years.

Those who rely on health and human services programs, and their advocates, say the state has saved money through outsourcing but in a way that is seldom discussed: by delaying or denying care to people in need, inadvertently or by design.

Roxanne Anderson, 39, a part-time library aide for the city of Grand Prairie, said she couldn't afford to take her three children – ages 7, 9 and 11 – to the doctor if they weren't covered through the subsidized Children's Health Insurance Program for working-poor families. Anderson said she liked the convenience of a call center in applying for benefits, but lost paperwork at one of the centers resulted in her children losing their coverage for a month in early 2008. Front-line staff at the call centers also don't know much about the program, she said.

"It takes them a long time to find out answers to questions, and quite often I have to get transferred to a second layer," Anderson said.

Celia Hagert, an expert on state social programs at the nonpartisan Center for Public Policy Priorities in Austin, said these are common complaints since the state began outsourcing applicant screening.

Outsourcing this work raises a potential conflict between a private company's need to maximize profits and the state's emphasis on providing benefits to qualified applicants, regardless of the time or effort required, she said.

Whether that conflict has cost Texas taxpayers is not fully known. Government oversight agencies – particularly the state comptroller and auditor – have analyzed only a few troubled contracts to determine what, if anything, was saved by shifting government functions to private contractors.

A 2006 federal review found that Accenture's call center workers performed so badly that a "high percentage of cases" had to be returned because of missing information and other errors.

A Texas comptroller's office review that same year said the call center project was a case study in poorly executed outsourcing.

"Successful outsourcing relies on two things: well-written contracts that base payment on the contractor's good performance, and strong contract management practices to oversee the contractor's work," the review concluded. "The Accenture arrangement has neither of these. HHSC's lack of proper contracting practices has led directly to project delays, cost overruns and failed service to Texans."

Last month, after 20 months of negotiations, the Health and Human Services Commission announced that the Accenture team had agreed to forgo $70.9 million in payments it was seeking from the state. The team also agreed to repay $20 million and provide a $10 million credit against future work performed by Maximus.

Winners and losers

Health and human services officials said taxpayers have profited from HB 2292, specifically $962 million in savings from the consolidation of state agencies and workforce reductions, as well as the introduction of a preferred drug list for Medicaid patients.

"More importantly, I think, for the long run, we have put in place a more rational structure and way of providing those services that will be cost-effective over years to come," Hawkins said.

Lawmakers, lobbyists, former health and human services staff and former Perry aides have profited in various ways, as well.

Craddick, who became House speaker after the 2003 Republican takeover of the Legislature, secured a call center and a document processing center for the entire system for his hometown, Midland.

Britton, the former Perry aide who now works for Accenture, got part of a state contract awarded to a company founded by Phillips, the former Health and Human Services official.

Britton's wife, Tiffiny, a former Texas House and Senate staffer, works for Wohlgemuth's Austin lobbying and consulting firm, Three Point Strategies, according to the firm's Web site. Like Wolhgemuth, her clients are mainly in the health-care sector, Texas Ethics

Commission records show.

Since leaving his Health and Human Services Commission position in 2004, Phillips has won government outsourcing contracts from Texas and other states. In 2007, he hired Wohlgemuth for up to $25,000 to lobby for one of his firms, GHT Development Corp.

Wohlgemuth, in turn, persuaded a former House colleague to insert an amendment in a bill that would have steered a state contract to GHT Development. That former colleague was Appropriations Committee Chairman Warren Chisum, who 18 months earlier had received a $9,000 contribution from a Wohlgemuth campaign fund, according to Texas Ethics Commission records.

After questions were raised by lawmakers, the amendment was stripped from the final budget legislation.

Phillips denied any attempt to steer a contract to his firm.

"I guess I don't understand what's inappropriate about a private business person hiring someone who's able to help them in the Legislature," he said. "Neither we nor she have violated any rules, laws or anything else."

Wohlgemuth didn't respond when asked about the amendment recently, but in 2007 she told The News: "I was trying to advantage my client."

GHT Development won a $275,000 no-bid contract in 2007 to supply the Texas Youth Commission with an automated placement system for juvenile inmates, state records show. Wohlgemuth had recommended Phillips, according to Jay Kimbrough, who was brought in to reform TYC and now serves as Perry's chief of staff.

A staff report in November by the Legislature's Sunset Advisory Commission found that Phillips' system had experienced such "significant problems" that TYC was still operating its old system.

Wohlgemuth ran unsuccessfully for a seat in the U.S. Congress in 2004 and resurfaced two months later as a lobbyist. One of her first clients was the Texas Optometric Association. Two years earlier, while still a legislator, Wohlgemuth had voted to cut optometry benefits for the children of working poor. The 2005 Legislature restored them.

Wohlgemuth's daughter, Cristen, a former lobbyist, served on the governor's staff from January 2007 until June 2008 when, the governor's office said, she went to work for Chisum.

"Former legislators who lobby do not violate either the spirit or the letter of Texas ethics laws," Arlene Wohlgemuth told The News in an e-mail. "People ... know that when I talk with them on behalf of a client they can rely on two things: first that what I tell them is absolutely truthful, and second that I bring to them only those ideas I believe are in the best interests of the State and her citizens."

Texans for Public Justice, which is critical of lobbyists and the influence of corporate money in state politics, said former lawmakers who use their legislative contacts and expertise for later profit erode confidence.

"Not many of these lawmakers remain there for life, and a shocking number of them wind up in the lobby," Wheat said. "If you have that in the back of your mind, you don't want to offend the biggest lobby interests in the state."

Staff writer Ryan McNeill contributed to this report.

The link to the article can be found HERE

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Texas health and human services chief to retire this year- American Statesman Staff

2009-05-15T19:19:00.001-05:00

Texas health and human services chief to retire this year

Hawkins called 'budget whiz' but couldn't solve all problems.

By Corrie MacLaggan
AMERICAN-STATESMAN STAFF
Friday, May 15, 2009

The Texas official in charge of everything from food stamps to the troubled institutions for people with disabilities announced Thursday that he will retire this year.

Albert Hawkins, 56, health and human services executive commissioner since 2003, did not say exactly when he'll step down.

"We're all part of something bigger than each of us, something that provides value beyond our measure to millions of Texans," Hawkins told employees in an e-mail Thursday. "I'm proud to have been a part of an organization with such a noble mission."

Hawkins oversees five agencies, 50,000 employees and a $25 billion total annual budget, including state and federal money.

He "has the toughest job in state government," said Scott McCown, executive director of the Center for Public Policy Priorities, which advocates for low- and middle-income Texans. "He was honest and delivered about as much as this underfunded, overwhelmed state system could deliver."

A former budget director for then-Gov. George W. Bush who also worked for Bush in the White House, Hawkins is known as a budget whiz.

He "has been a quiet but powerful force in state government for decades," Gov. Rick Perry said. "His budget expertise is renowned, and he has brought compassion and a commitment to quality to every job he's had."

State Rep. Dawnna Dukes, D-Austin, who is on the House budget-writing team, called Hawkins "a walking, talking Wikipedia" and a "phenomenal human being."

One of Hawkins' first tasks as commissioner was overseeing the consolidation of the state's 12 health and human services agencies into five, which stemmed from a law written during a 2003 budget crunch that also made cuts to state services.

McCown said that Hawkins didn't solve the state's problems with processing applications for programs such as food stamps and Medicaid in a timely, accurate way. But McCown said that was largely because the Legislature didn't provide money for enough staff.

State Sen. Bob Deuell, R-Greenville, vice chairman of the Senate Committee on Health and Human Services, said lack of financing from the Legislature might also be to blame for problems that the U.S. Department of Justice found at the state schools for people with mental disabilities.

(Mr. McCown, please. It had nothing to do with "not enough money for staff"- but everything to do with a rush to privatize to line the pockets of Perry's buddies. The state staff that had BEEN in place WERE processing cases timely and accurately before the entire privatization mess. Where do you think all that enhanced funding from the feds came from? No, staff left after they got "pink slipped via email" because the "powers that be" CONVINCED the legs that "private" could do it better, faster, and cheaper. I wonder what the TRUE numbers are to the amt of money that TIERS/call centers/etc have truly cost Texas compared to what it cost BEFORE all this mess)

In March, Corpus Christi police said they obtained videos showing employees of the state school there organizing fights among residents.

Hawkins drew sharp criticism for an extensive privatization effort: a deal with Accenture LLP (later canceled) to enroll Texans in public assistance. And an agency he oversees was key in the 2008 child-welfare raid on a West Texas ranch owned by a polygamist sect.

(Has Texas gotten their payments BACK from Accenture yet? Or have they swept all that under the rug?)

Perry has not named a replacement. But Hawkins let the governor know earlier this year that he didn't want to be reappointed, so Perry's office has begun interviewing potential replacements, said Allison Castle, a spokeswoman for Perry.

Among those, Castle confirmed, is Lowell Keig, general counsel for Youth & Family Centered Services, an Austin company that provides health, education and assisted living services to troubled children.

He is a former chief of the attorney general's Elder Law and Public Health division.

Keig, who did not return a call seeking comment, has given thousands of dollars to Republican candidates since 2001, including at least $3,000 to Perry's campaign, according to records filed with the Texas Ethics Commission.

(Fabulous, another Perry crony- I wonder if this is all because Perry is going to lose his behind in the next election, and wants to hurry and appoint someone else......)

cmaclaggan@statesman.com; 445-3548

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Thank Goodness!

2009-05-14T21:58:00.001-05:00

HHS Executive Commissioner Albert Hawkins to Retire

AUSTIN ― Texas Health and Human Services Executive Commissioner Albert Hawkins today officially notified the Governor of his intention to retire.

"I'm grateful for the opportunity to have served with so many state leaders and legislators who share a passion for public service," Hawkins said. "It has been an honor."

As commissioner, Hawkins oversees the state's five health and human services agencies, which have combined budgets of $25 billion a year and more than 50,000 employees. Gov. Perry appointed Hawkins to the role in January 2003.

"Albert Hawkins has been a quiet but powerful force in state government for decades," said Gov. Rick Perry. "His budget expertise is renowned, and he has brought compassion and a commitment to quality to every job he's had. We are going to miss his leadership."

Hawkins, who has 35 years of experience in state government, led one of the largest reorganizations in U.S. history after the 2003 Texas Legislature consolidated 12 state agencies into five new agencies under his oversight. The reorganization was completed on time and achieved almost $1 billion in savings with no disruption in services.

Under Hawkins' leadership, Texas: (see if you can guess what's MISSING from his accomplishments.....)

Reformed child and adult protective services. Texas has hired hundreds of additional frontline employees, improved training, and used technology to link the caseworker in the field to the supervisor in the office.
Made the Texas Medicaid program a national model for innovation. Texas has developed electronic Health Passports to help doctors better care for children in foster care, now provides 24-hour access to nursing care and personalized treatment plans for Medicaid clients with chronic health issues, and has made administrative changes that have saved hundreds of millions of dollars.
Organized massive and compassionate responses after Hurricanes Katrina, Rita and Ike. After Hurricane Ike, the Health and Human Services Commission set up makeshift offices in churches and tents to provide emergency food stamps to storm victims. And Texas was the first state to negotiate a federal waiver to provide assistance to Katrina refugees. While other states waited for Congress to act, Hawkins negotiated a deal that protected Texas taxpayers and provided the storm's victims with much-needed medical coverage and food assistance.
Increased federal funding for state services. Federal UPL payments to Texas doctors and hospitals more than doubled and funding for services to Texans who are deaf and hard of hearing increased significantly.
Expanded community placements options by working with the Legislature to provide services for almost 20,000 more people with disabilities and special health care needs.

Before his appointment as health and human services executive commissioner, Hawkins served as a senior White House aide to President George W. Bush for two years. From 1995 to 2000, Hawkins was the budget director for the Governor's Office, and he worked at the Texas Legislative Budget Board for 16 years.

Hawkins is the recipient of numerous awards, including the Bob Bullock Award for Outstanding Public Stewardship in 2004; Distinguished Alumnus of LBJ School of Public Affairs in 2001; the Texas State Administrator of the Year in 1998; the Whitney M. Young Award from Austin Urban League in 2005; and the Outstanding Leadership Award from the Austin Chapter of Blacks in Government in 2005.

Hawkins earned a bachelor's degree in government from the University of Texas at Austin in 1975. He received a master's of public affairs from the Lyndon B. Johnson School of Public Affairs at the University of Texas in 1978.

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Texas Overwhelmed Article

2009-04-10T23:05:00.000-05:00

Texas overwhelmed by food stamp, Medicaid applications

By Corrie MacLaggan | Thursday, April 9, 2009, 08:38 AM

Overwhelmed by an increase in applications for food stamps and Medicaid, the Texas Health and Human Services Commission has postponed plans to expand use of a new computer enrollment system, officials said today.

"The national economic situation has certainly arrived in Texas, at least in our offices," said Stephanie Goodman, a spokeswoman for the commission.

Statewide, Texas is struggling to meet the 30-day federal standard for processing food stamp applications and the 45-day standard for Medicaid applications. For example, in March, the state met the food stamp deadline for 76.4 percent of applications (95 percent is the goal).

Enrollment in food stamps is up almost 20 percent from a year ago, according to the commission.

The Commission has been gradually expanding use of the TIERS computer system, which was designed to replace a decades-old system called SAVERR that is still in use in many state offices.

TIERS (Texas Integrated Eligibility Redesign System) is already in place in the Austin area. The El Paso area was scheduled to get the new system next. But the commission's chief, Albert Hawkins, decided to delay the El Paso plan.

Goodman said: "It's tough to make any changes when you're drinking from a fire hose."

She said the problem had to do with workload and not the system itself. The state is struggling to meet time standards for applications in both SAVERR and TIERS, she said.

But TIERS has been criticized, and State Rep. Abel Herrero, D-Robstown, vice chairman of the House Committee on Human Services, has filed a bill that would halt further expansion of TIERS until cases processed in the system are completed accurately and on time.

"I applaud Commissioner Hawkins' decision to voluntarily postpone the expansion of TIERS so that previous mishaps, which resulted in lapse of services for eligible Texans, can be avoided," Herrero said in a statement.

Herrero's proposal, House Bill 3859, is scheduled to be considered by the human services committee today.

Here are some of the comments from the article:

By Wood Butcher

April 10, 2009 12:41 PM | Link to this

I think that we as state and a nation are in deep trouble. Discussion of any issue draws personal insults and slights. Dare to say that a program is unconstitutional, when it is popular and brings in votes, then it becomes a question of politics. I would like to see politics discussed but I would like to see the discussion moderated by someone that knows the American Constitution, the Bill of Rights and the Texas Constitution. We have lost sight of what is constitutional as opposed to what is a vote getter. We can not continue to support an ever larger government and ever increasing programs. The issue is not whether State Workers earn their pay but rather how is there going to be enough money to pay them? As more and more industries and institutions become tax free nationalized bureaucracies versus tax producing industries the money to make up the difference has to come from a shrinking pool of taxpayers. As we demand that our government take over personal well being we do so at our the expense of our personal freedom. When you suddenly start asserting states rights, that are incompatible to the way things were done "Back Home" or "Back Where I Came From", there is a culture clash caused by people not understanding the laws of "Our State".

By Beaula

April 10, 2009 9:48 AM | Link to this

The people who are getting food stamps while living in big homes and driving nice cars can't own the homes (and could be only days away from foreclosure) or the cars (could be borrowed). There are asset limits to these programs, which can be a real problem for people who have lost jobs, spent their savings, and can't sell the house or the car for more than the loan values. It takes awhile to learn how to live in poverty.

By kd

April 10, 2009 9:37 AM | Link to this

I am a state employee that left to go to work in the "real world". I more than doubled my salary but I did not enjoy the work. I made more money at the expense of my family. After two years I went back to work for the state but the only difference now is that before with the state I worked 40 hours a week…since being back 3 years I work anywhere from 45-70. And since the overtime has been cut I donate my time after 40 hours. It is against policy to work off the clock but these is no way to meet the demands of the job without the extra time. Remember we are in the business of helping the people of Texas. It may only be 50.00 a month in food stamp benefits but food stamps are a supplement to your income to assist with food cost. And last but not least it is a income based program so if a family is only receiving 50.00 a month it is due to the amount of income they receive monthly.

By Stateworker

April 10, 2009 8:13 AM | Link to this

Dear Newbieposter — you are seriously misinformed about state employees. All I can say to you is "don't hate!" Most of us work very hard, and for less pay than private employees doing the same kind of work. We do have good benefits, but we definitely earn them, and it is incentive to work for less pay than a private company. As far as we "can't get fired," welllll, let me say, I just saw about 4 people eliminated from our office just recently — kind of scary.

By amabo

April 10, 2009 8:03 AM | Link to this

Hey Newbieposter,

you are a newbie "cushy jobs and unlimited budgets"? What state are you talking about? You should try working in the eligibility system for a few weeks and then decide if you want to call it cushy. It's low pay, non-stop work. As for unlimited budgets; you must be overmedicated. This past year the governor asked all agencies to cut back their budgets by 10% due to the projected shortfall of funds. Welcome to the party, but please do a little research first.

By newbieposter

April 9, 2009 9:18 PM | Link to this

have you ever heard of a State worker that didn't think he/she was overworked and overwhelmed? they have cushy jobs where they can't get fired and unlimited budgets; try working in the real world

By Mary

April 9, 2009 5:25 PM | Link to this

National TV news reported that in some states people are getting food stamps that live in multi-million dollar homes, and drive very expensive cars. I hope our state doesn't have these type of applicants.

By DL

April 9, 2009 3:44 PM | Link to this

I would like to see any state politician try to live on $50.00 a week for food stamps, eating 3 square meals a day. No job, no insurance and facing eviction! Now that's what I call an enormous problem. Now what about the computer system???????

