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

I'm sure everyone got this- but I'm posting it for those who read here that do not work for HHSC.  So it appears as though HHSC is going to continue rolling out TIERS which STILL does not perform in a way that it should.  I suppose this also means that the issues that TIERS has in relation to fraud (where cases are basically not prosecuted that have fraud because there's no way to verify/prove that TIERS didn't cause the overpayment)...will now be spread into even MORE counties.

 

So while HHSC tells the public that they are putting the contract with Accenture rollout on "hold"- they are still going to rollout the system that doesn't work.

 

Good luck to the following counties:

 

 

 

I wanted to let you know that we now have a schedule for the next case conversions to our new computer system for eligibility services, TIERS. You may recall that we announced in December that we’d begin the conversion process this year and that we expect a statewide conversion to take about 18 months.

 

In April, we will begin a series of conversions over the spring and summer that will move more counties in Region 7 and a few in Region 8 to the new system. Each conversion will take place after cutoff for that month. Here's the schedule:

 

April          Bastrop , Burnet, Caldwell , Comal, Guadalupe, Lampasas and Llano counties

May          Bell County

June          Brazos , Burleson, Fayette, Grimes, Milam and Washington counties

July           McLennan County

August      Bosque, Coryell, Falls, Freestone, Hamilton, Hill, Lee, Leon, Limestone, Madison, Mills, Robertson and San Saba counties.

 

State workers will continue to process all cases, and all state offices will remain open. With each conversion, we will conduct thorough readiness assessments before reaching a final determination to move forward. We moved Williamson County cases to TIERS in November 2006, and we converted foster care cases in February of this year. Both those conversions went very well.

 

Staff in the conversion areas will begin receiving TIERS training, and ART workers will fill in at the offices while staff receive training. In addition, ART workers will be on hand in the offices to assist with each transition.

 

If you have questions or concerns, please let your supervisor know. One of the keys to any computer conversion is to identify and address issues quickly. You are on the front lines, and we need and value your input to make the transition successful.

 

Thank you for all your hard work and your commitment to our clients.

 

Anne Heiligenstein

Deputy Executive Commissioner for Social Services

 

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Just some rambling

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

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

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

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

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

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

What a wonderful example TEXAS has become

Eligibility outsourcing’s tough childhood
James SchultzWashington Technology2/28/2007

For Indiana , entitlement eligibility outsourcing could be a dream come true. For Texas it’s been more like a nightmare. Both states are in the uneasy vanguard of an ambitious attempt to modernize decades-old processes and systems at health and human services agencies.

At stake are potential savings of hundreds of millions of dollars, dramatic improvements in speed and efficiency of delivery of services and adherence to welfare-reform regulations that otherwise lead to hefty fines for states unable to prove progress in moving from federal subsidies to employment. Comprehensive retooling of paper-based legacy systems also promises an aggressive approach to prevention and detection of otherwise undetectable fraud and abuse.

“Policy changes made by the federal government have driven modernization,” said Brian Whitfield, vice president of state and local government for IBM Global Services. States that want to see a real difference will have to similarly change their business processes, he said. Upgrading the information technology without updating the processes will have only a minimal effect.

States have neither the IT infrastructure nor the staff expertise to go the modernization route alone. But private-sector IT providers, ready for upfront investment so long as the profits can be spied somewhere in the thicket of multiyear milestones and deliverables, are stepping up.

The biggest players have the greatest advantage: deep pockets and a ready bench of experts that together can justify the considerable upfront investment in breaking systemwide incompatibilities and creating interoperable, user-friendly prototype replacements.

In December 2006, an IBM-led coalition landed a 10-year, $1.16 billion deal with Indiana to provide administrative and technological support for the state’s eligibility-determination process. The IBM team will help modernize the Indiana ’s failing eligibility system, state officials said.

At a little more than 6 percent, Indiana is last on national rankings of states that monitor the portion of those recipients transferred from welfare to work.

No bandwagon vaulting

Nationwide the human-services modernization market could theoretically amount to tens of billions of dollars for IT providers, said John Kost, managing vice president for Gartner Government and Health Care Research Worldwide. That figure is based on a high level of nationwide adoption that so far hs not been borne out in reality. Most states are waiting to see how successful Indiana and Texas can be with their outsourcing efforts before vaulting onto the bandwagon, Kost said.

There are many pitfalls, including disgruntled public employees forced onto private-sector employment rolls or out of work entirely. As the IT kinks are ironed out, citizens may have their benefits delayed or interrupted. Even the savviest of IT efforts can be gummed up by the unintended consequences of a re-architecture. And skeptical federal lawmakers want assurances that states will retain oversight of firms whose profit motives may not dovetail with devotion to citizen needs.

Kost summarizes part of the dilemma: “Can government create a meaningful contract that transfers fiduciary responsibility for what is regarded as a core government responsibility — health and welfare — to the private sector? Government procurement is horribly inflexible under most circumstances and trying to create a contractual relationship in a new market is chronically difficult.”

Scaling back

Difficulties have already surfaced in Texas . The state’s Health and Human Services Commission has scaled back private-sector involvement in a 2005 contract with the original goal of coupling Medicaid eligibility with broader social-services eligibility. Texas planned to offer eligibility services at four call centers in the state, maintain and support an integrated eligibility determination system and broker programs for those who receive food stamps, cash assistance and benefits through Medicaid and the state’s Children’s Health Insurance Program (CHIP).

