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

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

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!

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

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. This post done through Yahoo! Mail. You can email me at hhscemployee@yahoo.com. Please know all emails are kept confidential, and your identity will never be disclosed.

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. 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 This post done through Yahoo! Mail. You can email me at hhscemployee@yahoo.com. Please know all emails are kept confidential, and your identity will never be disclosed.