By backwards move

April 9, 2009 2:46 PM | Link to this

Incompetence in updating a software system is typical on how backwards Texas is. Even in a company software or IT changes are really management facilitated process changes. They can typically take years to completey implement. But who in tarnation wants to stick with outdated methods of running state agencies? This is really shocking but not surprising that "confusion, irresponsibility and sheer incompetence " are what is playing into delaying modern technology that could eventually streenline a business (in this case a state agency).

By whatever

April 9, 2009 11:19 AM | Link to this

Tiers does not work.. If it worked, it would have been rolled out statewide years ago. I say the state should cut their loses and start over. STOP the maddness. The definition of insanity is doing the same thing over and over and expecting a different outcome. This insane.

By orlando garza

April 9, 2009 10:37 AM | Link to this

Stephanie Goodman is paid to tell you that all is well in the State of Texas. Ask her anything about what's really happening and her answer would be "duh?". The criminals in this case is HHSC "executive commissioner" Albert Hawkins and Governor Rick Perry. They should be hung by their toenails for crimes against humanity, namely the People of the State of Texas. These guys and their fat-cat cronies are robbing the State of Texas and lining their pockets with kickbacks and lining the pockets of their private sector co-horts with money that should be used to provide real services to those in need. You would think that after spending over one billion dollars on TIERS that it would be fully functional. Think again..TIERS is no where near being functional…as a matter of fact, it is estimated that it will be ten years before TIERS can be rolled out statewide. TIERS is the reason Texas is in this mess. I hope you do not have to wait in line for assistance because it will be a long wait for you.

By LB

April 9, 2009 9:50 AM | Link to this

In addition to my previous comment…the adminstrators and supervisors I have worked with to resolve problems have been extremely helpful and responsive to individual client issues. The problem is that there are so many screwed up cases they simply don't have the time or staff to go over every case that should have been handled correctly at the entry level in the first place. How about staffing local offices to full capacity again so clients can actually meet face to face, hand deliver documents, etc. so they don't get lost in the system. I know that the idea of having people apply over the phone was supposed to save money, but the problems created by this have certainly been extremely expensive as well.

By rubert

April 9, 2009 9:44 AM | Link to this

if we would as americans and start pointing are fingers at the people that are here illegaly just may be we wouldn,t have to support everyone that enters this country illegaly

By LB

April 9, 2009 9:38 AM | Link to this

Part of the problem with the current system being overwhelmed is that applicants end up having to apply over and over. A person will apply and the application is lost. When the applicant calls to check on why the benefits have not started in the allotted time, they are told we don't have your application, or you didn't send us the proper documentation, etc, etc. I have been working in the social services field for several years and have had more clients that I can remember have these issues with the system. This is on a good day. The last time the state switched computer/data base systems I had clients who were waiting 3 months or more for benefits only to be told the state had never received their applications. I understand that the system is overwhelmed and understaffed. Perhaps the state should concentrate on fixing the existing system (which is done primarily over the phone and through faxing documents) When you have clients submitting applications over and over and clients being removed from eligibility because the state lost their documentation you can begin to see the enormity of the problem.

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Marquez and Herrero Discuss TIERS Rollout

2009-04-10T22:48:00.001-05:00

Marquez and Herrero Discuss TIERS Rollout

FROM A NEWS RELEASE SENT TO THE KDBC 4 NEWSROOM:

Say HHSC Decision to Halt Expansion is Just a Start

AUSTIN, TX-State Representatives Abel Herrero (D-Robstown) and Marisa Marquez (D-El Paso) held a press conference today outlining a proposal they joint-authored, HB 3859, which will provide oversight for the rollout of the Texas Integrated Eligibility and Redesign System (TIERS). Last night, the Health and Human Services Commission (HHSC) announced that it is postponing its planned rollout of TIERS to Region 10 (El Paso, Hudspeth, Culberson, Jeff Davis, Presidio, and Brewster Counties).

"In times of economic hardship, as we face today, more Texans are in need of assistance in providing necessities for their families. For those families, I filed HB 3859 to ensure the health services they are eligible to receive are provided efficiently and continuously," said Herrero.

TIERS is a new computer system intended to streamline and consolidate the application process for vital state services, such as food stamps and temporary assistance for needy families (TANF). In its pilot phase in central Texas, the program has been plagued with design and implementation problems. The program routinely holds up applications beyond federal guidelines, leaving people who are eligible for emergency benefits without them.

"This is an issue that often gets little attention, but it is poised to affect thousands of El Pasoans. I believe strongly that El Paso has to take a stand and demand that this program improve its performance before it is rolled out in our city. We cannot have a situation where technical glitches hold up food and medical care for hard working mothers and families in our area," said Marquez.

As part of HHSC's pilot program, there exist several thousand Region 10 cases already being handled with the new system. Marquez cites the results from those cases to indicate that a lot must be done before expanding the program into El Paso is a responsible action. Of the 64,145 total Region 10 (El Paso) December food stamp cases, only 5,430 (8.5%) were processed in TIERS. Despite this small fraction of cases, HHSC is at only 70.9% of the federal timeliness requirements. The older SAVERR system is handling close to ten times as many cases, and yet it is still processing cases at 92.7% of the timeliness requirements.

"The numbers that HHSC has shared with us do not indicate that TIERS is ready for El Paso. There are still system issues, inadequate staffing, and inadequate training in the program. All of that means that we will likely see the same problems that central Texas has seen--people who are eligible not getting their benefits on time. In this economy, we cannot risk those kinds of delays. That is why I am urging the agency to rethink its plans, and I am encouraged that they have recognized the need to do so in this case," said Marquez.

Marquez has said she will continue to track the issue and has urged the El Paso delegation to monitor the issue closely with her. Herrero and Marquez are laying out bills in the House Human Services Committee today addressing different parts of the eligibility/enrollment system.

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Flood of food stamp applications slows state's conversion to new software

2009-04-10T22:42:00.001-05:00

http://www.dallasnews.com/sharedcontent/dws/news/texassouthwest/stories/DN-tiers_10tex.ART.State.Edition2.4abea62.html

Flood of food stamp applications slows state's conversion to new software

12:00 AM CDT on Friday, April 10, 2009

By ROBERT T. GARRETT / The Dallas Morning News
rtgarrett@dallasnews.com

AUSTIN – State social services officials, buffeted by a recession-driven surge in food stamp applications, have postponed further expansion of a troubled software system for handling requests for public assistance.

Social services czar Albert Hawkins said in a written statement Thursday that in Central Texas a recent conversion of about 75,000 families' cases to the new TIERS system has had "some challenges in achieving the timeliness benchmarks."

Under federal rules, applications for food stamps are supposed to be processed in 30 days.

But last month, Texas met that goal only about three quarters of the time, down from 83 percent of the time a year earlier, said Hawkins, executive commissioner of the Health and Human Services Commission.

He cited a 20 percent increase in food stamp enrollment over the past year – 24 percent in Dallas County. Aid applications of all kinds jumped by 14 percent during that time.

Hawkins also indicated, though, that state eligibility workers have complained about insufficient mentoring and too little time to practice their skills with software known as Texas Integrated Eligibility Redesign System, or TIERS.

The state has been shifting food stamp, Medicaid and welfare recipients in Central Texas from an old mainframe computer to TIERS.

It planned to fully convert the El Paso region's caseload to TIERS next. However, Hawkins suspended that rollout indefinitely.

For months, he has been telling lawmakers he was unhappy with processing times and quality at Central Texas state offices.

Hawkins' delay of the switch of El Paso to TIERS also slows conversion of other regions, including North Texas, which was to happen in three phases next year.

Commission spokeswoman Stephanie Goodman, asked if Dallas-area rollouts are affected, said, "Yes, they are also on hold."

Hawkins' move was applauded by lawmakers critical of TIERS.

Rep. Abel Herrero, D-Corpus Christi, who has filed a bill to halt further TIERS rollouts until it meets federal standards for timeliness and accuracy in processing applications, said families facing economic hardship deserve good service.

"I applaud Commissioner Hawkins ' decision to voluntarily postpone the expansion of TIERS so that previous mishaps, which resulted in lapse of services for eligible Texans, can be avoided," Herrero said.

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Vendor Scheduling

2009-04-10T22:21:00.001-05:00

Wanted to address this comment as well:

Now local office are told not to send in the applications for the vendor to schedule but to have the local clerical staff schedule them. This is due to vendor scheduling applications untimely and several regions are under corrective action for timeliness directly related to the scheduling by the vendor. Amazing that the vendor was hired to do this work but as always the work has been pushed to the local level. What are they being paid for?

I know. Funny how when it all shakes out, it's the ADVISORS- THE WORKERS- who are put on corrective action, coached, etc for failing to meet timeframes- EVEN WHEN THESE WORKERS DON'T GET THE INFORMATION/APPT TIMELY! Vendors, from what I understand, will schedule anything in the "next available appt" with NO regard to that particular case, when it's due, etc. So slots can get filled with May/June 2009 recertifications (for example) and then as April 2009 recerts come in ... THERE ARE NO SLOTS and they are scheduled into May- LATE. Local offices had control over that type of thing- and having vendor schedule, and not knowing how many apps are going to end up in Midland - it is impossible to plan the workload.

Again, the clients suffer and the workers suffer. When offices had control over their schedule, they could plan, hold open slots, etc. Problem is, you can have the local office schedule, but you never know how many clients are sending 1010's to Midland. When you have a rolled out area, all the recert packets have the Midland return envelope. So the choice to control it is GONE.

Local offices are on CAPS over this, is the vendor? The more they push through, regardless of whether it was done right or not, the more they "justify" their position.

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Email regarding 2-1-1

2009-04-10T22:15:00.001-05:00

Got this in email, and felt like I needed to respond:

The 211 information and referral option (option 1) actually works quite
well. That option has nothing to do with food stamps but gets a really bad
rap from frustrations like yours. I really don't mind your expressions of
frustration over the TIERS portion, but when you mention 211 in one lump
with TIERS, you are dragging the hard won, good work of 211 down with
misinformation. Dial 211 from Anywhere in the state, choose option 1 and ask
the call specialist to explain the difference. The option 1 folks are
wonderful and make a huge positive difference in peoples lives! They are NOT
for profit vendors. They work 24 hours a day, and they answer 80 percent of
their calls in 60 seconds or less.

To the writer, I'm not talking about the referral service. I'm talking about the componet of 2-1-1 that handles our client calls. They are given mis-information, and because they are not state employees and do not know policy- it's next to IMPOSSIBLE to give correct information. What is equally frustrating is the relationship between them and the local office staff. Let me give you an example- let's say I interview a client in TIERS. My case comments have my NAME, MY DIRECT PHONE NUMBER and all the information from the interview. Because my notices don't print my name, if the client has a question, they call 2-1-1. Instead of referring that client BACK TO ME personally, the LOCAL worker, they try to answer the question (or verify that information has or has not been turned in- true story: had a client sent in checkstubs- when scanned, they weren't readable. Client calls 2-1-1 and is told that information has been received- I try to contact client to ask them to bring checkstubs to LOCAL OFFICE for me, since they were not readable, can't reach client- I leave COMMENTS to that affect.....operator still tells client info there, case should be completed- had to DENY case- all the operator had to do is REFER *MY* CLIENT TO *ME*, but did not)...when you do have the operator refer client to office, they tell them they do not know who the worker is (remember, my NAME is there!) and give them main office number.

That's not client service, no matter how you slice it.

So again, yes- the information and referral service is fabulous. It is. Much better updated information than "we" have...but the other side of it? NOT at all.

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Rollout

2009-03-24T01:01:00.001-05:00

I've gotten some feedback of the last batch of "expansion" of TIERS- and it's not great. I really feel for the staff in those offices, being a worker myself (thankfully, still in SAVERR, but slowly moving more and more into TIERS)....and seeing what it's doing. I also know ART staff that are in Region 7 right now and trying to help the local offices, and in a word: chaos.

Again, the push from "higher ups" is to get timeliness back in line...but what isn't considered by them is that when you have local office scheduling, and the vendor scheduling, it turns into a nightmare. Also, local office staff are having to deal with clients who are thoroughly confused, and will call 211 for information, be given bad information, call the office upset- and you have new workers to TIERS trying to navigate the system and they don't know what to tell the clients EITHER.

I will say again what I've said all along- Texas had a well oiled machine before "jsap" and before TIERS- yes, SAVERR was somewhat antiquated, but it got the job done- timely and efficiently. After all, Texas was getting enhanced funding for the QC error rate and high marks on timeliness. And where has that all gone? QC has gone through the roof, and timeliness is below standards. TIERS, the way I understand it in a 100% TIERS office, has no real good tracking system for keeping up when cases are due. It's not like SAVERR where you had a WIP to keep progress on pending cases- you only have the portal (which doesn't distinguish between Food stamp cases and medicaid cases, when it comes to due dates) and old antiquated manual tracking. It's not enough, is it, to have workers learning TIERS in the midst of a job that won't slow down enough so you learn it well, and also having to manually report cases each day, and cases done, etc. Nevermind the turnover and all the new folks coming in right now to learn it all in an environment, I would imagine, doesn't provide for much one on one help.

Who suffers in all this? Why, the clients of course. What, with TIERS generated notices that ask for things they don't need, and workers who don't even realize TIERS is generating these notices, to clients getting them and not understanding what the hell is going on. This is client services?

My advice to anyone in the field in a newly expanded office is this: while we have long been discouraged from encouraging our clients to call the legislators in their area- tell them to. ESPECIALLY when the Vendor (2-1-1) is giving wrong information. It makes the local field staff's job so much harder to have to fix something that is messed up. Not to mention the fact that the state is continuing to expand into TIERS even though the call center that handles changes and Children's Medicaid Renewals are so very behind. You realize what that leads to, right? Clients leaning on the local office to do those things that CCC is supposed to do, adding to their already overburdened workload. I know, for those of you out there that must deal with legislative complaints, that they are a pain. Because then we (as an Agency) jump through hoops to get those cleared- but in the long run, if a local rep hears enough (much as they heard when Austin rolled), then maybe- JUST MAYBE- something would be looked at more closely. The powers that be are counting on the fact that a big portion of our population are un or under educated, and are so focused on what WE are doing, that they WON'T call a legislator.

When you take a concept like 2-1-1 to deal with the actual cases, and take away the relationship that can be built between a worker and a client, you lose something in that translation. I have heard stories where a client is interviewed, leaves the interview, has questions, calls 2-1-1 and is given crazy information. If the "call center" concept wasn't there, that client would be calling their WORKER for information, and since it's that worker that actually INTERVIEWED the client and KNOWS the client's situation, the information would be closer to being correct. That's gone. And what is interesting is the push to NOT tell clients to call 2-1-1 but rather to call the local office, but every notice they get TELLS them to call 2-1-1. Of course, the call center needs to have numbers, to justify their existence.

Please, email me what is going on. Again, I have never and WILL never disclose who emails me information. Never have. Never will. I need my job as well. I'm just trying to make it better.

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2009-03-12T23:51:00.001-05:00

Star-Telegram is doing a story on the Eligibility Offices- if you would be willing to be interviewed, or want to talk to them....you can email lnorder@star-telegram.com

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Long Time!

2009-03-11T19:08:00.001-05:00

Been busy!

I hear Region 7 is totally rolled out into TIERS- anyone got any info from any of those offices?

I'll post some this week/weekend

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Health agency audit reveals many woes

2008-09-06T20:02:00.002-05:00

AUSTIN — Texas health and human services agencies continued to pay 1,229 terminated employees a total of $738,192 over the past two years, according to a state audit released Wednesday.

The overpayments were among several deficiencies found in work force practices at the Health and Human Services Commission, which oversees four state agencies in a system that employs 50,000 workers with a payroll of $2.2 billion.

Auditors also complained of inadequately trained supervisors, lengthy paid emergency leaves for employees facing criminal charges and inconsistent efforts to verify workers' citizenship status.
"The Health and Human Services Commission should improve its compliance with laws, policies and procedures when carrying out human resources functions," the audit said.

The audit also said the agencies are in minimal compliance with procedures for maintaining employee records, because some confidential information such as medical documentation should have been maintained separately. However, the agencies are substantially following compensation and complaint resolution processes, the report said.

Sen. Jane Nelson, chairman of the Senate Health & Human Services Committee, said she is concerned about deficiencies in screening and training because many of the employees are caring for children, the elderly and disabled citizens.

"These results are unacceptable and require an immediate response," Nelson, R-Flower Mound, said in a news release Wednesday.

Drafting legislation"It is unimaginable that a terminated employee would continue to receive a paycheck or that someone could be placed on 'emergency' leave for a year while investigations of criminal background checks are taking place," she said.

Nelson said she will address deficiencies in legislation she is drafting to overhaul the screening process for direct care staff.

The employees who continued to get paychecks after they were no longer working for an agency represented 6 percent of the 20,348 employees who were terminated in a 20-month period beginning September 2006. The agency with the worst record was the Department of Family and Protective Services, which continued to pay more than 20 percent of employees who were terminated.

The other agencies overseen by the commission are the Department of Aging and Disability Services, Department of Assistive and Rehabilitative Services and the Department of State Health Services.

Some functions outsourced

The audit attributed some of the problems to the commission's human resources contractor, Ohio-based Convergys. In 2004, the commission outsourced a portion of its human resources function, including payroll processing and administrative training, to Convergys and reduced its own HR staff.

Stephanie Goodman, a commission spokeswoman, said the automatic payroll system has made it difficult to stop salary checks for employees who suddenly leave their jobs. Recent changes have made it easier to manually override the system, she said.

More than half of the overpayments — which amount to about $600 per individual — have been recovered and the agencies are working to collect the rest, Goodman said.

The commission reported that 43 employees were placed on emergency leave because their annual criminal background checks contained information that needed additional investigation.
The length of the leave periods ranged from less than one day to 343 days, with an average of 70 days.

Most extensive emergency leaves have occurred when employees are charged with crimes, but have not yet been convicted, Goodman said. Policies regarding those situations are being reviewed, she added.

The audit found that 92 percent of agency supervisors hired from September 2006 through March 2008 had not completed one or more required training courses.
And only 43 percent of non-supervisory employees hired during that same period had completed required training.