The effort, led by Accenture, was originally worth $899 million, but has since been reduced to $543 million. In December 2006, Texas said it would rebalance the model by limiting the contract’s original scope after an Accenture subcontractor generated unnecessary letters to CHIP applicants requesting information. The subcontractor denied applications, the state asserts, even though the requested information was either on the original application or had already been received but not properly processed.

Modernization will continue, albeit at a more modest pace. The Accenture-led team will continue to work behind the scenes, processing food stamp, Medicaid and welfare applications, but Texas will reassume an active oversight role. The state says it will recover about $30 million in contract costs through service credits and discounts and convert 900 temporary positions in eligibility offices to regular-status positions to help stabilize the state workforce.

“ Texas took a very big bite of the apple,” said Zach Main, deputy director of the Division of Family Resources at Indiana’s Family and Social Services Administration. “We had the advantage of being a year and a half behind [their plan]. We watched what Texas did and realized it was too much for us to do at once. It was much too risky.”

Standardizing business practice

Main said the estimated $50 million in annual savings Indiana expects to recoup from the IBM deal is spread over 10 years and is a relatively small part of the initiative. What’s more important is establishing accurate eligibility review, more responsive citizen services and metrics to address anticipated Medicaid growth rates.

“We have all kinds of issues with the way we do business. We have no standard practices,” Main said. “We wanted to see what the private sector could do. Why should the state reinvent the wheel? Why not purchase the expertise and products already out there?”

A key element in the Indiana plan, and one that has by Main’s account prevented some likely objections, was the insistence by the state that IBM hire and retain 1,600 state workers whose jobs are privatized under the plan. Main asserts that although there’s been some opposition, the unions are almost completely driving the effort, and 95 percent of the affected state employees have accepted a same or better salary and benefits working for IBM.

“Many states are watching Indiana very closely to see how things go,” IBM’s Whitfield said. “Other states are obviously very interested in doing something similar, provided they can see the benefits.”

Kost said pinpointing benefits could take some time. Measuring success in dollars and cents will continue to be a challenge, and there are no commonly accepted methods to measure modernization’s effectiveness. Federal officials also are on constant watch for irregularities. Any state plan must undergo close federal examination. The childhood of this fledgling market could be one marked by skinned knees.

Health Commissioner faces tough questioning in Senate

Health commissioner faces tough questioning in Senate

Robert T. GarrettDallas Morning News2/28/2007

AUSTIN – Conservative and liberal senators unhappy with Gov. Rick Perry over social initiatives and his order that girls be vaccinated against a sexually transmitted virus are holding up Senate confirmation of his point man for such safety-net programs as Medicaid and food stamps.

Health and Human Services Commissioner Albert Hawkins, who easily received Senate approval four years ago, faces tough questioning today from the Senate Nominations Committee.
Mr. Hawkins, who worked for the Legislature for many years as a budget analyst, is accustomed to kid-glove treatment from lawmakers.

But he's getting back of the hand swipes from Sens. Glenn Hegar, R-Katy, and Eliot Shapleigh, D-El Paso, both members of the nominations panel.

Mr. Hegar is upset that Mr. Hawkins' agency helped draft Mr. Perry's Feb. 2 order that sixth-grade girls be vaccinated against the human papillomavirus starting next year.

"I'm withholding my support until he can address some of the concerns that I have," Mr. Hegar said.

Mr. Shapleigh, who says he doesn't blame Mr. Hawkins for lawmakers' "underfunding" of social programs, nevertheless accuses him of incompetence in managing a 15-month-old privatization of eligibility screening for Medicaid, food stamps, welfare and the Children's Health Insurance Program.

Stephanie Goodman, a commission spokeswoman, said Mr. Hawkins is unfazed by the criticisms. "I think he's used to that role," she said.

Mr. Hawkins, who was budget director to Gov. George W. Bush, followed him to Washington , but returned to Texas in early 2003 at Mr. Perry's urging.

He advised the GOP-controlled Legislature that year on cutting programs to help meet a $10 billion budget shortfall. He has overseen a consolidation of 12 agencies into five. And he aggressively carried out one of the nation's most extensive efforts to privatize additional portions of social programs.

But Mr. Hegar is among social conservatives who have deplored Mr. Perry's HPV order as overreaching, an overly hasty promotion of one company's product and a possible signal to young girls that premarital sex can be safe.

The order provides "a false sense of hope to people" that cervical cancer can be avoided, he says. And he plans to sponsor legislation in the Senate to effectively override the order. A similar bill is moving in the House.

Ms. Goodman said the commission drafted the HPV order at the request of Perry aides. She said Mr. Hawkins probably would tell senators today about a federal agency's recommendation that young women receive the vaccine.

On the new eligibility screening system, Mr. Shapleigh said he's upset that Mr. Hawkins did not heed warnings that it wouldn't work.

"The alleged savings did not happen," Mr. Shapleigh said of the contract with a group led by Accenture. "Quality state employees were fired, and now we're hiring the same ones back. To me, that is incompetence on a major scale. I'll be asking what caused the agency to sign this contract."

Mr. Hawkins recently scaled back the contract by more than $350 million, limited the role of the contractor's employees and added back 900 state eligibility worker positions.

But while "not everything went as planned," Ms. Goodman said, the commission deserves credit for jumping on problems quickly and preventing a statewide rollout. If Mr. Hawkins' nomination clears the committee, the full Senate must act on it.

I haven't forgotten!

I haven't forgotten the blog...again, work is busy.

One thing though- please PLEASE if you can, sign up to go to Lobby Day April 18th.

Comment about what's going on in the offices.

News you can use....Links

State Plans Medicaid Experiment- Dallas Morning News

Here's a Budget Priority For You- OfftheKuff.com

HHSC Reverses Course on Welfare Privatization-Father John Whiteford


I also wanted to comment on the "change" in the contract. Correct me if I'm wrong, but does it now sound like Accenture/TAA have become nothing more than glorified clerical staff- now that it sounds like all they have to do is scan in documents?

Under the restructured contract, the Bermuda-based company will be largely relegated to data entry, leaving judgments about whether Texans qualify for food stamps, Medicaid and other welfare programs to state workers

So it sounds like the same thing WE were doing BEFORE TAA. Right?

We have to spend millions still for this?

Why?

Edited to add: Wanted to add the comment that was left so it won't be missed...I've bolded what stood out to me.....

I absolutely agree with your point here. I was at mini-lobby day on Wed. and this was the point we kept hammering home with the legislators. Throughout the next few months, it would be good to remind your state legislators and the members of the appropriations/finance committees and health and human service committees that it makes no fiscal sense to spend the same amt. of money (per year) for three years for Accenture to do less work. By the way, I did ask the question of whether the $543 million still being spent included money for TIERS maintenance or info. broker (because this will still go to Accenture for the full 5 years) and was told that this money is separate.

TSEU Broadcast Update 01/26/07

TEXAS STATE EMPLOYEES UNION
EMAIL BROADCAST UPDATE TO MEMBERS   January 26, 2007

 

Who is Accenture trying to influence with mega media campaign?

 

Since January 1 Accenture has spend hundreds of thousands of dollars on a media advertising blitz that includes at least seven full pages and five half-pages on the Austin American Statesman along with frequent spots on Austin-area radio and television. There radio campaign includes major donations to local PBS station KUT with the regular "announcements" of the corporation's name and slogans. Full page ads in the Statesman cost about $20,000, and half-pages cost about
$10,000 each, so the media buy in the Austin newspaper alone was about $150,000.

 

The newspaper ads are all close copies of one another, and feature full-page images of golf champion Tiger Woods with bits of inspirational wisdom like "relentless consistency 50%,willingness to change 50%, high performance delivered."

 

Accenture sells no consumer products or services, which raises the question of who the campaign is aimed at. The Bermuda-based corporation once had an $899 million contract with the Texas Health and Human Services Commission to provide human services eligibility via call centers.  The contract was reduced to about $566 million after Accenture failed to deliver on most of  the promised products and services. The contract has been a total failure, and many legislators are
calling for a complete cancellation. Press coverage of the problems has played a major role in bringing the issues to the attention of lawmakers. With legislators in Austin for the 80th session of the Texas Legislature, Accenture would not be helped by more media coverage of its failures.

 

Accenture's high-dollar advertising campaign appears to be a desperate attempt to restore its tarnished image and encourage less media coverage of its failure to deliver quality health and human services.

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Support in the local offices - Comments added to post in RED.

Time and time again it's been spoken that the disparity between employees and their Supervisor continues to grow. I'm not speaking on ALL Supervisors. There are many out there who are heartsick at the overwhelming work that their workers and clerks are facing daily. I'm not talking about them.

I'm talking about those in "charge" that have chosen to just go along with whatever is told to them, and in no way backing their workers up in the local offices. This may come in the form of fighting for their workers to have worktime that is sufficient to get some things done (rather than almost force their workers to work weekends - time away from family and their personal life - in order to stay caught up).....it may come from backing workers up when a client calls to complain.

Here's what needs to be understood- we are ALL behind. In everything. Not because we "like" it, but because it is the way it is. Why does upper management think that piling more work on top of more work is going to "fix" the problem? The more cases you interview (by phone, no less), the more cases that sit pending waiting to be finished. Our offices have gone from 6-8 per day to as many as 20-22 per day. And rather than the same amount of "worktime", in many cases- workers aren't given ANY worktime or very little. So management says "schedule them with 2-3 more each per day" without giving a thought that we are ALREADY SEEING TOO MANY. And front line supervisors - in many cases- don't say anything. Just go along. Yet, they (supvs) expect the work from their workers who feel lost in all of this.

In NO WAY SHAPE OR FORM AM I HARPING ON SUPERVISOR'S IN THE LOCAL OFFICES. I can't IMAGINE being in your position. I wouldn't even want to be. That's not what this is- but whether it's nice to read or not- IT'S THE PERCEPTION AMONG YOUR STAFF THAT'S MOST IMPORTANT. Workers who feel like they have the back up and respect of their supervisor WILL perform FOR their supervisor.

If "The Powers That Be" want to keep and retain the little tenured staff they have left...then it's time to step up to the plate. It's time to stop sending out these emails proclaiming your appreciation for "all our hard work" and do something about it. Quality is suffering in this (Does QC even matter anymore?) and you've got good workers who have tried to stick it out now leaving because it's just become too much.