"The lack of adequate training may expose the (health and human services) agencies to risks such as lack of employee productivity and litigation," the audit said.

The training deficiencies discussed in the audit involve civil rights and human resources training, Goodman said. But she stressed that workers are receiving the training they need.

Auditors also said the commission could not locate 52 of 150 employment verification forms selected for testing. Those forms are required by the federal government to document whether individuals are eligible to work in the United States.

"I think we have the policies in place but we need to do a better job of implementing those in every office," she said.
janet.elliott@chron.com

Some comments from the article:

(0)
Cousin_It wrote:
There's no end to government incompetence and waste, dysfunction and ineptness.
9/4/2008 7:50:12 AM
Recommend: (7) (1)
(0)
NativeHoustonian1961 wrote:
Writing those checks was a huge mistake, but cashing them was a crime. Scary to think these people were working for our benefit as state employees at one time.
9/4/2008 1:47:17 AM
Recommend: (5) (0)
(10)
steelman wrote:
well as long as they continue to hire workers based on everything but intelligence this will happen again and again and... well you get the idea
9/4/2008 8:45:34 AM
Recommend: (5) (1)
(0)
Cousin_It wrote:
If a direct deposit is made into your account by mistake that doesn't make it your money because someone else screwed up. Those people knew they had no right to those funds and knew the right thing to do is to return it.
9/4/2008 7:53:10 AM
Recommend: (4) (1)
(0)
SWTSUguy wrote:
NativeHoustonian:1. The state has a rule requiring that all payroll payments be made by direct deposit unless the employee cannot obtain a bank account or the employee is so new that they could not have been timely setup on direct deposit. So, my guess is the vast majority of these payments were made by direct deposit.2. Texas has well settled case law called the voluntary payment rule (which the state itself has used to keep millions of dollars in payments that were deemed to be unconstitutional). Unless the state endorsed any of these checks as payment in protest, which from the context of this article is doubtlful, former employees have every right to cash such checks without recourse.

Audit finds HHSC workers overpaid, undertrained

2008-09-06T19:57:00.001-05:00

Group urges Dewhurst investigationASSOCIATED PRESSThursday, September 04, 2008
HEALTH AND HUMAN SERVICES

Audit: Most agency workers lack training

Most employees at the five agencies of the Health and Human Services Commission are not given required training and more than 1,000 fired employees continued to get paid over the past two years, according to a state audit released Wednesday.

The agency, which employs about 50,000 people and has an annual payroll of about $2.2 billion, had not administered commission-required training courses to 92 percent of supervisors hired between Sept. 1, 2006, and March 31, 2008, auditors said. Only 43 percent of agency employees hired during that time had completed at least one of the required training courses.

Commission spokeswoman Stephanie Goodman said the agency is working on a notification system so managers know when employees have not completed required training.

The audit also found that the commission continued to pay 1,229 terminated employees in the past two years. Those payments amounted to more than $738,000.

Goodman said more than half of the overpayments have been recovered and the agency is working to recover the rest.

This comment was under the article, and my response to it is in red below that:

HHSC paid terminated employees $738,000 for two years. That sounds like a major fraud to me. Where are the HHSC Inspector Generals? Where are the HHSC Internal Auditors? Simple audit procedure could have detected this type of error. It looks like the Inspector General and the Internal Audit Director were asleep on the job. In the private business both will be fired. Let's see what HHSC will do. I bet you nothing.

Internal Office of Inspector General (OIG) is too busy right now going into field offices and putting caseworkers on levels for forwarding joke emails. /smirk

Privatization Hangover: State audit of health and human service agencies shows continuing management problems

2008-09-06T19:30:00.004-05:00

The drive to hire private contractors to take over duties performed by state employees in agencies under the oversight of the Texas Health and Human Services Commission — mandated by the Legislature five years ago — has been a slow-motion disaster. The commission was forced to terminate a major contract with Accenture last year after the attempt to privatize eligibility screening for social service programs caused chaos and erroneously denied services to thousands of qualified Texans.

In early 2006 the state auditor issued a report critical of another commission contractor, Convergys, which was selected in 2004 for a five-year, $85 million pact to provide human resources and payroll services for the 46,000 employees in the agencies the commission supervises. Auditors warned that supervision of the contract was lax, resulting in late and incorrect paychecks to workers and inadequate training and spending on technology.

A return visit by the auditors this year found that payroll and management problems at the state agencies continue. Texas State Auditor John Keel reported that more than $738,192 had been mistakenly paid out to more than 1,200 former state employees after they had been terminated. Only half of those taxpayer dollars have been recovered. In addition, 43 employees were allowed to take paid emergency leave because of criminal charges, with an average length of 70 days. Nine out of 10 agency supervisors had not received required training, while nearly three-fourths of employees sampled had no performance evaluations in their files.

According to commission documents, Convergys is responsible for time and leave collection and tracking, payroll processing, performance evaluations, and administrative training and staff development. The commission is responsible for oversight of the Convergys contract. Neither the commission nor the contractor seems to be performing at an acceptable level.

The chairman of the Texas Senate Health and Human Services Committee, Jane Nelson, R-Flower Mound, called the audit results unacceptable and demanded an immediate response from agency officials. According to Nelson, "It is unimaginable that a terminated employee would continue to receive a paycheck or that someone could be placed on 'emergency leave' for a year while investigations of criminal background checks are taking place."

She also noted that employee screening and training are particularly critical in agencies where workers are entrusted with the care of children, the elderly and other vulnerable citizens.

For $85 million, Texans deserve better than an automated payroll system that blindly sends checks to ex-employees while promised evaluations and training are not carried out. Health and Human Services officials must also be held accountable for failing to provide the contract oversight they've been promising for years.

*****************************************************************************

Here are some comments posted under the article at the Houston Chronicle:

ebb wrote:
This is another fine mess those Republican voters have gotten us into. Do they really want four more years of failed policies? The drive to hire private contractors does not work.

johncoby wrote:
Our state rep, John Davis in Clear Lake is directly responsible for this. He championed privitization and it failed miserably.

HighAnxiety wrote:
So, why is it that these big bureaucratic government agencies are only reviewed periodically? AFTER they have already wasted our tax money and created problems that only get aired a year later. Does NO ONE in our government actually keep an eye on things on a day-to-day or month-to-month basis? They have computers, don't they? Why is it so difficult to push a button and "deactivate" someone from the payroll? Does no one with authority review "emergency leave" requests? If we're going to privatize these government functions let's do it with the conditions that anytime they waste tax money, it gets deducted from their contracts. Or SOMETHING!!!!!!! Other than being the subject of nasty editorials, let's hear from our govenment folks how they are going to make Convergys pay for their screwups.

milby wrote:
In 2007 I lobbied against Mr. Albert Hawkins, the head of HHSC in the Texas legisature. I was the only person to speak against the nomination of Mr. Hawkins at the Nomination Committee hearing. Seven senators voted against his nomination on the floor of the State Senate. I hope to lobby again next year against his nomination in Austin.Robert Kenney

renehebert wrote:
We all know government buracracies waste money. Maybe the private contracters will waste less money. Give contract to Halliburton they know how to make money at lower cost to government.

Women's Health Program

2008-07-16T22:24:00.003-05:00

HHSC Employee here....

I just wanted to remind anyone reading that while there can be plans for rollouts, there can be a "wait and see" attitude- through WHP (Women's Health Program), cases (I'd venture to say 100's per day) are pushed into TIERS DAILY.

Statewide.

So Hawkins can talk all day about all these plans, however he is "back door" rolling out TIERS as. we. speak.

Daily.

Think about this- when W.H.P. was created, what was the real motivation? What does WHP really pay for, in the long run? Birth Control? It's not "Medicaid". So who thought up the WHP program? Who decided that this program should be done exclusively in TIERS- even when it was common knowledge that TIERS was having major problems in the Pilot Area?

How much easier than to sell a program that "helps poor women in Texas" and decide that TIERS would be how it was done. And what happens once in TIERS? Always in TIERS. Remember?

It seems, upon thinking about it, that WHP was the PERFECT vehicle to get as many cases in TIERS.

Who gets WHP? Women, right?

Who are most of our clients? Child-bearing age women. What faster, easier way to do it?

What about the fact that clients, once they realized what getting on WHP did to their case- BEGGED to be put back in the "old system"?

I've seen it personally. Clients who got on WHP through somewhere like Planned Parenthood thinking that it was a form of "Medicaid"- find out it wasn't really, then they would literally say to local office staff "never mind that program then, put me back in the old system". This at a time when those in the "old system" were still being done timely (and still are), and those in TIERS were waiting up to 45 days just to get an APPOINTMENT to apply for Food Stamps.

Is it any wonder the clients might have felt duped by this?

There was no major "outcry" when WHP was created, as anything Hawkins could do that made it appear that he cared about client services was what he needed at the time it was done. Right?

WHP serves many women. It provides birth control (that was, by the way, given at PP on a sliding scale based on income anyway, meaning many didn't pay in the first place- and it's not like Planned Parenthood *for example* wasn't receiving funding to pay for these services already), and well women checkups, as well as various screenings- however, what people do not realize is if a woman goes for that screening and something is WRONG- WHP does NOT pay for the treatment of that issue. So a woman can get a preliminary diagnosis, but not help to take care of the problem.

Nevermind the fact that the spenddown program was virtually eliminated for all but pregnant women and children (most of which qualify for either Pregnancy Medicaid or for kids- Medicaid or CHIP).

Just think on the relationship between WHP and TIERS.

Back. Door. Rollout.

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

2008-07-15T21:56:00.002-05:00

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

Just a note

2008-07-15T21:40:00.003-05:00

Just wanted to throw this out there......with the talk of MEPD (elderly/disabled) going to TIERS.

I got an email from a reader in April 2006.....which reflects on this...and now I find that it's appropriate.......here is part of it...........and this is the truth. Believe it.

When this rolls out for the NH (nursing home) cases, then you will see
some organized, active, and vocal public complaints. “Our” clients may be
poor, (although with spousal impoverishment, many aren’t) but their relatives
aren’t. The responsible parties are usually younger, more educated, and
more motivated to complain than FS clients. After all, a monthly NH bill
and medications are very expensive. Waiting around for an answer, or being
lost in the shuffle, just won’t cut it with those folks.

Texas lawmakers demand details of new application process for disabled, elderly services

2008-07-15T21:20:00.001-05:00

08:47 AM CDT on Tuesday, July 15, 2008

By KAREN BROOKS / The Dallas Morning News kmbrooks@dallasnews.com

AUSTIN – Skeptical legislators on Monday directed Health and Human Services Commission chief Albert Hawkins to bring them a detailed plan for how he would put nearly 1 million elderly and disabled Texans through a new application process that has been plagued with problems.

At a meeting of a House and Senate joint committee to discuss the embattled TIERS – the Texas Integrated Eligibility Redesign System, a private computerized system used to enroll clients in state programs – members grilled the commissioner about those plans and expressed anger that the state had made that decision without consulting them.

"I am absolutely shocked and dismayed at what has happened and cannot believe that there is such an obvious attempt" to get around legislative oversight, said Sen. Judith Zaffirini, D-Laredo, former chairman of the Senate Health and Human Services Committee.

The panel was formed in response to dismal performance by TIERS pilot programs rolled out in 2003, including high staff turnover as well as wait times for food stamp applications that were three times longer than the federal mandate.

House Human Services Committee Chairman Patrick Rose, D-Dripping Springs, said it is "critical" that high standards are established before any expansions of the program.

Mr. Hawkins agreed to return with specific criteria that would have to be met before TIERS was expanded, saying the system is being improved and more workers are being hired.

The agency said Friday that it would add 953,000 elderly and disabled Medicaid patients to TIERS by September 2009, on top of the 288,000 food stamp recipients it already plans to add by then. Of the 3.8 million Medicaid, food stamp and welfare recipients in the HHS system, about 15 percent are on the TIERS system

Lawmakers criticize plan to expand troubled public assistance system

2008-07-15T21:07:00.002-05:00

Advocates for people with disabilities worry about impact.

By Corrie MacLaggan
AMERICAN-STATESMAN STAFF
Tuesday, July 15, 2008

Members of a legislative panel on Monday sharply criticized a plan to nearly triple the number of Medicaid and food stamp cases handled by a troubled computer enrollment system.

Under the plan, Health and Human Services Executive Commissioner Albert Hawkins proposed adding about 953,000 elderly and disabled people to the system between December 2008 and September 2009. Some lawmakers and advocates for people with disabilities called that reckless because the state has had problems processing cases in the system as quickly as the federal government requires.

"If this conversion is not totally successful, people will be without services — this is probably the most vulnerable population we have," Colleen Horton of the University of Texas Center for Disability Studies told lawmakers. "It's really unfair to place the burden of the consequences of such a massive, untested conversion" on this group.

The expansion plans for TIERS — Texas Integrated Eligibility Redesign System — comes at a time when the agency is struggling with worker shortages and high turnover. The state has had trouble getting enough workers trained in TIERS, which was designed to modernize the enrollment system.

Several lawmakers said they were surprised to learn of the plan last week from an early copy of Hawkins' testimony Monday to a joint House-Senate committee looking at the enrollment system.

"I'm absolutely shocked and dismayed at what has happened," said state Sen. Judith Zaffirini, D-Laredo, "and cannot believe that there is such an obvious attempt to go counter to what I consider legislative intent."

Texas received federal approval to expand TIERS in a limited manner starting this month, but Hawkins said he won't do so until the commission meets a series of benchmarks.

Hawkins said that the agency is working to smooth the conversion and that he will continually evaluate the conversion plan and will not move forward if there are problems. The bulk of the change, which requires approval from the federal agency that oversees food stamps, is set to begin in March.

"It's not etched in stone," Hawkins said of the plan. "It's the plan to guide our efforts, but we're not going to be bound to it."

Additionally, he plans to expand TIERS to other Medicaid and food stamp recipients in Central Texas and the El Paso and Lubbock areas.

The Center for Public Policy Priorities, which is an advocate for low- and middle-income Texans, warned in a report Monday that the state should halt plans to convert any more cases to TIERS until there are enough trained workers to process applications quickly enough to meet federal standards: 30 days for food stamps and 45 days for Medicaid.

In June, Texas completed more than 70 percent of food stamp applications on time in TIERS — an improvement since January but short of the more than 90 percent that were completed on time in the old system in June. Most public assistance enrollment in Texas is still processed using the old system.

Kalese Hammonds of the Texas Public Policy Foundation, which is an advocate for limited government, told lawmakers that delaying TIERS expansion is not the solution — in part because of what keeping two systems is costing taxpayers.

The state spends $1.6 million a month to maintain the system that TIERS was designed to replace, agency spokesman Geoffrey Wool said.

cmaclaggan@statesman.com; 445-3548

Here are some comments posted regarding the article on the website (click title of this post):

lbd82 wrote:
TIERS WILL LITERALLY LEAVE YOU IN TEARS! IT'S A MESS! THE PEOPLE NEEDING THESE PROGRAMS/SERVICES ARE GOING TO BE THE ONES TO SUFFER. I KNOW THERE IS MUCH MORE INVOLVED THAN ANY ONE OF US COULD IMAGINE. BUT WHEN YOU WORK FOR THE STATE YOU KNOW WHAT MAKES SENSE ISN'T WHAT ALWAYS HAPPENS. STAFF ARE JUMPING- NO ONE WANTS TO BE FORCED INTO TIERS! THERE IS NO WAY POSSIBLE TO QUICKLY AND EFFECIENTLY PROVIDE SERVICES IN TIERS WHEN YOU CAN WORK TWICE AS MANY AND 10 TIMES AS FAST IN THE CURRENT PROGRAM. AS A TAX PAYER I'M HIGHLY PISSED OFF THAT MORE AND MORE MONEY IS BEING THROWN INTO THIS PLAN. THE TRAININGS, THE TRAVEL INVOLVED FOR THE TRAINING, THE EFFECTS THE STRESS IS HAVING ON EMPLOYEES HEALTH. THE MORE IT SEEMS IMPOSSIBLE THE MORE IT IS PUSHED TO "ROLL OUT" GIVE ME A BREAK ALREADY! YES STATE EMPLOYEES ARE PAID TO DO THEIR JOB- BUT THERE IS NOT ENOUGH MONEY ANY WHERE THAT WOULD MAKE ME WANT TO WORK CASES IN TIERS!! WE ARE DROWNING IN CASES AS IT IS - YOU CAN'T EFFECIENTLY WORK IN BOTH PROGRAMS AT THE SAME TIME! HOW MUCH MORE MONEY ARE WE GOING TO THROW INTO A PROGRAM THAT DENIES BENEFITS FOR THOSE THAT NEED IT AND GIVE EXTRA TO THOSE THAT AREN'T ELIGIBLE. OUR TAX DOLLARS AT WORK????
7/15/2008 7:50 PM CDT on Statesman Staging

arnoldbowerfs wrote:
jUST THINK IF THEY ALL QUIT JUST HOW MANY TAX DOLLARS THEY WILL SAVE AND WITHOUT A CLIENT LIST AND A COMPUTER WE WILL NOT NEED SALES TAX MUCH LONGER AND PERHAPS WE CAN GET RID OF HIGH WAY TAX. THE OLD AND SUPPOSELY HANDICAPED OR WHAT HAVE YO WILL ALL BE GONE AND WE WILL NOT NEED ANY TAX IN THE STATE OF TEXAS THEN PERHAPS WE CAN GET RID OF THE IDIOT CALLING HIMSELF GOVERNOR PERRY AND THE CONGRESS; PEOPLE JUST THINK OF THE MONEY WE CAN SAVE FOR THE WORKERS THEMSELVES TO USE RATHER HAVE IT THROWN TO ANCHOR KIDS AND WELFARE FOLKS.. FRANK BOWERS
7/15/2008 1:34 PM CDT

RedEx wrote:
If the agency doesn't do something about workload, there won't be any staff left to work in either system!
7/15/2008 12:00 PM CDT on Statesman Staging

PressProgress wrote:
Many of us in Texas believe that our tax dollars should be used as a collective expression of our values. Ever more often that means ensuring that all Texans have access to adequate food, shelter and health care. TIERS is an effort by the Republican Legislature and administration of the state to reduce the care we offer to individuals so they can continue their personal slush funds to deliver cash to private entities, foreign and domestic (economic development incentives, privatization and toll road contracts to name three vehicles). In the name of updating our technology and being more efficient, we have created the TIERS system to frustrate those applying for help so that more and more just give up or do without for months. How much money has the state "saved" and then delivered to private contractors hands in the name of this efficiency and how many Texans have suffered? To expand this program before the bugs are worked out simply extends the cold shoulder we started in 2003 giving Texans who need help with drastic budget cuts. It is unconscionable to expand implementation of this system before we can make it work for those it should serve.
7/15/2008 10:21 AM CDT on Statesman Staging

Morgan1313 wrote:
Here we go again......the shredding facility in Washington state must need something to do(the DHS contractor in Midland "accidentally" shredded 10,000 active case files 2 years ago leaving 10,000 households with no food, health care and/or TANF).
7/15/2008 1:37 AM CDT on Statesman Staging

ELIGIBILITY SYSTEM PROGRESS REPORT

2008-07-15T20:27:00.002-05:00

July 14, 2008 Contact: Celia Hagert, hagert@cppp.org No. 08-335
900 Lydia Street • Austin, Texas 78702-2625 • T 512/320-0222 • F 512/320-0227 • www.cppp.org

ELIGIBILITY SYSTEM PROGRESS REPORT

Legislative Oversight Committee to hold hearing on Monday, July 14

Access to health care, good nutrition, and cash assistance is vital to low-income Texas families who don't earn enough to make ends meet, particularly during economic downturns. Yet, enrolling in programs like Food Stamps and Medicaid has gotten harder over the last year due to problems with TIERS.the new computer system.and a shortage in state workers that
resulted from the Legislature.s failed attempt to privatize the system in 2006.