I sure miss our "old" DHS.

Great comments, posting for all to see.....THANKS for your input, anyone else?

Anonymous said...
The work being piled up and piled up is what eventually sent me packing. I left. I couldn't take it anymore. I have been out about 3 months and am a different person. You don't realize how oppressed you are as a worker until you get away from it. I finally told myself, "This is HHSC's mess, not mine. It is not my problem anymore." My family agrees. They said they would eat out of the trash before I go back to that place... My hair is no longer falling out..No longer on anti depressants..No high blood pressure...You may need some time off. Talk to you Dr if you are feeling stressed or ill alot. I have not been ill one time since leaving. I used to be sick alot. The doctor said it was stress. It can kill you...That scared me. Have you started having panic attacks in the middle of the night yet? I was at that point. I hate what is happening, I was good at my job as a worker, but felt it was so political and that our voices were not being heard. They need to make all temps permanent and quit the temp thing. They are just taking those jobs to get their foot in the door and then moving on to other departments or agencies.
How far will they let it go?
Too far apparantly. I don't know if it can ever be fixed.
I used to love the "old DHS" too. When Clinton was president it was a good place to work. Why is that?
It's all politics. The rich getting richer. The poor getting poorer. What is going to happen to these people on benefits when minimum wage is raised? Will they lost them. Sorry for rambling.
GOOD LUCK to you all that stayed and God Bless You All.



Anonymous said...
One of the things I learned as I worked my way up the ladder at DHS/HHSC was that a lot of people in DHS had a client focus that was not popular in the general population, the Governor's office, or TWC.

Granted, there are radicals at both end of the political spectrums. I dont want to make this a liberal/conservative issue. But as a slightly conservative leaning person, I was proud of the work I and the agency did in helping the truly needy.

Well, Albert Hawkins and his clique hate the old DHS heirarchy and it's "baby-ing" of clients. If you were with the old DHS and specifically the old Texas Works section, you carry a certain stigma within HHSC and their heirarchy. Your competence, intelligence, and integrity are considered questionable and the old DHS guard, to a large degree, has been pushed out.

My greatest pain has come in having to see some of the most caring, self-sacrificing public servants I've ever known be driven off. They were replaced by "headhunters" such as Greg Phillips and Sidonie Squire. Parasites who came in, bathed the halls of DHS with blood of long time employees, then left to greener pastures elsewhere. And by the way, both Phillips and Squire, personally or through their families, have connections with private companies that made out like bandits in the privatization efforts here in Texas. For example, at one time, the manager responsible for oversight of the vendor under the new eligibility system was.... a former vice-president of one of the companies that won the bid. Talk about putting a rat in charge of the cheese.

How I wish a thorough and indepth investigation of the whole privatization and exploitation of the contracts under Hawkins were conducted by the FEDERAL government. The loss in public monies and client services is a crime and a shame for the state of Texas.

Word on the Street

Got this from someone in email.....please, if you hear something or know something, email me the info- I NEVER reveal where it comes from.

On to the info:

Rumor has it that Planned Parenthood offices are signing up clients for
that new program (Woman's Insurance Program), apparently without their
knowledge...... A woman came in to apply recently for benefits and found that
she was a TIERS client. The only thing that she had done remotely close to
applying for benefits prior to this was visited the local Planned Parenthood for
an exam. Another woman had gone to Planned Parenthood to get birth control. She was willing to pay for any services provided, but was told she couldn't, that
she had to sign up for "a Medicaid program" that would cover it.... This is all
second party hearsay, but the source is reliable, as they had to try to explain
the why's and wherefores of the new program to the clients.

Wait a minute, what? So PP is signing clients up without them knowing? Are those one page applications required to be signed? If this is happening, who do we tell? Will it matter?

The second tidbit is that the new program has already overwhelmed the
unit that is supposed to be working the cases and converting associated cases.
Over 7000 applications were tallied through 011507, with more on the way. They
are already asking some of the other ART workers to help out. This really Chaps
my hide, as they KNEW that they would have a gadjillion applications to process
at first. Are these poor clients going to go without if their cases come up for
review during the transition?

I've heard this as well...that there is already a massive amount of overflow into ART. Again, as was said here before....these clients have NO IDEA that this will throw them into TIERS for ALL their cases.

Comment left by client......comments?

i have read several of your blogs, and would like to contribute some thoughts from the other side of the coin. being a single mother of two children, one of which is handicapped, i would beg that you and your co-workers, the good ones, the ones who really truly care about the people who come to them for help, will respond, and let me know how we change this system. i have no doubt what-so-ever that when the federal assistant programs were started by the FDR administration, today's end result is NOT what was intended at all. i work. have worked up to 3 jobs at a time. because my son's disability is very expensive, i have no choice but to make sure he stays eligible for his medicaid. its not a fact im proud of, quite the contrary actually. but its a fact all the same. which means SSI dictates how much money i can make and still allow my son to be eligible for the benifits that are necessary for his life...yet, i only qualified for $107 per month worth of food stamps. my childrens father , who owes over $35,000 in child support and REFUSES to work, and has 4 other children he refuses to support, lives with 2 of his children and his common law wife, and they get SSI, social security disability, and nearly $600 a month in food stamps. have money for beer. they eat steak all the time. my kids are lucky to have hamburger helper. someone please tell me how this is fair? now, because i refuse to lie, i dont qualify at all. nothing. still cant make more money, or loose my son's medicaid. so how do i feed my children? why does the system force us to lie? why does the system reward laziness, yet punishes those of us who WANT to work? i dont understand. and honestly, it pisses me off. not at you workers. i get that you follow rules. i get that you are frustrated with the system. but i dont get why we cant work together to change it...to make it right. to make it fair. im glad i stumbled across this blog. it makes me happy to know there are some HHSC workers who give a damn. tell me who to write..who to call....how do we change what obviously does not work? i have a friend who works for HHSC..i know he is so frustrated with the way things are. he gets angry with me because i wont lie. i wont just do what he tells me to do in order to get benifits. i just cant do it that way. i know he is one of the good guys. and i know he cant be alone out there. thanks for letting me vent. maybe some day this system will return to what it was meant to be. a helping hand. not a hand out. not a free ride. help those of us who desperately need assistance, and make those who refuse to work, refuse to even try, fend for themselves. i know that sounds harsh. but im sick of paying medicaid taxes out of every check i make for some lazy jerk who wants nothing more than a few more kids so the benifits go up for doing nothing. ITS WRONG. plain and simple. you all have the power to make those in charge understand...its time

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Update!

Got this in comments:

Can you update the blog more regularly?

And in response to that- I update as much as I can. I'm an Advisor interviewing a huge amount of clients everyday, working late and weekends to stay caught up. What little "free time" I do find, I try to spend with the family I have that has had their time with me cut back by the job.

I update when I get information or when someone emails me information. I try to post on big stories as they happen, or sometimes prior to happening as I did when I posted the press release was forthcoming in regards to the contract "changes"-before it was official.......anyone reading is more than welcome to send me an email with a concern or issue they have and I'll be more than happy to post it on the blog. In fact, I encourage anyone reading to do just that- just email me whatever- what you are seeing in your area, your opinion on things- etc. Anyone of us could be "hhscemployee" and most of us are.

Saturday's News Roundup

Privatization lessons learned-Austin American Statesman

Undoing the damage-Texas Health and Human Services acknowledges the shortcomings of its privatization plan - Houston Chronicle

Texas scales back plan to privatize its social services
By LIZ AUSTIN PETERSON-Associated Press

Blogs commenting on the "mess":

HHSC Reverses Course on Welfare Privatization - Fr. John Whiteford

More Privatization Tales - Eye on Williamson County

State finally cuts bait on Accenture - OfftheKuff

Wasn't Such a Good Idea to Privatize Social Services with Accenture (Remember them? Used to be Arthur Anderson Before ENRON!) - Somervell County Salon

Accenture gets the Clear Lake Axe - Bay Area Houston

Full Speed Ahead into 2007!

Remember when I posted a reader's letter to many reps/state officials regarding the Women's Health Program?

Well, that reader has received ANOTHER response...this time from the Comptroller's Office...it was posted in the comments, but I feel it's worthy of being on the blog itself so no one misses it:

This was from the Comptroller's office:

Dear (worker):

Comptroller Strayhorn has received your e-mail regarding Medicaid's new
Women's Health Program, its potential negative impact on the troubled TIERS
system and potential problems that could result for families receiving other
types of financial assistance.

She has asked me to respond to you. We are forwarding a copy of your e-mail
without your name to the attention of Anne Heiligenstein, Deputy Executive
Commissioner for Program Services, Health and Human Services Commission. Alert local employees are often the first to realize potential problems and issues
involved in the application of new policies, programs and procedures within the
context of complex systems.

It is important for staff to stand up and be heard so that unforeseen negative consequences can be avoided. We applaud you for having the courage to do so. We are confident that Ms. Heiligenstein will investigate your concerns and make any appropriate changes in the Commission's plans so that the new program can proceed without creating additional problems for our state's neediest families.

If you need further assistance, please contact me by e-mail at vicki.anderson@cpa.state.tx.us.

Sincerely,
Vicki Anderson

Let this response serve as a reminder to all of
us "in the field"- your voice CAN be heard. I encourage everyone willing to email whoever you can as much as you think possible to get the word out. We do have a voice, and we WILL be heard.--hhscemployee

Merry Christmas!

I'm going to take a break from all things HHSC for the Holidays, but let me say to anyone reading here that I wish you a VERY MERRY CHRISTMAS and a GREAT 2007!

To my fellow workers: The work you do for the people in the State of Texas means something. You continue to work under very pressured conditions, yet somehow we are able to help those who need us. Because of the work we do, there are families in Texas who will be able to have a little hope for the holidays and the New Year. No matter the pressure we feel from those "in charge"- what you do is important. We are feeding children, keeping kids covered under Medicaid so they can get medical care, and we are helping those who need us make a better life for themselves and their families. Don't let anyone "out there" make you feel like you aren't in the business of HELPING OTHERS. We are. We can make this agency what it once was. We just must continue on trying to get others to see the same things we do.

In the News

Of course, we all know HHSC has been in the news quite a bit for the last few days...rather than link every article, you can check them out by clicking HERE.

Women's Health Program

I got this from someone who sent the following to all his/her reps......it would be great if any and everyone could take this letter and send it to their reps as well:

I sent this email or a little longer version to all the State representatives and Senators (also dewhurst) I may not be working by the end of the week, but I will get heard..