Rebuilding and sustaining a viable eligibility system promises to be one of the most important challenges facing Texas in the years to come. Today, the Legislative Oversight Committee overseeing efforts to rebuild the eligibility system will hold a public hearing. The Health and Human Services Commission (HHSC) will provide a progress report and present the benchmarks that will be used in determining whether to continue implementing TIERS.

Background

When Texans seek assistance from the state to support themselves or their families, they generally need help fast.whether to pay their rent, put food on the table, or take a sick child to the doctor. It is the states responsibility to figure out whether an applicant is eligible and enroll that person as fast as possible. This is why it is so important to have a system in place that can of
process applications for assistance timely and accurately.

Federal law requires that most applications be processed within 30 days for Food Stamps and 45 days for Medicaid and TANF (cash assistance).

Applications that take longer to process are considered untimely.

Timeliness in application processing has been below these federal standards since January 2006, though some improvement occurred over the last several months. The delays are most severe in applications processed in TIERS, the new computer system currently being used for approximately 13% of families receiving assistance.

Several staffing factors are contributing to these delays: worker shortages, high turnover, reduced tenure, and problems training staff quickly enough to work cases in TIERS. Thus, the first step HHSC must take to rebuild the eligibility system is to stabilize the workforce. In support of this effort, HHSC should postpone any additional expansion of TIERS and hold off on awarding a new contract to expand the call centers until there are enough trained workers to
meet the federal standards for timeliness in application processing.

Staffing Levels Plummet and Workload Skyrockets

Ten years ago, roughly 10,000 workers handled a caseload of approximately 4.1 million clients. Since then, the Texas Legislature has cut the number of eligibility staff at HHSC by almost 40%, despite a 50% increase in the number of clients served by the system. As a result workload has more than doubled and client services have suffered.

Fiscal 1998 Fiscal 2008
Average number of workers 10,404 7,136
Number of cases per worker 389 756
Total clients (recipients may receive more than one
benefit)
4.1 million 6.1 million
Turnover rate NA 23.9% (year to date, FY 08)*
Percent of staff with less than 3 years experience 4% (Sep. 04) 23% (Sep. 07)
*The statewide turnover rate for classified employees was 17.4% in fiscal 2007.

HHSC Takes Steps to Increase Staff and Stabilize the Workforce

The original staffing target for fiscal 2008 was 7,136. However, the 80th Legislature authorized HHSC to increase eligibility staffing levels up to 10% over the agency.s cap for the 2008-2009 biennium, increasing authorized staffing level to 7,438.

HHSC had made progress toward reaching this staffing level, increasing the number of eligibility workers from 6,343 in September 2007 to 7,027 in June 2008, for a net gain of 684 eligibility staff.

Despite this growth, high turnover and decreased tenure continue to complicate efforts to rebuild the workforce. In fiscal year 2008 (YTD), the average turnover rate for eligibility workers was 20.9%, higher than the 2007 state average of 17.4%, but down from 28.8% in 2006. The tenure of staff also has fallen dramatically over the last four years. In 2004, only 4% of eligibility workers had less than 3 years experience. By 2007, 23% of eligibility workers had less than 3 years experience.

HHSC has taken numerous steps to stabilize the workforce, including:

. Converting 2,000 temporary jobs to permanent status;
. Actively hiring qualified candidates for vacant positions,
. Conducting outreach to retirees and former eligibility staff,
. Implementing improvements to reduce overtime and divert work from local offices to specialized teams and centralized units,
. Assuring state staff that no reduction in force or office closures will occur (despite ongoing plans to privatize the eligibility system see Call Center Procurement Plans below), and
. Increasing salaries.

These efforts have started to pay off. As of March 2008 there were 756 clients for every worker, down from 816 recipients per worker in December 2007. However this is still almost double the workload per worker 10 years ago, when workers handled fewer than 400 cases. Moreover, timeliness still remains below federal standards, particular for those cases processed in TIERS.

The good news is that TIERS timeliness has improved dramatically since December 2007, when it hit an all-time low of 47.2%. In June 2008, 71.2% of Food Stamp applications were processed timely. However, this is still far worse than a year ago, when 92.6% of Food Stamp cases in TIERS were processed on time.1 The decline in TIERS timeliness is the result of a
sharp increase over the past year in the volume of cases processed in TIERS, without a corresponding increase in the number of staff trained to work cases in TIERS. In other words, the number of cases in TIERS has been growing faster than HHSC can train workers to use the system. This growth in TIERS and its impact on timeliness is discussed below.

The Impact of Uncontrolled Statewide TIERS Growth on Application Delays

The original TIERS implementation plan called for a geographical rollout, starting with two counties in July 2003. Confining TIERS cases to the pilot area proved impossible, however, as clients moved from the pilot counties to other parts of the state.

However, the vast majority of the growth in TIERS cases over the last year was not caused by this movement; it is the direct result of HHSC's decision to put both new enrollees and denied applicants for the Women.s Health Program (WHP) (a Medicaid-funded program that provides family planning services) into the TIERS system, along with any family members with
open Food Stamp, Medicaid, or TANF cases. The addition of the WHP and associated cases to TIERS has caused the number of TIERS cases to almost triple statewide over the last year. It also has led to a diffusion of TIERS cases throughout the state.

In December 2006, the month before WHP implementation, approximately 150,000 total cases (all programs) were in TIERS, representing 5% of the statewide caseload. Roughly one-third of TIERS cases were located outside of the TIERS pilot area. As of May 2008, approximately 469,000 total cases were in TIERS, with more than twice as many TIERS cases outside of the pilot area as inside the pilot area. (See chart above.)

The three-fold increase in TIERS cases over the last year has strained the capacity of local offices, particularly outside the pilot area where many offices lack enough TIERS-trained staff to handle the increased volume of cases. This haphazard expansion of TIERS is driving the serious delays in application processing as well as limiting access to competent workers able to assist
TIERS clients. HHSC should put further expansion of TIERS on hold until timeliness in both SAVERR and TIERS meets federal standards.

HHSC’s Plans to Expand TIERS Despite Timeliness Problems

HHSC recently received federal approval for a limited geographic expansion of TIERS to additional offices in Regions 7 (Central Texas), 10 (El Paso), and 1 (Lubbock) that would occur between October 2008 and February 2009. HHSC also plans to convert all .MEPD. (Medicaid for the elderly and people with disabilities) cases to TIERS over an 8-month period beginning in December 2008.

HHSC has developed certain benchmarks that must be met before proceeding with the geographic rollout or MEPD conversion. Prior to each conversion, HHSC will use these benchmarks to determine if the office is prepared for the conversion. The chart below shows the .pre-conversion. benchmarks:

Benchmarks to Determine Readiness for Conversion Measure

Adequacy of staff trained in TIERS and available to process cases-500 cases per TIERS trained worker

Capacity of on-site support to assist the office Minimum of 1 per office/1 on-site support worker for every 30 eligibility workers

Capacity of TIERS mentors to assist the office Minimum of 1 per office/1 TIERS mentor worker for every 30 eligibility workers

Availability of Assistance Response Team (ART) staff to assist with conversion corrections. (As evidenced by prior conversions, a proportion of cases will require manual processing and/or correction.

SAVERR continues to issue benefits until the case is successfully converted into TIERS.)

1 ART staff per 2,500 cases converted

Stable and appropriate call center performance measures-Call abandonment rate of 10% or less for 4 of the 6 weeks prior to conversion / Average Speed to Answer of 180 seconds or
less for 4 of the 6 weeks prior to conversion

Appropriate and stable TIERS server utilization levels (lower levels ensure better system performance)

Server utilization at or below 80% during business hours in the month prior to conversion

Appropriate and stable TIERS transaction response times (the most commonly used transactions are monitored to ensure better performance)

In the month prior to conversion, inquiry/query transactions are completed within 4 or fewer seconds; and update/save transactions are completed in 5 or fewer seconds

Consistent TIERS system uptime (to ensure availability of the system during business hours)

In the month prior to conversion, the system is available a minimum of 99% during business hours

In addition, HHSC has developed a .post-conversion. benchmark to determine if and how conversion to TIERS is affecting clients. HHSC will monitor the post-conversion performance of offices recently converted to TIERS by looking at timeliness.

If timeliness drops more than three percentage points below the office.s average timeliness in the three months prior to conversion, HHSC.s Independent Validation and Verification (IV&V) vendor will do a .root cause. analysis to identify the factors contributing to the decline. HHSC will evaluate timeliness at 30, 60, and 90 days post-conversion. If the IV&V vendor identifies changes necessary to prevent future conversions from delaying services to clients, then HHSC will develop a remediation plan and reassess its roll-out schedule.

Benchmarks Must Be Revised to Include Timeliness Measure

Though we heartily support the use of benchmarks to determine readiness for a TIERS rollout, there are several flaws in HHSC.s approach that must be addressed to ensure that expansion of TIERS does not undermine the significant progress made in rebuilding the state workforce and reducing the delays in application processing:

. No Real Limit on TIERS Expansion. USDA.s Food and Nutrition Service (FNS), the federal agency that oversees Food Stamps, approved an expansion of TIERS to up to 22% of the Food Stamp caseload. However, the limits on geographic expansion only apply to Food Stamp cases currently in the system and those added during the geographic rollout. The limits do not include cases that are converted to TIERS through the WHP,2 which is driving the rapid increase in TIERS cases and causing a much larger volume of cases to enter the TIERS system than would occur under the limited geographic rollout approved by USDA. In other words, FNS. limit will do little to control the rapid increase in TIERS cases that is straining the workforce and causing delays in services to needy families.3

. No Real Timeliness Goal; Improvements in One Region May be at Expense of Others. The benchmarks include a workload measure, which is good, but fail to include timeliness as an indicator of system readiness. Yet, timeliness is the best indicator of a system and a workforce that is stable enough to weather the strain that is inevitable in the conversion to a new computer system. The workload measure alone does not accurately assess performance. For example, there may be enough bodies in an office to reach 500 cases per worker, but not enough tenured workers to ensure the timely and accurate processing of applications. Moreover, the workload measure by itself only captures the circumstances in that particular office. It does not capture what is happening in other offices, which may be struggling as a result of losing staff who have been sent to support the TIERS rollout. Any further expansion of TIERS before the current
workforce is capable of processing all applications timely and accurately4 in both SAVERR and TIERS will only rob Peter to pay Paul.

MEPD Rollout Poses Risks to Vulnerable Population

HHSC is proposing to convert all cases for Medicaid for the Elderly and Persons with Disabilities (MEPD) in four phases, currently scheduled to begin in December 2008. The proposed conversion schedule is as follows:

Proposed MEPD Conversion to TIERS

December 2008 . Approximately 13,000 cases. This will convert MEPD cases currently in SAVERR for clients with existing Medicaid, Food Stamp, and TANF cases already in TIERS. This will not add new Medicaid, Food Stamp, and TANF cases to TIERS.

March 2009 . Approximately 300,000 cases. This will convert SAVERR cases to TIERS for MEPD clients who do not receive Supplemental Security Income (SSI).

June 2009 and September 2009 . Approximately 320,000 cases for each conversion. This will convert SAVERR cases to TIERS for the remaining MEPD clients who do receive Supplemental Security Income (SSI).

Note: The conversion of MEPD cases scheduled for March, June and September 2009 will also result in an increase in the number Medicaid, Food Stamp, and TANF cases in TIERS. This is because many MEPD clients also receive, or have family members who receive, these benefits. Once the MEPD client is converted to TIERS, their family members. cases would be converted as well. HHSC does not yet have an exact number for how many Medicaid, Food Stamp, and/or TANF cases will be converted in conjunction with the scheduled MEPD conversions.

Before converting any MEPD cases to TIERS, HHSC must make certain enhancements to TIERS. These changes are planned for August 2008 and are intended to simplify data entry for MEPD cases and allow data to be transferred electronically between HHSC and the Department of Aging and Disability Services (DADS), the agency that determines .functional eligibility..the medical necessity for MEPD services.

We have several grave concerns with the proposed MEPD conversion:

. The pre-conversion benchmarks developed for the geographic expansion are not appropriate to determine readiness to convert the MEPD cases. They should be revised to address the specific concerns associated with adding these programs and population to TIERS. As with the geographic conversion, the benchmarks must include a timeliness measure in addition to a workload measure to ensure that the conversion of MEPD cases does not result in delays in application processing in other programs or areas of the state.

. MEPD clients are among the most vulnerable served by HHSC. Many have cognitive impairments such as dementia that interfere with their ability to understand or communicate effectively. Moreover, any disruption in their Medicaid benefits could have dire consequences for their health and well-being. HHSC should take extra care before converting any MEPD cases to TIERS to ensure that it will not cause disruptions in services and that enough staff are available to assist clients when problems occur.

. It is unclear why HHSC is planning to convert such large numbers of the MEPD caseload at one time. A more rational and cautious approach would be to convert only a small number of cases at a time. This would allow HHSC to maintain close control over the conversion and ensure they have the resources needed to intervene when problems arise.

We recommend HHSC halt all plans to convert any MEPD cases to TIERS until they have implemented more meaningful benchmarks and thoroughly tested the new functionality being added to TIERS to ensure that the interface between DADS and HHSC works smoothly. The legislative oversight committee as well as stakeholders and advocates should be given the
opportunity to comment on the revised conversion plan prior to implementation.

Call Center Procurement Plans

HHSC continues to forge ahead with its plan to use privately run call centers to modernize the eligibility system. In October 2007, HHSC released two draft Requests for Proposals (RFPs) related to the development and operation of an eligibility system for Food Stamps, Medicaid, TANF, and CHIP. Similar to the original, now defunct contract with Accenture, the RFPs asked vendors to submit their proposals for operating a system of call centers to provide .eligibility support services. for Food Stamps, Medicaid, and TANF; determine eligibility for CHIP-only cases; and provide document-processing services through a centralized mail center. Last week, HHSC received the federal approvals needed to release final RFPs and move forward in the
procurement process.

CPPP has always supported the general concepts and goals behind the state.s plans to modernize its eligibility system. We share HHSC.s vision of a system that is easier for clients to use and more economical for the state to administer. We agree that better technology, more efficient processes, and the right mix of call centers, online tools, and local eligibility offices could produce a state-of-the art eligibility determination system for these programs. However, we strongly urge the Legislature and HHSC to learn from the painful experience with the Accenture contract.which caused harm to thousands of Texas families and cost taxpayers millions.and proceed with great caution before entering into any new contracts.

Above all, the draft RFPs outline an enormous undertaking that will require years to accomplish and require extraordinary additional resources from HHSC at a time when HHSC is struggling with the limited resources it has. A project of this magnitude will change the fundamental role of HHSC in providing these services. Even if it chooses to outsource to private companies certain tasks related to the eligibility and enrollment process, HHSC remains responsible for ensuring that eligible families receive timely and accurate benefits in accordance with federal law. This creates new responsibilities for HHSC.

Where previously HHSC was required to administer the system, now it is responsible for developing requests for bids, negotiating contracts, monitoring performance, and enforcing compliance. HHSC needs to determine whether it has the capacity to play this role and include the costs of contract monitoring and enforcement when determining whether the bids that result from the final RFP are truly cost-effective.

We further recommend that HHSC do a new cost-benefit analysis to determine whether privately operated call centers are the best approach to improving services and achieving greater efficiencies. The assumptions in the .business case. analysis developed in March 2004, which ultimately served as the basis for the Accenture contract, have since been proven wrong. A rational approach to contracting must begin with a new set of assumptions, including a valid staffing analysis that determines how many workers are needed, and the right mix of workers (public vs. private; skilled vs. unskilled), to operate an effective eligibility system. HHSC should then test these assumptions in a controlled pilot experiment that allows the state to compare
the .old. system to the new and determine which works best before entering into any long-term, high-dollar contracts.