Dear Representative whoever:

Let me start by introducing myself. My name is Worker (used my real name and Town in the emails) and I am a Texas Works Advisor in Whereeveryouare, TX. As you most likely know by now, HHSC has been trying to push to get privatization for the issuance of State benefits (Food Stamps, Medicaid and TANF) for quite some time now, and have had limited success to say the least. The Feds have put a hold on any further rolling out of the system until HHSC can show that the system works.

HHSC is going to start a new Medicaid program on January 1st, called "The Women's Health Program." It is explained in Texas Works Bulletin 07-05 (http://www.dads.state.tx.us/handbooks/TexasWorks/res/Bulletins/index.htm) In theory, it sounds like it could benefit a lot of women in Texas, but there are a couple of issues that I am concerned with.

The program is designed to help women between the ages of 18 through 44 who meet the eligibility criteria. This limited benefit Medicaid program provides health screenings and risk assessment exams for preventable conditions. It also provides family planning counseling and contraceptives to eligible women. The problems that I have with the program have really started to bother me:

1.) It is not a full coverage Medicaid program. The women that would qualify for this program are probably not going to be able to get any treatment for problems that are found…It provides coverage for gynecological exams, related screenings, and birth control. If during any of the exams or screenings a problem is found, they have no medical coverage to pay for any related treatments or medications. They are probably over the income limit for adult Medicaid and TANF, or they would more than likely be on one of those programs already. It doesn't make sense to me to cover someone for a diagnosis, but then not let them be helped for treatment.

2.) This program is being worked through the TIERS system. It has already been shown that this system is flawed, and the government has put a hold on any further rolling out of this system. All of these women between 18 and 44 that apply and are certified for this Medicaid program are going to be in the TIERS system, which means that all associated cases that they have (Food Stamps, Children's Medicaid, etc.) are going to be converted to TIERS cases, along with all other people on those associated cases. In my estimation, in any given week probably 40% to 60% of the women applying for Adult Medicaid in my office are doing so to get birth control. Being the pessimist that I am, I am seeing this program as a ploy to get more people into the TIERS system, so that if and when the powers that be realize that the system is too flawed and cannot save the state any money, there will be too many clients in the "new" system to just trash it and return t the "old" system (which is still working fine.) Once a person is taken off of the SAVERR system and put into TIERS, they can't be put back (although there used to be a way to correct mistakes that would put clients back into the SAVERR system.)If I were a woman between the ages of 18 and 45, and there was a program that would help me to get birth control plus medical screenings for women's problems, I think I would jump at it. If I knew anything about the problems with the TIERS system, and knew that I was going to have to have all of my cases worked through that system for the rest of time, I might think twice before applying. Couldn't this program be implemented through the SAVERR system? They have created more complex programs through this system before.What I am trying to say is that the public (and our government) need to be informed COMPLETELY about this program before it is implemented. Something has to be done to keep all of these clients from being converted to the TIERS system, or there may be more problems than anyone wants to deal with.Thank you for your time, and I apologize that I am sending this so late in the game. I am not a political activist; I just kinda go with the flow of things…usually.

This whole privatization issue has bothered me from the start, mainly because of the way that things were done, not the privatization itself, and I guess I have just gotten fed up. It seems that since HHSC has been stopped from rolling out anywhere else, they are going to virtually roll out with numbers of clients instead of with actual offices in areas.This privatization is adversely affecting workers, clients and it seems the general public now.

Please feel free to forward, cut & paste, or otherwise get this letter to whomsoever you see fit to inform them of the issue. I would rather be kept anonymous for obvious reasons, but if you need or want to, you may use my name and address as a source.

The sender then received a response to his/her letter which - with permission - is being posted below:

Dear Mr./Mrs. (Worker):

Thank you for your information regarding The Woman's Health Program. I understand your concerns with this issue, and it is something our office will research further. I agree with you about the problems associated with the Texas Integrated Eligibility Redesign System (TIERS).

In a report issued by the Texas Comptroller' s office in October, TIERS was credited with having many difficulties, such as not processing dates correctly, not distinguishing between eligible and ineligible members in a household, and failing to determine residency status.Thank you again for the additional information, we appreciate it.

If you have any questions in the future, please do not hesitate to contact our office again.

Thanks
Katherine

Katherine Frolow
State Representative
Pete P. Gallego
Texas State Capitol - 4S.5(o) 512-463-0566(Second e-mail)

One thing I found interesting was that in the Q&A last week (was it last week?) someone had asked about this:

According to Texas Works Bulletin 07-05, applications for the Women’s Health Program are to be processed by special Texas Works Advisors in TIERS. Does this mean the rollout has resumed? This will increase the workload for the workers who are trained in TIERS. Is the state looking at providing training for this program?

Applications for the Women’s Health Program, which begins Jan. 1, will be processed in TIERS by a new HHSC eligibility unit created just for this program. The new unit has 34 staff, including 25 eligibility advisors, who will process all Women’s Health Program applications statewide. These employees are receiving training in TIERS and the new program and will be ready to process applications Jan. 1. The rollout of the new eligibility system remains on hold.