Summary of Recommendations

. HHSC should postpone any additional rollout of TIERS until it has hired and trained enough workers to meet the federal standards for timeliness in application processing.
. HHSC should devise an alternative to putting Women.s Health Program (WHP) and associated cases into TIERS to slow the rapid increase in TIERS cases and ensure enough trained workers are available to handle the volume of TIERS cases.
. HHSC should revise its pre-conversion benchmarks for TIERS expansion to include a meaningful timeliness measure. Timeliness statewide for cases processed in both SAVERR and TIERS should meet federal standards prior to adding any new cases to TIERS.
. HHSC should halt all plans to convert any MEPD cases to TIERS until they have developed and implemented more meaningful benchmarks and thoroughly tested the new functionality being added to TIERS to ensure that the interface between DADS and HHSC works smoothly. The legislative oversight committee as well as stakeholders and advocates should be given the opportunity to comment on the revised conversion plan prior to implementation. Before eleasing a call center RFP, HHSC should determine whether it has the capacity to rigorously oversee a large contract and include the costs of contract monitoring and enforcement when determining whether the bids that result from the final RFP are truly cost-effective.
. Before entering into any contract for call center services, HHSC should perform a new cost-benefit analysis to determine whether privately operated call centers are the best approach to improving services to clients and achieving greater efficiencies for the state. This exercise must include a .baseline. staffing analysis that determines how many workers are needed, and the right mix of workers (public vs. private; skilled vs. unskilled), to operate an effective eligibility system.
. HHSC should test its assumptions about the benefits of privately run call centers in a controlled pilot experiment that allows the state to compare the .old. system to the new before entering into any long-term, high-dollar contracts.

Committee Members

2008-07-13T23:03:00.001-05:00

Texas Legislative Committee on Human Services can be seen HERE

House Committee on Appropriations-S/C on Health & Human Services is HERE

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Texans Against Hunger Blog

2008-07-12T22:52:00.000-05:00

*Click on Title for Link*

Thursday, July 10, 2008
Texas' Trouble with Timeliness

For those following the slow-motion implementation of TIERS, Texas' new social services enrollment system, yesterday was another step forward - although not a wholly positive one, according to the Dallas Morning News.

Since its introduction, 217,000 hungry Texans in need of food stamps have been transferred to TIERS, whose privatized, high technology was supposed to make life easier for everyone.

Last winter, however, half of new food stamps cases in the system were not resolved in the federally mandated 30 days, stranding hundreds of hungry families without food around the holidays and putting HHSC on the wrong side of the law.

Yesterday, after state lawmakers demanded accountability from the system before approving an expansion, HHSC released a set of nine measures designed to improve TIERS' performance. Not on the list? Timeliness.

"The test is whether you're processing cases in a timely way, and that's not in here," said food policy expert Celia Hagert of the Center for Public Policy Priorities.

Timeliness is a key aspect to fighting hunger. What would you do if your local firemen only showed up in time to fight half the fires?

Posted by jc at 8:25 AM

Texas' new eligibility system to take on Medicaid, food stamp recipients

2008-07-12T20:38:00.000-05:00

01:26 AM CDT on Saturday, July 12, 2008
By ROBERT T. GARRETT / The Dallas Morning News
rtgarrett@dallasnews.com

AUSTIN – State social services officials now plan to switch 1 million or more needy people in the next year to a different application process for benefits, including Medicaid and food stamps.

The state says it intends to shift 953,000 elderly and disabled Medicaid patients into its problem-plagued "integrated eligibility" system by September 2009 – on top of its previously stated goal of moving in 288,000 more food stamp recipients by August 2009.

The state's decision, tucked into an advance copy of Health and Human Services Commission chief Albert Hawkins' planned testimony to a legislative panel next week, caught advocates for the poor, state employee groups, and a veteran Democratic lawmaker by surprise Friday.

They expressed alarm that Mr. Hawkins would so greatly accelerate the rollout of TIERS – the Texas Integrated Eligibility Redesign System – to aid recipients statewide.

"I'm concerned that the commission is going to take one of the most vulnerable populations, the elderly and disabled, and convert these extremely complicated cases into TIERS so quickly," said Rep. Elliott Naishtat, D-Austin. He said the Medicaid recipients are "most likely to have problems" and there could be "dire consequences."

The Texas State Employees Union, which has said an old mainframe-based system works much better than TIERS, denounced the plan.

"It borders on irresponsible behavior," said union spokesman Will Rogers. "They haven't worked out all the bugs with TIERS. You're playing with people's lives by doing that."

Mr. Hawkins has said the mainframe computer used for Texas benefit applications is one of only seven of its type left in existence. The old approach is outmoded and costly, while TIERS is being improved, he has said.

Commission spokesman Geoff Wool, when asked whether the state was expanding TIERS too fast, said: "This proposal reflects a measured approach. We're going to monitor very closely the benchmarks that have been established and if there are indications of problems, we'll adjust the rollout."

He referred to measures, such as reduced caseloads and caller hold times, that the state plans to use to determine if the 331 eligibility field offices can be switched to the Web-based TIERS software technology. Only six, all in the Austin area, have been fully converted.

Legislative Oversight Committee on TIERS/Eligibility System to Hold Hearing on Monday, July 14

2008-07-12T17:40:00.002-05:00

Author:
Celia Hagert /(512) 320-0222 x110

July 11, 2008

Contact: Celia Hagert, hagert@cppp.org

LEGISLATIVE OVERSIGHT COMMITTEE ON TIERS/ELIGIBILITY
SYSTEM TO HOLD HEARING ON MONDAY, JULY 14

Access to health care and good nutrition is vital to low-income Texas families who don’t earn enough to make ends meet. Yet, enrolling in programs like Food Stamps and Medicaid has gotten harder over the last year due to problems with TIERS—the
new computer system—and a staff shortage that resulted from a legislatively-mandated attempt by the state to privatize the system in 2006, which failed. Rebuilding a viable eligibility system promises to be one of the most important challenges facing
Texas in the years to come.

On Monday, July 14, the Legislative Oversight Committee overseeing efforts to rebuild the eligibility system will hold a public hearing. The Texas Health and Human Service Commission (HHSC) will provide a progress report and present the benchmarks that will be used in determining whether to continue implementing TIERS.

Hearing Details

The hearing is scheduled for Monday, July 14, 2008, at 10:00 a.m., Capitol Extension, E1.028, Austin, Texas. The committee will hear invited testimony from HHSC on their efforts to rebuild and enhance the eligibility system including:

• Stabilizing the workforce (increasing staff, reducing turnover, and training staff to use TIERS);

• Expanding TIERS; and

• Awarding a new call center contract.

The committee will also take public testimony. We encourage stakeholders to attend and provide input.

Issues of Concern

• Timeliness in application processing is still below these federal standards, with the most severe delays occurring in applications processed in TIERS. Several factors are contributing to these delays: staffing shortages: high staff turnover rates, reduced staff tenure, and problems training staff quickly enough to work cases in TIERS. HHSC should postpone any additional rollout of TIERS or entering into any new contracts until the system is meeting the federal standards for timeliness in application processing for all clients already in TIERS, and has enough workers to meet those standards for new rollout populations as well.

• HHSC is planning several significant expansions to TIERS, yet the proposed benchmarks for determining readiness to expand do NOT include timeliness as a measure of system readiness. HHSC is planning a limited geographic expansion
of TIERS as well as conversion of all of the “MEPD” (Medicaid for the elderly and people with disabilities) over the course of eight months beginning in December 2008. HHSC has developed certain benchmarks that must be met before proceeding with these expansions. Though we support the use of benchmarks to determine readiness for further TIERS rollout, several flaws in HHSC’s approach must be addressed first. Most significant, the benchmarks fail to include timeliness as an indicator of system readiness, despite timeliness being the best indicator of a system and a workforce that is stable enough to weather the strain that is inevitable in the conversion to a new computer system. We also have serious concerns about the decision to convert all of the MEPD cases to TIERS, as well as with the proposed timeline for the implementation.

Texas to hire hundreds to determine eligibility for social services

2008-07-11T19:33:00.002-05:00

By ROBERT T. GARRETT / The Dallas Morning News
AUSTIN –

The state's main social services agency, trying to stabilize a troubled enrollment system for aid programs, said Thursday it will increase the eligibility determination workforce this summer by several hundred people.

"We're hiring as many people as the Legislature will allow us to hire," said Health and Human Services Commission spokesman Geoff Wool.

Lawmakers, foreseeing the need after what critics say was a botched privatization experiment, gave the commission flexibility to go over a payroll cap.

Since September, the number of state eligibility workers has climbed to 7,027, a gain of 684 employees.

However, in a report this week to a legislative oversight panel, the commission said problems remain.

"Despite the increase in net staffing levels, turnover continues to be an issue," it said.

This year, 21 percent of the state's eligibility caseworkers, clerks and supervisors are expected to quit – only a "modest reduction" from last year's 22 percent turnover, the commission said.

To halt the flight, Health and Human Services Commission chief Albert Hawkins announced last winter an unusual set of midyear raises for eligibility workers. Last month, most received at least a 5 percent raise. Last fall, entry-level workers were paid an average annual salary of $26,100.

But Mr. Hawkins has conceded there's much work to do.

On Thursday, the commission announced it lifted this year's target for eligibility staff to 7,438, from 7,136.

Mr. Wool said if the goal can be reached, the commission will have used up all the flexibility lawmakers permitted

Updates! Updates! Updates!

2008-07-10T21:13:00.004-05:00

No time to post right now, but wanted to give you this

Have you seen the Health and Human Services Eligibility Transition Plan July 2008 Update? The link is this (but it's not working right now?)

Anyway, some highlights are as follows:

Rollouts are coming folks.....no matter what they might be telling you in the offices.

Region 7 is first- and this will start October 2008 with the following offices:

LaGrange, Bastrop, San Saba, Hamilton, Elgin, Lampasas, Llano, Marble Falls, and Goldthwaite (9,000 SAVERR Cases)

November '08(with approx 19,500 SAVERR Cases):

Temple, Killeen, Copperas Cove, and Gatesville

January '09(with approx 22,500 SAVERR Cases):
(I'm going to tell you what is really going to hurt here....the cases they are currently "bumping" certifications on? This is when they will all be coming in for recertifications after going an entire 12 months without an interview....for you workers out there, think about this....you are now in TIERS, and you will be interviewing clients who have not had an interview in a year. Think of the changes you will have to put in, the updates you will have to make. For those who are not yet on TIERS, ask some of your fellow co-workers who ARE on TIERS how horrible this will be)

Bryan, Centerville, Madisonville, Navasota, Giddings, Hearne, Caldwell, Brenham, Rockdale, Marlin, and Cameron

February '09 (with approx 29,000 SAVERR Cases- this will complete Region 7):

Waco, Hillsboro, Meridian, Mexia, Teague, Luling, and Lockhart.

April '09 (with approx 54,300 SAVERR Cases)

Canutillo, Yandell (Midtown), Diana (Mountain View) and ElPaso Drive

May '09 (with approx 32,300 SAVERR Cases)

Edgemere (Eastside), Lomaland, and Alameda (Riverside)

June '09(approx 22,100 SAVERR Cases- Completes Region 10):

Fabens, Socorro (Mission Valley), Alpine, Marfa, Van Horn, and Presidio

July '09 (approx 30,700 SAVERR Cases):

Amarillo, Perryton, Borger, Dalhart, Dumas, Pampa, Childress, Memphis, Plainview, Muleshoe, and Tulia

August '09(Approx 33,500 SAVERR Cases-Completes Region 1):

Lubbock Parkway, Levelland, Lorenzo, Post, Brownfield, Hereford, Denver City, Littlefield, Tahoka, and Dimmitt

Accenture apologizes for ‘outrageous’ redaction

2008-07-01T23:17:00.002-05:00

Accenture apologizes for 'outrageous' redaction

By Corrie MacLaggan Tuesday, June 17, 2008, 01:04 PM

Accenture spokesman Jim McAvoy apologized for the heavily redacted document the company's lawyers sent me earlier this month.

"I am really sorry, deeply sorry that this happened, and it shouldn't have happened," McAvoy said. "It was outrageous."

I wrote last week about how Accenture is trying to keep me from getting access to documents I requested from the Health and Human Services Commission regarding negotiations to unravel a major contract to enroll Texans in public assistance. The deal was originally worth $899 million, and the state has paid some $243 million.

The heavily blacked-out document I got from Accenture's lawyers was a legal brief the company sent Attorney General Greg Abbott explaining that the documents contain trade secrets and should remain private.

Today I got a "revised redacted copy" of the legal brief from the Accenture lawyers. This time, instead of blacking out the information they view as trade secrets, the redacted words are just blank spaces. So the revised version is a little less jarring to look at. And more importantly, there are fewer words redacted.

For example, page 6 of the brief as originally redacted was almost entirely blacked out, but in the new version of the same page, I can read about how Accenture is concerned about releasing trade secrets involving a system called the Rapid Transition Suite.

So the fact that I can read more of this brief is good news. But the brief just explains why the documents I requested should remain private. Frankly, I'm not that interested in all of Accenture's trade secrets.

What I really want is what I requested in the first place: the documents detailing Accenture's negotiations with the state of Texas. A lot of taxpayer dollars are at stake.

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Despite federal OK, Texas delays computer system expansion

2008-07-01T23:13:00.002-05:00

My comments in RED

Despite federal OK, Texas delays computer system expansion

Legislature increasing oversight of TIERS system used to enroll Texans in food stamps, Medicaid.

By Corrie MacLaggan
AMERICAN-STATESMAN STAFF
Friday, June 20, 2008

Texas recently got federal permission to expand use of a controversial public assistance enrollment system beginning this month, but Health and Human Services Executive Commissioner Albert Hawkins has agreed not to do so — at least for now.

Shock! Stop the PRESSES! Is this the SAME Mr. Hawkins that has DEFIED instructions in the PAST to not continue putting clients in this system? Really? All of a sudden, now that the Women's Health Program has thrown THOUSANDS of households in TIERS, he's willing to not "expand"? I'm dumbfounded. And curious- what "politics" are at play here?

Hawkins said this week that he'll abide by a legislative request that the commission first establish — and meet — a series of goals before expanding use of the computer system known as TIERS. That stands for Texas Integrated Eligibility Redesign System.

Of course! Now that the state is in TURMOIL with TIERS. Very interesting INDEED.

Federal officials have been concerned about expanding TIERS, in part because Texas has struggled to process food stamp cases as quickly as required.

No, really? It's been like that since DAY ONE. Of COURSE food stamp cases take longer. The system itself is long. Laborous. What used to take a worker 30 minutes to do can take HOURS to do if TIERS isn't cooperating. That is NO exaggeration.

"No expansion of TIERS will be undertaken prior to the benchmarks being established," Hawkins wrote in a letter to lawmakers this week. "As a result, we will not begin rollout in July 2008."

So am I to assume that the State will ALSO stop loading clients into this system via WHP?

The request to Hawkins from state Rep. Patrick Rose, D-Dripping Springs and chairman of the House Committee on Human Services, stems from a new law requiring legislators to more carefully scrutinize the state's work enrolling Texans in programs such as food stamps and Medicaid.

The legislation created a committee "to maintain oversight, hold the commission accountable and ensure to Texans that TIERS was being expanded in a prudent manner," Rose said. "It's important for Texas taxpayers and to those eligible for all critical services."

Rose has asked Hawkins to propose specific benchmarks later this summer to the oversight committee. The goals may include ensuring that there is adequate staff trained in TIERS, according to a letter Hawkins wrote to Rose.

Adequately trained? What does that mean exactly? You mean, more workers ON PAPER that have BEEN to training? Because that does not equate "adequately trained". No. It takes at LEAST 6 months of WORKING on TIERS to fully grasp alot of the nuances that go with the system. Mind you, the training is TWO WEEKS LONG and does NOT cover things that happens in the "real world". Training in TIERS is a BREEZE because hey! all the cases work like they are supposed to!

The state has had trouble processing food stamp applications in TIERS as quickly as required by the U.S. Department of Agriculture — 30 days — in part because there aren't enough workers trained in TIERS. Texas has struggled to retain employees who enroll Texans in public assistance.

Yes, and you know why? Because for too long, no one has ever listened to the actual people in the field that have to do these cases. Too many chiefs, not enough indians. Period.

"The combination of not enough staff trained well enough and too many cases coming into TIERS and the fact that it takes longer to process a case in TIERS than (the old system) is a recipe for disaster when it comes to timeliness," said Celia Hagert of the Center for Public Policy Priorities, which aims to help low- and middle-income Texans. "The whole reason we have a standard is that people who go to get food stamps are people in an emergency situation."

In April, 49.2 percent of Texas food stamp applications processed using TIERS were completed on time, compared to 92.6 percent processed in the old system in the same period.

Anyone in the field could have told you this. We've been screaming about this since all this started. Is it any wonder that there is a difference? The old system, "old" as it may be, got the JOB DONE.

This week, USDA officials gave final approval to the state's plan to expand TIERS. They told Hawkins in May that Texas could expand it, but only to 22 percent of food stamp cases because "far too many approvals remain untimely."

About 9 percent of cases are now in TIERS, agency spokeswoman Stephanie Goodman said. About 2.3 million Texans are on food stamps.

I find that 9% questionable. There are offices that haven't "rolled out" that are closer to 30%. Austin is 100% TIERS and the timeliness there is beyond bad. Not the fault of the workers at all, it's the system. It's double edged, because you throw workers through basic policy training, then give them TIERS for 2 weeks, then they go to the field. Depending on the state of the office they are in, they may get to gradually amp up to full caseload, but in many offices the need is too great to do that slowly, the way it should be. So you fully schedule them, it becomes impossible to keep up with and they quit. Sad thing is, it's the "worker" that gets all the heat when it comes to timeliness. It's never ever because the expectation is too high. You know why? Because the "decision makers" have NEVER EVER BEEN A FULLTIME CASEWORKER IN TIERS. They simply do NOT know.

cmaclaggan@statesman.com; 445-3548

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new timeliness nightmare.....changes

2008-06-14T18:18:00.001-05:00

Now that local offices in Region 7 are responsible for their own SAVERR *and* TIERS cases, one thing that was left was changes. Local offices were told that CCC (Customer Care Center) would still handle TIERS changes on cases. Wonderful! No way could local offices do that TOO, right?