Of course, you realize the Q&A did NOT address the fact that once a client is certified for this program, all cases will convert to TIERS which means LOCAL ART WORKERS will be the ones having to process those applications and reviews. The "new unit" will only certify someone for the WHP, not have to deal with overflow that will occur when this client's other cases end up in TIERS.

Other Links/News

Eye on Williamson County has a post up today regarding fraud within HHSC.....

Dig Deeper Texas has a post up (kinda late in posting this, sorry) regarding Albert Hawkin's involvement with the Texas Health Institute.

****************************************************
TEXAS STATE EMPLOYEES UNION
EMAIL BROADCAST UPDATE TO MEMBERS

VICTORY FOR TSEU, TEXANS

HHSC announces partial cancellation of IEES/Accenture project

"New Strategy" could be beginning of the end for failed experiment

HHSC will announce publically later today a "new strategy" on its call center experiment and the Accenture contract. In a tacit acknowledgment that the experiment is a failure, HHSC will

* Drop most plans for Accenture to do eligibility work. The HHSC announcement says that in the "rebalanced model" Accenture will scan the case documents into the system, run data-broker checks, and report the information to state staff, who will proceed with the case.

* The JSAP system put in place to decide who will get state jobs under the new system will be scrapped.

* 900 Texas Works positions that are currently considered temporary positions will be converted to regular full-time positions

* Cut the contract by $356 million (about 30%) and end it in 2008 instead of 2010

* Accenture will take over direct operation of CHIP eligibility from Maximus. (This is probably the result of Maximus' plans to reduce its participation in the IEES project after losing nearly $50 million on the "Texas Project" in 2006)

* No further roll-out with Accenture. The pilot in Travis, Hays, and Williamson counties will be resumed "after a rigorous readiness review" and "with a more limited role for the vendor". No other roll-out will be attempted before the contract ends in 2008.

* The HHSC announcement also says that TIERS will be rolled out statewide over about 18 months beginning in January 2007.

TSEU'S POSITION:
It's a good start. Now, cancel the contract, rebuild eligibility, look hard at TIERS.

The announced changes are a welcome sign that HHSC is moving in the right direction in managing this failed experiment, but the $543 million that will still go to Accenture will be wasted, and the time from now to the end of 2008 will be wasted trying to keep a failed experiment on life support.

* The contract with Accenture should be cancelled. Several provisions allow the state to cancel at any time. We have already paid Accenture over $120 million and there is no indication that the State of Texas will get any value from this contract: the remaining $543 million will be throwing good money after bad.

* We should start right away on rebuilding our capacity to provide human services eligibility to the people of Texas . Converting the temporary positions to regular status is a start, but we need to hire an additional 1000 or more staff, and rebuild our capacity to train them.

* Before we commit more resources or cases to TIERS, the whole system must be evaluated by competent staff who are not paid by HHSC. If the system can be fixed, it should be. If it cannot be fixed, it must be replaced

News Release

NEWS RELEASE

Albert Hawkins
Executive Commissioner

Date: Dec. 21, 2006
Contact: Stephanie Goodman or Ted Hughes, (512) 424-6951

HHSC Announces New Strategy to Modernize Eligibility System

AUSTIN — The Texas Health and Human Services Commission (HHSC) today announced a new strategy to modernize the state’s eligibility system and make it easier for Texans to apply for services. Under the plan, the state will retain some functions originally envisioned to be performed by the private sector, reduce the terms of the contract, and change management of the Children’s Health Insurance Program (CHIP).

"We remain committed to implementing a system that works better for consumers and makes efficient use of taxpayer dollars," said Health and Human Services Executive Commissioner Albert Hawkins. "We have evaluated the results of our pilot and concluded that we need to take a different approach to achieve our goals."

Hawkins said the new strategy includes rebalancing the roles of the state and the private sector.

"Our goal from the beginning was to design a system that efficiently supports state workers and keeps complex decision-making in the hands of trained, experienced state employees," Hawkins said. "The pilot has shown us that we need to redraw the line between the state and private sector to clarify that the private sector is there to provide a support role to state staff."

In June 2005, HHSC concluded a competitive procurement process and entered into a contract with the Texas Access Alliance (TAA) for call center operations, CHIP processing and eligibility determination, maintenance of the TIERS computer system and enrollment broker services. Most of the functions, including CHIP processing, have long been performed by the private sector. The critical new elements in the contract included establishing call centers and moving some work currently performed by state eligibility workers to the private sector.

Under the original contract, for example, vendor staff image food stamp, Medicaid and TANF applications into the system and attempt to verify some information through independent sources. If an application lists no cars and the independent check indicates the household has a car, vendor staff attempt to resolve the discrepancy before sending the case to state staff. In the rebalanced model, vendor staff will image the case into the system, run the independent checks and submit all the information promptly to state staff who will decide how to proceed.

Within the contract, management of CHIP will change with Accenture taking over responsibilities previously handled by Maximus. CHIP eligibility determination, which is less complex than most other social service benefits, has been handled by a private contractor since the program’s inception in 2000. The state changed contractors in November 2005 and has noted several ongoing performance issues since that time. The most serious issue involved unnecessary letters to CHIP applicants requesting more information. A review found that in some of the cases, the requested information was either on the original application or had been received by the subcontractor and not attached to the case properly or within required timeframes. This issue led the state to implement manual checks to ensure that families were not inappropriately disenrolled.