Wrong.

See, what happens is client is in TIERS. Cl has a loss of income, for example, and calls 2-1-1 to report this. A task is generated and assigned to the CCC portal for completion.

a month goes by- nothing.

2 months go by- nothing.

Finally, client calls local office in frustration, and guess who then has to complete the change? THE LOCAL OFFICE.

This also usually generates supplements on the case. Not for just one month either, mind you.

Supplements, because of the inefficiency of TIERS- can sometimes be erroneously generated, therefore all cases that have any kind of "extra" benefits they are entitled to for a previous month, must be caseread first. Oh but wait! Not just caseread. But approved through a process called a "second level review" which has to be done by a Program Manager (in some areas).

If the second level doesn't get done the same day as submitted, the worker has to go in again the NEXT day and request it AGAIN.

Then, and ONLY then can a supplement be done.

CCC is not to blame, they are stacked unbelieveably with changes from across the state.

Who loses?

The client.

And the local office.

Why the local office?

Because we usually don't hear about the problem until it's a HUGE problem, meaning someone has to stop doing interviews or their own work to work this change because it MUST BE DONE NOW.

A change that, while local offices would be overburdened if they had to take them all, could have been worked before 2 months later had we known about the problem TO BEGIN WITH.

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Tenured Staff

2008-06-03T23:47:00.001-05:00

Long time, no post. Sorry about that.

I don't have an article this evening, but more of a rant/shout out.

You know, back in 2005 when the "jsap" thing happened, alot of people left the agency. I don't blame them either, because you have to do what you have to do.

However, there are alot of us that did not leave. We stuck it out. Some of us stuck it out for personal reasons that had nothing to do with the "mission" of the agency. Some were too close to retirement to jump ship. Some of us actually enjoyed working for the agency and believed in what we did. So we stayed.

In doing so, many "tenured" staff were put in a horrible position. Being tenured, and being one of the few in some offices that were tenured (I'm talking 5+ years here)- we took on a lot of work. We did more because we could. We knew policy, we were fast and could get the job done. However, as almost 3 years have passed- tenured staff are still bearing the brunt. Unreasonable expectations. Do it all. Do it right now. Do it timely.

QC was discussed at one point, and the error rate among those who are "tenured" has risen. Is it any wonder? It's not that those staff don't care, it's just that in a mess like the one the offices are STILL in, it's quantity over quality. Do more. Just get it done. Don't care how tired you are. Don't care if you are burnt out. Oh look! Here's some trainees that have a fast track in training- help them too.

Throw TIERS in the mix and it's a literal nightmare. If you happen to be in an office that is now taking on their own TIERS cases in addition to the SAVERR cases, and are TIERS trained, you are getting SLAMMED. I know. I've seen it, know workers in lots of offices and they are seeing/feeling it too.

What is the solution? Unfortunately, with the jsap mess that started this, offices are in a quandry. On paper, they might be staffed or almost fully staffed. However, when most of the "new" people are barely trained, then you have a problem. How fast or slow do you schedule new people? Throw them in there? That's dangerous. You not only risk QC errors and cases being worked correctly, but you also risk burning out new people early on before they have THEMSELVES invested in the job. They leave. Then the cycle starts all over again.

What are the priorities? Getting clients taken care of? Doing reports? Doing "busywork" that really has nothing to do with the business at hand? Either upper management wants cases worked, or they want reports done (for example). Which? Surely "upper management" does NOT EXPECT staff to work until 9 or 10 each night? That's the new fear among staff. That while overtime is allowed, it's also becoming expected. And if you do work overtime, chances are you are having to take time to document every case you touch after 5:00. You have to justify your work now. There is no more "honor system" because too many people abused the overtime and the pay from it, and now EVERYONE gets to pay for that. I know one worker in a HUGE office that said it takes her close to 2 hours per week to do the logs for overtime each week. TWO HOURS. That's how many CASES that didn't get done? Sometimes, that's ONE TIERS case.

My point is that someone somewhere needs to realize something- the last thing "the powers that be" should want is to burn out the very staff that have stuck it out. Forget that their employees are also moms, dads, husbands, wives, and caregivers. We have families too. We have obligations outside of work as well. This is a JOB. Not a "life" for us. I certainly don't live and breathe the Food Stamp office. It's a JOB. I will certainly do my best and not ever change my work ethic. But I know that I, along with many of those just like me in the field, am not willing to sacrifice my family and my personal obligations for a JOB.

I'm sure someone reading will likely tell me to just quit the job then and go somewhere else. And it's a valid reaction. However, I believe in what I do everyday. I'm not there just to pass the time each day. I've invested many YEARS into this agency and have always produced top notch work. I have the stats to prove it. I've always done over and above what is expected of me. The LEAST TPTB could do it recognize that and adjust accordingly. Supervisors are strapped. Worker IV's are strapped. PM's are strapped.

Does everyone realize who really pays for this? Aside from our co-workers? The clients do. The taxpayers do. The food banks do. Other social service agencies do.

We are not super-humans. We are people who work at an agency designed to help people. That's what we do. All the field staff want is someone to take away some of the fluff until we can get back on our feet. Seriously. That's it. Don't give me a certificate. Don't even bother giving me performance leave. It's not even like anyone can take off. Taking 1-2 days off just throws workers further behind. Take away something that, in the big scheme of things, doesn't have any affect on client services. Let me do what I was hired to do. Interview clients, and help them. Finish cases. Complete them correctly.

I'm a caseworker. It's what I do.

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State, Accenture still haggling over money after privatization bid fell apart (my comments in red)

2008-05-19T02:14:00.001-05:00

Contract canceled a year ago, but talks continue

State, Accenture still haggling over money after privatization bid fell apart

By Corrie MacLaggan
AMERICAN-STATESMAN STAFF
Sunday, May 18, 2008

More than a year after Texas canceled a deal with Accenture LLP worth hundreds of millions of dollars to run call centers enrolling people in public assistance, the breakup is still not final.

Yes, and guess who is paying for this screw-up? The clients, and the employees in the field.

"It's a complex contract with lots of moving parts," said Stephanie Goodman, a spokeswoman for the Health and Human Services Commission. "I don't expect anything soon."

Of course not! The wheels of "justice" turn slow, don't they?

Since Executive Commissioner Albert Hawkins announced the end of the Accenture deal in March 2007, the divorcelike process has involved negotiating over money and assets tied to what started as a five-year, $899 million deal. Texas has paid Accenture nearly $243 million, Goodman said.

$243 MILLION TAX PAYER DOLLARS! Insanity!

As Hawkins disentangles his agency from the privatization attempt, he's moving forward with plans to hire a different company to run the call centers when he gets federal approval.

It took months of negotiations before the state agreed in September to pay Accenture $25.8 million for thousands of items from computers and software to office furniture and phones, according to a state report. And nine of the 10 office leases related to the contract have been transferred to the state, Goodman said.

Still under negotiation: money, she said.

Accenture spokesman Peter Soh said there is no particular sticking point.

"We knew this was going to take some time, and we are just working through the unwinding process," Soh said.

Goodman said there's no legal obligation to finish the negotiations by a certain date.

"There are basically two options," she said. "We reach an agreement, or we go to court."

Of course there is no "date". Nevermind, that there is a legal obligation to finish a case by a certain DATE...but hey! What's a "date"? Those due dates never mattered, so why should this?

Goodman said she can't discuss details of the negotiations because they're related to potential litigation. But she said the talks include what to do about $30 million the state has sought from Accenture since December 2006.

Accenture didn't take the contract to pay US any money- they only wanted to be PAID no matter how screwed up it all was. I bet if a client owed the state money, they'd get it.

That's when the contract was scaled back to $543 million, with the state taking over some tasks originally assigned to the contractor.

Yes, the STATE took back the work we had always DONE and did WELL. So with a reduced workforce, we now have all that work BACK. (Yes, the State is hiring, but when you have an office that's 80% NEW and it takes 2-3 months to even get new workers TRAINED, then guess who the burden falls on?)

State officials said Accenture would pay Texas the money to compensate for unexpected costs such as sending state employees to help call center employees with policy

questions.

But the state and Accenture never agreed to final terms of the revamped deal, and the contract was soon canceled.

When Hawkins announced on March 13, 2007, that the state and Accenture had agreed to part ways, he said the final transition of services would take place by Nov. 1, 2007.

Although that happened ahead of schedule — enrollment work is now done by state employees and former Accenture subcontractor Maximus Inc. — the legal separation continues.

"They made it sound like it was going to be a quick and neat exercise," said Celia Hagert of the Center for Public Policy Priorities, which advocates for low- and middle-income Texans. "It could drag on so long, we could have forgotten about what happened and who owes who what."

Goodman said it took the state and Accenture nine months to create the contract after Texas received bids for the project.

About 3.7 million Texans receive public assistance.

The state hired the Texas Access Alliance — led by Accenture — to run call centers to enroll Texans in programs such as food stamps and Medicaid. Much of that work had been done by state employees; the ambitious privatization effort was supposed to save the state money and give applicants the option of signing up by phone or online instead of only in person.

But the project hit problems — such as applicants receiving letters asking them to send information they'd already sent and eligible people losing benefits — and the savings never materialized.

And the beauty of that was, in "the old days"- if a WORKER in a local office had done that kind of SHODDY work, and people were losing benefits, I'm pretty sure that worker would have been terminated. But see, when "the contractor" made errors, there was no FACE for the client to go back to and question. They'd call and call and call and call, talking to different people- when had this been a local worker, it could have been resolved much quicker. The State lost control over client services, never hearing of a problem the client was having until it had escalated to a point that it was "serious".

Unraveling a contract of this size is largely uncharted territory for the agency, said state Rep. Bryan Hughes, R-Mineola, co-chairman of the joint House-Senate panel overseeing the health and human services eligibility system.

"I don't know what we really have to compare it to," he said. "We do want to make sure that the state, the taxpayers get everything they're entitled to as the contract is wound down."

Meanwhile, Accenture and Maximus are engaged in arbitration to resolve a dispute over the Texas deal. Maximus, which claims Accenture failed to deliver required technology and made unfounded assertions about Maximus' work on the Children's Health Insurance Program, is seeking more than $100 million from Accenture, according a filing with the Securities and Exchange Commission.

Accenture disputes the claims and is seeking unspecified damages from Maximus.

As Texas officials look toward hiring a new company, their approach draws on lessons learned from the Accenture deal about what work is best to assign to contractors, Goodman said.

Wow. The State is going to try this again. To the tune of how much money THIS time?

Under the new deal, contractors will scan documents, for example, but state workers will decide who is qualified to receive benefits, she said.

Wow. We are paying out all this money- taxpayer money- for someone to SCAN documents? But state workers have been the ones to decide eligibility from DAY ONE. It's FEDERAL POLICY. The state workers are the ones with the policy knowledge to do that.

"We do think this will be different," she said.

We can only hope so.

cmaclaggan@statesman.com; 445-3548

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Article

2008-04-11T22:36:00.001-05:00

Check out this article from the Dallas Morning News.

I'll try to comment on it tomorrow.

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Have you heard?

2008-04-11T22:28:00.001-05:00

Region 7 will be doing all their own TIERS cases locally effective Monday. So for all offices in Region 7 except Austin, good luck in figuring out how to have a SAVERR schedule, a TIERS schedule, and have your workers try and do both.

Many offices think they are ready, however word is that many really aren't. New users aren't familiar enough with TIERS to be able to handle the workload. Take them away from SAVERR cases, and then THAT caseload gets delinquent- quickly.

If anyone is reading from Region 7, please check in and leave a comment on how it's going in your office next week. At least rumor is that ART is keeping everything through today.

Good luck fellow workers! It's going to be rough! Hang in there!

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Check this blogger out!

2008-03-26T20:36:00.001-05:00

Bluebonnet Blog has a take on the Statesman Article

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Media

2008-03-26T20:25:00.001-05:00

Media attention is up again, so you must have your voices HEARD!

Does anyone out there have a contact AT ALL at FNS?

Isn't it true that FNS has forbidden Hawkins, Co from "rolling out" TIERS? Then why are there rumors that TIERS is about to expand and start handling CHIP cases? We all know what that means.

How many of you "non-pilot" offices have lost a worker(s) to help Pilot area or ART?

Who's helping you?

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Read this, go there, and get in on the action in the comments section! BE HEARD!!!!!!

2008-03-26T20:15:00.001-05:00

Privatization failure is taxpayers' burden

Go HERE to comment!

By The Editorial Board | Tuesday, March 25, 2008, 05:04 PM

Because of an effort five years ago to run part of state government more like a business, the Texas Health and Human Services Commission is struggling to provide food and medical services to some of the state's poorest people. It's a disaster that ought to be remembered every time a legislator or lobbyist starts babbling that "privatization" of this or that state service will boost efficiency, lower costs to taxpayers and cure all fraud and waste.

As the American-Statesman's Corrie MacLaggan outlined in a Sunday story, the commission's staff of about 6,500 workers down from about 10,400 in 1998 despite the state's population growth who determine the eligibility of applicants for aid is heavily overworked and increasingly inexperienced. Since September, the commission has hired 1,010 workers, even as 733, including veterans who know the system, quit.

These employees process applications for food stamps and Medicaid for about 3.7 million people. To do so, they must master both the rules for qualifying and the computer systems to track applicants. Because of the staff's workload and inexperience, many applicants are having to wait too long for help.

Those tempted to shrug off the departures as "good-bye, good riddance" should understand that such turnover hits taxpayers in the pocketbook. It costs $7,500 to train an eligibility worker, so when one leaves, the investment in training is not only lost, more must be spent for the next worker.

Not surprisingly, part of the problem is pay. Starting workers make $26,000. The agency is trying to attract and keep more eligibility workers with raises averaging 5 percent and faster promotions, which also bring raises. And to reduce the workload, the agency is adding 600 employees.

The agency, though, really is engaged in damage control. The damage was inflicted by the Legislature, which for years slashed away at the ranks of the eligibility workers and, in 2003, ordered the commission to consider farming out its work to a private company. The theory was that a profit-seeking company would do a better of job wringing out inefficiencies than any state bureaucracy. And Health and Human Services Commissioner Albert Hawkins decided to try.

An $899 million contract was signed with a business alliance led by a major consulting company, Accenture. Hundreds of state eligibility workers were told to prepare to lose their jobs; some did and others began leaving rather than wait. To make a long story short, the experiment failed. In fact, it failed so badly that the state and Accenture agreed to end the contract last spring, and the Legislature later made provisions to try to salvage the state's eligibility work force.

You can argue that the privatization theory is correct but, in this case, was badly carried out; or that the theory is wrong and no amount of competence could have saved it; or that the theory is wrong and it was incompetently carried out.

What's not debatable is that this attempt to run state government more like a business failed. And the price for that failure is being paid by taxpayers, the state workers and poor people who truly need the help.

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Austin American Statesman Article

2008-03-24T02:07:00.001-05:00

Texas struggles to retain caseworkers

Pay raises, faster promotions aim to combat rapid turnover.

By Corrie MacLaggan
AMERICAN-STATESMAN STAFF
Sunday, March 23, 2008

First thing Thursday morning, a dozen new state caseworkers arrived at a North Austin office building for a training class on enrolling Texans in the food stamp and Medicaid programs. Just a couple of months into their jobs, one after another said they're excited about helping people and confident they can handle the work. But if history is any guide, eight of them will be gone by fall.

Employees overwhelmed by their workload are leaving the Health and Human Services Commission in droves. With fewer experienced workers on staff, applications are piling up, and the state is failing to handle them as quickly as required by the federal government. Since September, Texas has hired 1,010 employees known as eligibility workers; 733 resigned in the same period.

Bret Gerbe/FOR AMERICAN-STATESMAN

(enlarge photo)

Krystle Carr of Austin trains on the computer system known as TIERS. Complications with that system have been blamed for part of the state Health and Human Services Department's backlog of food stamp and Medicaid applications.

(enlarge photo)

Jennifer DeLuna

(enlarge photo)

Doug Bell

(enlarge photo)

Mohammed Ali

MORE ON THIS STORY

Health and Human Services employees talk about the heavy workload and burnout

"Right now, there's a very vicious cycle," said Mike Gross, vice president of the Texas State Employees Union. "New hires barely replace the people who are leaving, they're trained thinly, they're thrown into the work, the work is demoralizing because the workloads are so high ... and they leave."

The problems have plagued the agency for years and can be traced in large part to 2003 state budget cuts and a decision to hire a private contractor to enroll Texans in public benefits, a partnership that didn't work out.

In recent months, the problems have spiraled, and last month, Texas was forced by the federal agency that oversees food stamps to come up with a plan to correct poor performance. The state announced it will raise entry-level salaries (which now average $26,000), give current workers raises and promote workers more quickly.

Texas officials hope to attract more workers and retain current employees with the plan. Most of the raises are 5 percent, but the new promotion schedule means workers could see a larger raise than that within months.

Texas' 6,500 eligibility workers are especially struggling to quickly handle the 12 percent of cases that are in a controversial new computer system known as TIERS. This month, federal officials warned Texas that TIERS use should not be expanded as the state had planned.

Slightly fewer than half of Texas food stamp applications processed in December using TIERS were completed within the 30 days required by the federal government.

"It's been hard to get ahead," said Stephanie Goodman, a spokeswoman for the Health and Human Services Commission.

Such delays mean that some of the 3.7 million Texans on public assistance are struggling to make ends meet and straining resources of nonprofit organizations, according to local groups.

Austinite Doug Bell, who started as an eligibility worker in January, got a sense of the work ahead of him when, between training sessions, he was assigned to answer the phone at a South Austin office on Eberhart Lane.

"People were calling who had applied in November or December, saying, 'We still haven't gotten our benefits,' " said Bell, who attended a Medicaid training class Thursday. "Some of these people really needed it bad. They had medical issues; they needed food."

The stress of having applications piling up drove El Pasoan Sandra Blanco to quit her job this month. The 15-year veteran took another state job, saying the new raises weren't enough to keep her in a position where there were not enough hours in the day to do her work.

"It's just been horrible," Blanco said during one of her final days on the job. "I felt I was being forced out the door because I just couldn't handle the work anymore."

Blanco said she had never had problems completing cases on time, but as she was assigned more work, she recently slipped to the lowest rate of on-time application processing of her career.

Meanwhile, the state is replacing workers who leave and adding 600 more employees, spending $7,500 per worker to train them, Goodman said. That cost includes the worker's salary and the trainer's salary but not travel costs for employees who go to other towns for training.

At the Eberhart Lane office, about two-thirds of the 60 workers arrived in the past year, said program manager Susan Lozano.

So with three years' experience, caseworker Jennifer DeLuna is considered a veteran. Like her colleagues, she stays late many evenings, but she said she thrives on helping people and the workload doesn't get to her.

"Some people are overwhelmed here," said DeLuna, who meets with a different client about every 30 minutes in person or by phone. "I guess I'm good at multitasking."

But her colleague Mohammed Ali, an aspiring politician who said he likes having a job that's considered admirable, said he's thought of quitting many times. He said he's seen his workload triple in his year and a half on the job. Colleagues regularly call in sick because they can't handle the stress, he said, leaving more cases for those who show up.

Like many eligibility workers, he often works overtime, putting in an extra 12 to 15 hours a week, he said. Nearly 400 eligibility workers took home at least $10,000 last year in overtime pay and some earned much more according to records from the commission. The state spent $18.2 million on overtime last year for eligibility workers, who make up 68 percent of the commission's employees but 99 percent of its overtime spending, Goodman said.

Part of the problem, said Judy Lugo, a supervisor in Blanco's former office in El Paso, is that the state is pulling hundreds of employees to work on cases in TIERS, which stands for Texas Integrated Eligibility Redesign System, leaving the rest of the workers to handle the majority of cases still in the old system.

Employees "are on the verge of a nervous breakdown," said Lugo, who is also president of the employee union. "I find them in their offices in tears."

Goodman acknowledged that transferring workers to TIERS cases "is a bit of robbing Peter to pay Paul."

"No one thinks this is a perfect solution," she said, "but TIERS cases are growing faster" than those in the old system.

That growth is mostly because the state has added a women's health program to TIERS, Health and Human Services Executive Commissioner Albert Hawkins told William Ludwig of the U.S. Department of Agriculture in a letter. And, though there is no set timeline, Texas does plan to roll out TIERS to the entire state.

But Ludwig, whose agency oversees the food stamp program, cautioned Hawkins: "We are not convinced that a continued roll-out of TIERS is warranted unless accompanied by strong measures to improve timeliness and ensure customer service."

Some of the agency's staffing problems date to fall 2005, when Hawkins informed 2,900 eligibility workers that they would not have a job after the start of a privatization plan. The agency hired Accenture LLP to run call centers to enroll Texans in benefits. After a troubled pilot program in Central Texas in 2006, the state parted ways with Accenture and canceled layoff plans. But hundreds of state employees had already left.

Texas is in the early stages of selecting another private company to run call centers, though the new plan leaves more decision-making in the hands of state workers. Delays in food stamps have strained the resources of organizations such as Caritas, which provides rent, utilities and food in times of crisis, said Jo Kathryn Quinn, director of self sufficiency services.

"These families are utilizing our food pantry as a primary food source, and it's certainly not intended to be that way," she said.

After Bell, one of the new eligibility workers, spent time talking to such families by phone and watching others file in and out of caseworkers' offices, he said the chaotic situation didn't seem fair to clients or workers. "I don't know how they cope with it," he said of employees.

But when asked whether he'll be able to do it, Bell who said he's "been very blessed" and wants to help make life easier for people in need responded confidently: "I think so."

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TIERS mentioned in another BLOG

2008-03-11T20:02:00.001-05:00

Off the Kuff talks some about TIERS......AMEN!

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All Staff Meetings

2008-03-10T01:28:00.001-05:00

Have any of you been to the "All Staff Meeting" that are being done around the state with Anne and company?

Feedback?

Was it a waste of time? Did you learn anything new? Anything to share?

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Misc

2008-02-23T00:46:00.001-06:00

Wow, here's a BLAST FROM THE PAST......too bad those days are LONG GONE.

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Raise? woohoo?

2008-02-22T23:51:00.001-06:00

http://capitolannex.com/2008/02/21/tiers-system-failing-texas-families/

You know, we all got an email the other day about "raises" that we will be getting this summer.

Woohoo! That 5% is a start, but you know, it's not going to "solve" the problem like HHSC is hoping it will. You can pay someone more money, but if it doesn't reduce the workload and expectations (BE TIMELY BY GOD OR YOU GET COACHED, never mind that you are having to do the work of 2-3 because TIERS? Takes a WHOLE lot longer to work a case than the "old world" system, SAVERR) then the raise won't help. I realize that the state is trying to hire and get new workers trained. I get that. I also know that to be a GOOD worker, it takes about a YEAR of doing cases to get really comfortable with all the ins and outs of the system. So if you have an office where 80% of the workers have 2 years or less of tenure, then you aren't able to produce like we did back in the day when ALL our workers were fairly tenured (5+ years).

Not to mention that caseloads are INCREASING while all this is going on.

You can throw money at this all day, and it's not going to change the fact that TIERS is still around, and cases are being backdoored into the system EVERY DAY. We do NOT have enough workers out there to handle the influx of cases into the TIERS system statewide.

I cannot express enough how much the clients HATE this program. Those not in Austin or Round Rock that are in TIERS are interviewed by someone from anywhere in the state. No local worker to talk to, no local worker to hand information to. They can't even get a worker's number from 2-1-1 if they forget to ask for it during an interview.

I feel sorry for the workers in ART (Assistance Response Team- the workers who are TIERS training statewide that handle the cases that aren't in the pilot area). These workers are stacked UP everyday, and every single case they touch is delinquent when they get it. By the time they get to do an interview, the client is BEYOND frustrated and all that anger is taken out on the worker. In the "old days", a client had a local worker and things were handled on a LOCAL level. You just cannot outsource or privatize the benefit that comes from local people handling a case for a local client. You just CANNOT.

So for all my fellow HHSC employees- I hope the raise helps a little.

Especially when you are having to work late in the evenings and on weekends to just stay caught up.

I KNOW how hard it is. I do.

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Texans Waiting Longer for FOOD STAMPS

2008-02-19T22:25:00.001-06:00

http://www.statesman.com/blogs/content/shared-gen/blogs/austin/politics/entries/2008/02/19/texans_waiting_longer_for_food.html

Texans waiting longer for food stamps

By Corrie MacLaggan | Tuesday, February 19, 2008, 12:57 PM

To Texans applying for food stamps, it may not seem to matter whether their application goes through the state's old computer enrollment system or the newer one.

But new state data show that fewer than half of Texas food stamp applications processed using the updated computer system, known as TIERS, are completed within the 30 days required by the federal government. TIERS average of 48 percent of applications within 30 days is significantly lower than the 90 percent under the old system, SAVERR.

That 48 percent which is from December, the last month available represents a steady decline from last summer. The federal standard is 95 percent. See page 26 of this report.

Timeliness is also an issue for Medicaid applications.

"If we are that abysmally low on meeting federal timeliness requirements," State Rep. Patrick Rose, D-Dripping Springs, told state health officials during a Capitol hearing today, "it makes sense to figure out what those kinks are before we begin to expand (TIERS) further."

But TIERS expansion is already under way. About 350,000 cases for programs such as food stamps and Medicaid are in TIERS, compared to about 150,000 a year ago, Rose said.

High staff turnover is one of the main reasons for the backlogged applications, state officials said. Attrition of employees who enroll Texans in food stamps and Medicaid has tripled since 2003, state officials said.

The Health and Human Services Commission today announced a plan to hire more state workers and to give existing employees raises.

"We recognize that we have got to make a serious infusion and fast" in the number of state workers who can handle TIERS cases, said deputy executive commissioner Anne Heiligenstein.

TIERS, which is now in use in Travis, Hays and Williamson counties and elsewhere for certain programs, was first mandated by the Legislature in 1999 to replace the outdated SAVERR system which stands for System of Application, Verification, Eligibility, Referral and Reporting.

State auditor John Keel reported last year that because of chronic problems, TIERS is not ready to be used statewide.

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TIERS

2008-02-08T00:40:00.001-06:00

Anyone familiar with TIERS- can you email me? It's all anonymous. I disclose NOTHING. I just have some questions.

Food stamp proposal would force Texas shift

2008-02-08T00:23:00.000-06:00

Food stamp proposal would force Texas shift (my comments in red)

By JASON EMBRY, CORRIE MacLAGGANWednesday, February 06, 2008

WASHINGTON — Texas would have to rework its plans to privatize food stamp enrollment under a proposal that is moving through Congress.

Language in a major farm bill approved by the House would bar states from allowing employees of private firms to interact with people who are applying for food stamps or to decide someone's eligibility for the program.

The author of that language, Rep. Joe Baca, D-Calif., said it was inspired in part by problems in Texas, where some eligible families were improperly denied food stamps, Medicaid and cash assistance during a 2006 privatization test in the Austin area.

"The disastrous attempt to privatize food stamps in Texas was a large reason behind my anti-privatization provision in the House farm bill," Baca said. "The Texas project was a complete fiasco."

Although Texas canceled what was originally a five-year, $899 million contract with Accenture LLP to run call centers enrolling people in services, the state did not abandon its plans for private call centers. Texas Health and Human Services Executive Commissioner Albert Hawkins has said privatization will save the state money and give Texans more ways to apply for services: by phone and online instead of just in person.

Here we go AGAIN with the "ways" to apply for benefits line. Hawkins loves it, doesn't he? Guess what? You can apply ONLINE OR BY PHONE EVERYDAY- but if your case either never gets worked, gets lost in the shuffle, takes 45 days to get an APPOINTMENT (like in ART), then applying "by phone" suddenly isn't so convenient.

A draft request for proposal that the state released in November would allow for private companies to enroll clients in food stamps in the future. The Baca proposal "would mean a change in our plan for food stamps," said Stephanie Goodman, a spokeswoman for the Texas Health and Human Services Commission. "It does reduce the states' flexibility — and does potentially increase the cost — but we're certainly prepared to comply with whatever goes through."

Under Texas' new plan, state workers would continue to have the final say on who is eligible for food stamps, but employees of a private company would answer applicants' questions about the status of their case, Goodman said. That is the sort of contact Baca's proposal would prohibit.

A private company — Maximus Inc., a former subcontractor of Accenture — now answers food stamp application questions at call centers in Midland and Athens. Maximus handles applications for about 275,000 of the state's 2.35 million food stamp recipients, Goodman said. Most of the applications Maximus handles come from Central Texas.

And alot of the "questions" that the vendor answers for clients are answered WRONG. I cannot tell you HOW MANY CLIENTS end up the the local offices that have been told something totally completely wrong. I've SEEN some of the case comments left by TAA (Maximus? Whoever)- and let me tell you, state employees are having to go through alot of hell calming down clients who were told one thing, but policy states something else. Example: Client calls 2-1-1 to see if they can have an appointment sooner (let's say they are in ART, and right now- ART is scheduling appointments well into MARCH already)....2-1-1 tells the client to just go into the local office and apply for EMERGENCY food stamps if they want to be seen sooner. No, this is NOT correct. Clients LOSE benefits if they do this. I've seen more than I can post on this blog. But beleive me, clients get a much bigger RUN AROUND through the VENDOR (who do NOT know policy) then they EVER did in the local office.

She said the legislation is so broadly written that it may stop Texas' use of private workers to scan in documents and process mail.

The provision also may keep states from relying on private companies — or even nonprofits — to help prevent fraud, connect food stamp recipients with jobs or conduct nutrition education programs, said Larry Goolsby, director of legislative affairs for the American Public Human Services Association, a nonprofit organization of state agencies.

"There are many, many very innocent and helpful activities like that that this law would potentially bring to a complete halt," he said. The provision seems "to be very ill conceived to address what some are worried about going on in one or two states and in fact (would) have huge consequences for many, many states."

The House and Senate have each passed separate versions of the farm bill, but a conference committee that will work out a final bill has not yet been named. The Senate version does not include the privatization ban, but it calls for greater federal oversight when states make major changes to their programs, such as the push for call centers.

"I am committed to ensuring the anti-privatization provision stays in the final version of the farm bill," Baca said. "If we open the door for the privatization of food stamp administration, we risk putting sensitive information about millions of families into the hands of private companies, with no way to monitor how this data will be handled or protected."

But Mary Katherine Stout, vice president of the Texas Public Policy Foundation, which supports limited government, said privatization has a long history of improving performance and that private companies have shown they can handle sensitive information. She said Texas' call center pilot demonstrated the importance of testing an ambitious effort. After initial problems — such as long hold times and call center representatives who couldn't answer applicants' questions — Accenture's performance improved, she said.

Ahh, of course Mary Katherine Stout would say that all these issues are improved. She's not a client having to navigate it either. She has no idea.

"It would be unfortunate to see the federal government close this option to Texas," Stout said.
Rep. Mike Conaway, R-Midland, called Baca's proposal an attempt to please public-employee unions.

Please. Appease the unions? How about the employees? You know, the ONES ACTUALLY DOING THE WORK? What do you think the union is made of? Us. We are the ones who are completely overwhelmed. Totally without a doubt overwhelmed.

Privatization was a bad idea from the start. Field staff called it a long time ago. The years of service/knowledge that the state has lost in employees is staggering. No one has ever listened to US.

"Texas might have bitten off more than they could chew," Conaway said. "But to categorically eliminate the opportunity for outside help — helping government be more nimble and quicker and less expensive and more efficient — to me is just bad public policy."

But Celia Hagert of the Austin-based Center for Public Policy Priorities, which advocates for more spending on programs that aim to help low-income families, said states can still modernize their programs using public workers.

You know, the public workers in Texas are the ones who previously had the General Fund in Texas benefit in enhanced funding. Sure- change can be good. But, we had a fairly decent oiled machine across the state (the big cities- Houston, Austin, Dallas- have always and will always have a high turnover rate due to the opportunities in those places). We had tenured staff. We had good training. Not just initial training- we had supplemental trainings all the time that made workers better at their jobs. We had those who actually wanted to and planned to retire from the State. Not so much anymore.

"In general," Hagert said, "these types of functions are better performed by trained eligibility workers who don't have a conflict of interest, for whom the bottom line is making sure clients get benefits on time and that benefits are delivered accurately, and not the profit of their company."

Amen.

a day in the life as a client in TIERS

2008-01-11T19:04:00.001-06:00

Client needs Food Stamps for her family. She has lost a job. File application in local office on 11/16/07. They are not expedited, so they are not eligible for same day service.

Local office faxes the application to TAA on 11/16/07.

Client calls 2-1-1 to see if an appointment has been set on 11/30/07 because her last check has come and gone and now client has NO income.

Client calls back to 2-1-1 on 12/3/07 to check and see if an appointment has been set yet- and is told that they have an appointment by phone on 1/9/08 at 4 p.m.

Client calls back to 2-1-1 two days later to see if there is any way client can be seen earlier- but there are no slots available, so the answer is no. However, TAA tells client that if she wants expedited she can go to local office and FILE ANOTHER APPLICATION (which is incorrect). Client does not realize that if they were to do that, she will lose benefits from 11/16 to 12/5. This is why this is wrong information.

Client gives up and goes to overburdened food bank to get help- remember, she has NO income coming in for bills (rent/utilities) much less food.

Mind you, a food stamp case- according to the Feds- must be either certified or denied within THIRTY days of date of application- that due date would be 12/16- we all know that won't happen, because the appointment isn't until JANUARY 9th.

January 9th finally gets here. The ART worker that is going to interview client is overwhelmed and doubled up at every appointment slot that day- so the Advisor is unable to call client until 4:30.

Interview is FINALLY done. Guess what? There is information that is needed to complete the case- since all interviews are done by phone, rather than someone locally, there is no way to have information at the interview to hand the worker (wow, phone interviews are GREAT!)......client has until 1/22 to get the case done. MORE THAN 60 FULL DAYS AFTER THE CLIENT HAS FILED THE APPLICATION.

Client gathers information and faxes information to TAA.

Calls 2-1-1 to find out if they have received fax, and is told that it can take a couple of days to be scanned. Client is, of course, frustrated.

Cl calls 2-1-1 again on 1/14/08 to see if they have the information yet. They do. She asks them when case will be done, and they tell her to contact her caseworker. Client may or may not have access to long distance mind you. Also, TAA may see who the advisor is in the case comments, but continue to put client off and won't give her the workers number. Instead, they offer to transfer her so that she can file a complaint.

On the worker.

Client is transferred and sits on hold, gives up and hangs up.

Client finally gets ahold of caseworker- and because the worker is double booked everyday, and may or may not get a full workday that week (thereby doing the cases that have HAD information turned in before THIS client) so the worker may not even GET TO IT.

The client still has no food or income.

Client calls 2-1-1 and is taken through transfer hell.

Complaint is filed.

Against the caseworker.

Emails are sent out to everyone, and the worker is directed to complete case that day.

Worker works until 8 p.m. to do so.

Client still can't get benefit access until the next day when she can go to the local office to get a lone star card.

Now, think about that for a minute.

Let me say this- if the client had missed the phone call and had called to reschedule, she would have been able to- and the next interview available would have been in FEBRUARY.

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Links

2007-12-22T23:50:00.001-06:00

See these:

Grits for Breakfast Blog Posting- talks about Gregg Phillips and Wohlgemuth .... a comment on there said to try this search in Google to see what comes up- so here ya go:

Google Search for Phillips and Wohlgemuth...HERE are the results. Interesting.

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Happy Holidays!

2007-12-22T23:34:00.001-06:00

Just wanted to send out a Merry Christmas / Happy Holidays to all my fellow HHSC Employees. What you do is important, and we are all doing the best we can under the circumstances. Here's to hoping that the time off over the Holidays will refresh each and every one of you and here's to hoping 2008 sees some changes in our Agency for the better and overall changes for Texas.

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Good Comment

2007-12-22T23:31:00.001-06:00

Saw this in comments and thought it deserved to be on the page so no one missed it:

Demand on food banks reflects lack of adequate benefits through "safety net" programs
The news has been filled with stories of food pantries and soup kitchens that are struggling to meet the growing problem of hunger. These groups are frequently staffed with volunteers and depend on donations. They deserve our gratitude. The growing demand on food banks reflects the failure of our elected officials to provide adequate benefits through âsafety netâ programs. What happened to the safety net of Food Stamps, Supplemental Social Security Income and TANF cash assistance? These programs were intended to meet the basic needs of low income citizens. It is extremely distressing to see that the official government policy for feeding hungry people is to rely on the charity of food pantries and soup kitchens.

Forty years ago the Food Stamp program was established to end hunger in America. Yet, it was only designed to provide 75% of what the U.S. Department of Agriculture determined necessary to meet minimum nutritional needs. Poor families were expected to make up the rest with cash. Unfortunately, that is nearly impossible for those who must rely on SSI or TANF. The payment levels for these programs are very low. It is difficult for these people to find extra cash to buy food when they spend every dime available for rent, utilities, and other essentials. As a result our food pantries must deal with constant demands from people who are already receiving help from the safety net.

This is unconscionable. This is not the Depression. People need to be able to get their food from the grocery store and should not have to wait in lines to get a meal or box of food. We cannot continue to rely on the kindness of volunteers and donations to meet a responsibility that we all have towards our less fortunate neighbors. We must insist that our government officials ensure that our safety net does its job.

http://athensjfs.blogspot.com/

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TSEU News Bulletin from 11/8/07

2007-12-13T00:16:00.001-06:00

The Texas State Auditor's Office released its report on TIERS in October. The investigation was ordered by the Texas Legislature during the last session.

SIGNIFICANT FINDINGS:

* TIERS can correctly determine eligibility and calculate benefits, but only when users have access to "other processes" that are NOT identified in the report.

* As of JUNE 2007, HHSC had spent at least $351.7 MILLION on TIERS, which is 61% of the TOTAL projected budget through 2010, and correcting the problems would cause many millions of dollars.

* Fundamental design flaws, described as "Poor architectural design and chronic problems," make TIERS slow, ineffecient, and overly complex. Inefficient use of data storage and processing capacity will require massive system expansion.

* TIERS could not handle statewide rollout without correction of flaws and massive expansion.

Among the Details:

Eligibility staff could encounter more than 250 screens (of the total 1059 screens in the system) in working a SINGLE case.

TIERS was not designed as a relational database system, a basic design flaw that makes the system inefficient, increases requirements for data storage, and makes data integrity questionable.

FOR further information, please go to www.cwa-tseu.org. I'd encourage any state employee out there to join the union.

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"Texans waiting for food stamps, other programs"

2007-12-06T21:31:00.001-06:00

Texans waiting for food stamps, other programs

Corrie MacLaggan
Austin American Statesman
12/5/2007

Applications for food stamps and other programs are backlogged across Texas because there aren't enough state workers trained to process cases in the TIERS computer system, state officials acknowledged Tuesday.

The percentage of food stamp applications processed on time in October was the lowest since January. Texas continues to add cases to the Texas Integrated Eligibility Redesign System despite a recent warning from the state auditor that the software is not ready for use beyond a Central Texas pilot region.

Yes, and they are going to continue adding until a "rollout" regardless of what the state auditors says becomes necessary once ALL cases end up in TIERS.

The delays are worst in Central Texas . For example, of the 25,417 Austin-area food stamp applications handled in October, a third of them did not get processed within the 30 days required by the federal government. Statewide, 14.1 percent of food stamp applications were processed late in October, the most recent month for which statistics are available.

The sad thing about this is in Austin, word is the workers are having to see anywhere from 20 to 30 appointments PER DAY. With the policy and complexity of the dynamics of various families- this all but guarantees that the cases aren't being looked at like we would back when 10 per day was considered too many. When you are seeing that many each day, there is no time left "in between" appointments to complete other cases where information has been provided after the interview. This also causes workers to have to work late, work weekends, come in early- each and every day just to stay somewhat on top of their game. The lost voices in this ARE the workers, given that no one seems to realize that while we are employees of the state of texas, we are ALSO mothers, fathers, caregivers, etc at home. By the time some workers GET home, it's late and time to go to bed to get up early and do it again. This is the reason staffing is the way it is. You cannot expect a worker (especially in a major city like Austin,TX) to stay in this mess rather than go somewhere else. It is wrong when it comes to the clients that are having to wait, and it's wrong when it comes to the workers who are breaking their backs trying to do the best job they can do.

"There is very clearly a TIERS workload issue," said Stephanie Goodman, a spokeswoman for the Health and Human Services Commission. "We're trying to staff up. We do think that with additional staff ... we'll get through this hump."

It seems as though for every extra worker that gets hired, 2 have left. The starting pay for caseworkers is not enough or does not match the level of work they have to do. Yes, they are being paid overtime- but this is not a guarantee that it will always be that way. Historically, the State NEVER paid overtime, but rather would convert any hours worked over 40 in a week into time and half VACATION/COMP time. I can assure anyone out there who questiosn this that many of the workers suffering through this right now would not be if they were to end the paying of overtime.

She couldn't say exactly how many people are waiting. The backlogs, she said, are due in part to the addition of statewide cases from a new women's health program. State Auditor John Keel warned last month that TIERS is cumbersome.

"Every day, more and more cases are being put into TIERS ... without an infrastructure to deal with those cases," said Katie Romich of the Texas State Employees Union. "Workers are frustrated."

Rumor has it that ART staff across the state that are having to interview those clients NOT in pilot areas but who ARE in the TIERS system are seeing clients 40-60 days after the client applied. Mind you, as has been said on this blog before and is mentioned in this article, Food Stamp FEDERAL POLICY is very clear- a client MUST be certified or denied no later than 30 days from the date they filed their application. Obviously, this is not happening.

About 3.7 million Texans are enrolled in food stamps, Medicaid (a federal-state health insurance program) and Temporary Assistance for Needy Families. All the programs are affected by the delays.

Demetria Johnson, an Austin mother of two, said she tried to renew food stamps in June. She's still waiting.

"I do get paid weekly, but it's still hard for me to buy groceries," said Johnson, 28, who said she earns $9 an hour at a department store. "I fall off on the other bills."

Celia Hagert of the Center for Public Policy Priorities, which advocates for low- and middle-income Texans, said, "It's really not acceptable to tell someone they have to wait for months to put food on the table."

TIERS, envisioned by the Legislature in 1999, is a Web-based system meant to modernize the state's 1970s-era enrollment software.

"TIERS does so much more than the current system does," Goodman said. "Not to mention, it's technology we can actually support going into the future."

In January, the state debuted the Texas Women's Health Program, which provides gynecological exams and birth control to 70,000 low-income women. State workers have used TIERS to process the case of any woman who applies for that program and anyone in her household who seeks food stamps, Medicaid or temporary family assistance.

"The thing that has been somewhat of a surprise is how many of those women and their families have applied for other services," Goodman said.

Surprised? No, the surprise came to them when they realized that by applying for that program it threw ALL their cases in TIERS. I cannot tell you how many clients have asked local office staff that are not housed in the pilot area to please switch them BACK to the old system, and please get their cases OUT of TIERS. These women aren't people who have never been on benefits who suddenly get on WHP and then start applying for everything we offer. No. Many clients are very frustrated in their dealings with 2-1-1 and will continue to be as long as the 'status quo' remains.

Adding 50,000 foster care cases to TIERS this year had an impact, Goodman said.

And what exactly was the justification in adding all those cases? Pilot area is struggling to keep up, so what better way to fix that? Oh, let's add about 50,000 more cases to TIERS. So now if a child has been in foster care goes home and has to be added to their families case, it now throws all of THOSE cases into TIERS.

The Children's Health Insurance Program, which serves 341,000, is scheduled to be added to TIERS next year.

Any idea how many clients we have who receive Food Stamps and also CHIP? This will throw their FOOD STAMP case into TIERS as well. Local office staff OUTSIDE of the pilot area are not equipped to deal with the large numbers of TIERS clients that this will create. Since the Feds have told them to not rollout- this is the State's way of doing it anyway. Instead of a controlled rollout by county, this will just add thousands of cases "undercover".

"Until we have eliminated every bug in TIERS," said state Rep. Dawnna Dukes, D-Austin, "we don't need to be integrating anything into it."

Unfortunately, they are going to increase the TIERS clients. And the local offices will, in turn, begin losing people again.

Lovely.

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This was in comments.....I've colored "extra comments" by the comment leaver in red.

2007-12-01T21:17:00.001-06:00

THIS WAS IN COMMENTS:

Even though the State is sending every person they can to TIERS training now that it has opened up again, and even though they have alsomst 500,000 folks back doored into their system even though the feds said no more roll out, the new system IS NOT guaranteed. This was from the Houston Chronicle the other day. My comments have been inserted:

Auditor: Pricey state computer system flawed
Agency defends health, welfare unit as reliable

By CLAY ROBISON
Copyright 2007 Houston Chronicle Austin Bureau

AUSTIN A computer system, which has cost Texas taxpayers more than $350 million over the past eight years, remains plagued with problems and isn't ready to handle statewide processing of health and welfare benefits, the state auditor's office said Thursday.

(We that are there already knew this)

The Texas Integrated Eligibility Redesign System, or TIERS, was established by the Legislature in 1999 to improve access to benefits and services.

It now serves 430,000 welfare, food stamps and Medicaid clients each month, mostly in Travis, Hays and Williamson counties in Central Texas.

(The numbers were bolstered by the Womens Health Program, Foster Care kids and Old cases from all over the state being transferred to the TIERS system, without federal approval)

Auditors didn't find any significant errors in how eligibility was determined and benefits were calculated in the cases they studied.

(Significant? What determines a significant error?)

But, they concluded, the Health and Human Services Commission "will need significant additional processing capacity and storage to support a statewide rollout of TIERS," including the addition of the Children's Health Insurance Program, scheduled for March.

(And rumor has it that SSI cases handled through state office are being switched to TIERS starting in Jnurary)

CHIP will add about 325,000 active and 650,000 inactive clients to the system, the report said.

(Why are they adding inactive clients?)

It also criticized a "poor architectural design" that made the computer system cumbersome to use and hindered TIERS' ability to process and maintain the integrity of data. It also said DHS should consider streamlining its application process for public assistance, including the adoption of a shorter application form.

(Wouldn't this cause "significant" errors?)- HHSC Employee's note: No, the longer application is so cumbersome and confusing, that clients who use it leave off important information all the time. A shorter app (like the one we had- what, 4 pages?) that captured the most important information: Who is in the household, where they live, what income they have, and what their expenses are- would be MUCH better. A good worker doesn't need an application asking what the last grade completed in school was, what elementary school their kids go to, etc. A good worker out there will ask those questions anyway.

DHS officials said they stood by the system and were happy with the audit's finding that, in the cases studied, TIERS had accurately processed welfare, Medicaid and food stamp claims.

They said some problems cited in the report already were being addressed.

Auditors said they tested a sample of 60 TIERS clients who received benefits between July 20 and Aug. 17.

They also reviewed client samples initially tested by DHS and KPMG, a private audit firm.

"We're pleased that the state auditor confirmed that TIERS works," said Health and Human Services Executive Commissioner Albert Hawkins.

(Apparently Al didn't read the first paragraph in the story.)

"The audit also reaffirmed a decision we made in 2004 to change the TIERS database design. We've completed that redesign, and we're continuing to implement other improvements recommended by the state auditor and our technology team."

(As per a TSEU broadcast "...As of September 20, 2007, there were 1373 outstanding "service requests," which are documented requests for changes in the system to ensure its accuracy or functionality. Only 155 of these have been analyzed, and it will cost approximately $27 million and take over 200,000 hours to correct them.
42 versions of TIERS have been released since January, but HHSC is not independently testing the functionality of the system. Instead, HHSC is depending the contractor's reported testing results."
That is a whole lot of changes in two months, not real reaffirming.)

Hawkins said TIERS will be an important part of the state's transition to a new system that will allow Texans to apply for services in person, over the phone or Internet or by mail. He said TIERS can be adapted to meet those changes.

(I thought TIERS was the new system?)

The transition, so far, has been rocky. Earlier this year, the state canceled a contract with Texas Access Alliance, a group of contractors headed by Accenture, which had been hired in 2005 to operate call centers and process applications for CHIP.

The cancellation was prompted by backlogs and errors in processing applications.

(I personally know workers that are interviewing clients whose applications are past the 30 day time frame for foodstamp benefits. The case is considered to be delinquent before the client is even interviewed.)

HHSCEmployee: Not only are the cases that are interviewed in TIERS more than 30 days old, in some cases they are 40-60 DAYS OLD.

According to the new audit, the TIERS application/database was down for more than 27 business hours in July during the contract transition period. DHS said the down time was unusual and had been reduced to only 19 minutes in September.

(19 minutes on what day?)

The auditor estimated that TIERS will need at least 230 additional computer processors and an unknown amount of additional storage for a statewide rollout of the system.

(Let's guess, a processor costs, say, 2000.00. You do the math.)

DHS spokeswoman Stephanie Goodman said more than $2 million already has been budgeted for additional hardware. She said the addition of CHIP to the system will represent a major step in taking the system statewide.

(A major addition to the numbers race.)

But she said she didn't know when the process will be completed because federal approval will be required for some programs.

(Has this stopped them before?)

She said TIERS already serves about 12 percent of the state's health and human services caseload.

(What percent of of those are actually in the rollout areas?)

"It already has more cases than many other states have total," she said.

According to the audit, DHS' Office of Inspector General hasn't investigated potential criminal cases involving fraudulent claims or payments on the TIERS system since November 2004 or civil overpayment cases since April 2005.

(This is because there isn't any way for them to investigate. It was never set up so that they could be refferred or investigated through TIERS.)

DHS said the inspector general began conducting fraud investigations on TIERS cases last month and on civil overpayments in September.

(In name only. Word has it that they still can't investigate the cases in TIERS.)

The auditor recommended that DHS contract with the state Department of Information Services to provide guidance on the appropriate design and architecture for TIERS. The agency said it expects to complete an agreement with the information services agency next month.

(Ummm, the system is already desinged, right? That's were all that money went four or five years ago?)

The audit noted that DHS' application for public assistance was 11 pages long, based on state and federal requirements. Some other states, it said, have shorter, more streamlined applications.

(Operative phrase - "based on state and federal requirements."

The report included the draft of a suggested, four-page enrollment form. But the auditor noted that, unless supplemented with additional information, the suggested application would require DHS to obtain "at least 25 waivers from federal regulations."

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Ramblings of an HHSC Employee amidst chaos

Happy New Year!

Rollout done?

Test

I'm still here!

Links

Texas hit with fine for food stamp errors

And the rollout is back on

Complete Insanity

11:59 PM CST on Saturday, March 13, 2010

Hello!!

TIERS

Food stamp woes grow with need

Food stamp workers share frustrations

Dismissed

More...

article

Legislative Budget Board nixes more HHSC staff; Texas warned it could lose federal food stamp funds- from TSEU

Another article

Feds: Texas must speed up food stamp processing

Backlog, processing errors bedevil food stamp program

Hmmm?

Searches

Gov. Perry Names Suehs Executive Commissioner of Health and Human Services

To feed hungry Texans-Houston Chronicle

Watchdog: As Texas bureaucracy flounders over food stamp applications, a couple settles for potatoes

More from the Texas Bloggers

All about the lawsuit

We had a system in place that worked. BEFORE tiers. BEFORE Accenture/Maximus. It WORKED. We proved it worked. And now? I just don't know how you fix something like this.

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I'm shocked this hasn't happened before now.

Texas Health and Human Services sued over food-stamp response times

Article- HHSC in Daily Kos!

TIERS

State of Neglect: Outsourcing enriches contractors, ex-legislators

Texas health and human services chief to retire this year- American Statesman Staff

Texas health and human services chief to retire this year

Hawkins called 'budget whiz' but couldn't solve all problems.

Thank Goodness!

HHS Executive Commissioner Albert Hawkins to Retire

Texas Overwhelmed Article

Marquez and Herrero Discuss TIERS Rollout

Flood of food stamp applications slows state's conversion to new software

Flood of food stamp applications slows state's conversion to new software

12:00 AM CDT on Friday, April 10, 2009

Vendor Scheduling

Email regarding 2-1-1

Rollout

Long Time!

Health agency audit reveals many woes

Audit finds HHSC workers overpaid, undertrained

Privatization Hangover: State audit of health and human service agencies shows continuing management problems

Women's Health Program

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

Just a note

Texas lawmakers demand details of new application process for disabled, elderly services

Lawmakers criticize plan to expand troubled public assistance system

ELIGIBILITY SYSTEM PROGRESS REPORT

Committee Members

Texans Against Hunger Blog

Texas' new eligibility system to take on Medicaid, food stamp recipients

Legislative Oversight Committee on TIERS/Eligibility System to Hold Hearing on Monday, July 14

Texas to hire hundreds to determine eligibility for social services

Updates! Updates! Updates!

Accenture apologizes for ‘outrageous’ redaction

Despite federal OK, Texas delays computer system expansion

My comments in RED

Despite federal OK, Texas delays computer system expansion

Legislature increasing oversight of TIERS system used to enroll Texans in food stamps, Medicaid.

new timeliness nightmare.....changes

Tenured Staff

State, Accenture still haggling over money after privatization bid fell apart (my comments in red)

Contract canceled a year ago, but talks continue

State, Accenture still haggling over money after privatization bid fell apart

Article

Have you heard?

Check this blogger out!

Media

Read this, go there, and get in on the action in the comments section! BE HEARD!!!!!!

Austin American Statesman Article

Thoughts?

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