Other elements of the state’s new strategy include:

Modernizing technology by converting cases statewide to the state’s new computer system. In early 2007, HHSC will begin a gradual conversion of 8 million food stamp, Medicaid and TANF clients to the Texas Integrated Eligibility Redesign System (TIERS). State workers will continue to process all cases, and all state benefits offices will remain open.

Recovering $30 million in state costs through service credits and discounts.

Reducing the contract by $356 million. The original contract was valued at $899 million and expired at the end of fiscal year 2010. The revised contract is valued at $543 million and ends after fiscal year 2008.

Resuming the pilot in Travis, Hays and Williamson counties with a more limited role for the vendor in food stamp, Medicaid and TANF cases once the technology solutions are in place to support improved performance. The state will not expand the pilot beyond the current three counties during the current contract term.

Converting 900 temporary positions in eligibility offices to regular-status positions to help stabilize the state workforce.

"We recognize that modernizing a system of this size and complexity is never easy," Hawkins said. "But we remain focused on implementing a system that finally allows Texans to choose how they want to apply for services, is built on modern technology and makes the most of limited state resources."

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Just received this...hmmmmmmm

HHSC to make announcement about Accenture deal

By Staff | Thursday, December 21, 2006, 10:14 AM

 

Texas Health and Human Services Executive Commissioner Albert Hawkins will make an announcement this afternoon about the state’s controversial $800 million-plus deal with the Texas Access Alliance, a commission spokeswoman said. The Texas Access Alliance, led by Accenture LLP, was hired to run an enrollment system for food stamps, Medicaid and Temporary Assistance for Needy Families. The privatization of tasks formerly done by the state was supposed to save the state money and make it easier for Texans to enroll by allowing them to sign up via phone, Internet, fax, mail or in person instead of just in person.

 

But when the private group took over in Hays and Travis counties nearly a year ago, the system became plagued with problems. Some Texans eligible for public assistance were declared ineligible or received benefits late. Hawkins delayed statewide rollout of the new system, and some legislators have called on him to cancel the contract. Commission spokeswoman Stephanie Goodman did not say what the announcement will be, but she did say: "I promise you a headline." Stay tuned.

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Spin

I've read and re-read the article that is linked below, and something kept standing out to me and that was the response from HHSC:

"Commission spokesman Ted Hughes said that, although officials are sensitive to the stress workers are under, the shift is part of the transition to a more automated system. In the long run, the changes should decrease workloads for eligibility workers, Hughes said. Plus, it has already allowed people to apply for benefits over the phone or through the Internet, he said."

So, in reading that I'm struck - it's kind of like that spokesman from Iraq that would constantly get on TV and tell his people that Iraq was winning when we first went over there- although obviously everything he said was absolutely false.

Officials are sensitive to the stress workers are under? Is that why pressure continues to be put on local office staff that they must maintain timeliness? Integrity in cases? How does one do that when workers are having to see upwards of 20 appointments per DAY? What about the stress the clients are under, and take out on staff? There are folks in Texas who are going without benefits Mr. Hughes. WITHOUT MEDICAID, WITHOUT FOOD STAMPS, WITHOUT CASH ASSISTANCE TO PAY THEIR BILLS. What Mr. Hughes fails to realize is that when clients go without, it's US in the local offices that bear the brunt of THEIR frustration. WE are the ones blamed because their child needs a prescription filled and the Medicaid isn't done yet. It's us they blame when they have to go to the local food bank for help because there aren't enough hours in a day to see 20 clients and finish all the cases that are ready to be finished. What about, Mr. Hughes, the stress workers' families are going through while mom/dad are having to work late evenings and every weekend? In the long run the changes are going to decrease workloads? When is that Mr. Hughes? When TIERS works? When TAA figures out how to do their jobs?

Are we still harping on the "applying by phone" and "internet" thing? Seriously? Again, let's remember that while a client can call 2-1-1 and apply for Food Stamps- or PARDON ME- can give their info to an operator who will basically complete an application for them, then MAIL the application to them for their SIGNATURE and then refer the client to their LOCAL office- this is not "applying by phone". Internet? Apparently, we are all forgetting the clients we serve. Sir, most of our clients don't have PHONES much less internet. Let's not forget also, that it serves little purpose to apply by phone when one must still have an interview to get certified. When it's taking over a month to get an interview scheduled and THEN pended for more information- how convenient is THAT? How about this- for all the workers reading here- when a client calls you to complain at how long it's taking to get an interview or get their cases finished, tell them that at least now they have the option to apply by phone and the internet and ISN'T THAT GREAT?! After you get screamed at and told that applying by phone doesn't get them what they need- then tell them that THAT is the stance that those in charge take- that it's busy, and the offices are understaffed- BUT BY GOD CLIENTS CAN NOW APPLY BY PHONE AND INTERNET. See how that goes over and refer them to Mr. Hughes.

I wish every office in the State of Texas got with the Union and staged their own rally. I think it's amazing. It's time to do something. It's time to stop letting the puppets in State Office continue to pile work on and then say it's all great and wonderful.

If enough news gets created- then maybe someone will start listening.

Rally in Waco!

Thanks for the links and the heads up commenters-

 

There was a "Rally" in Waco Tuesday- workers who are evidently fed up and feeling like their voices are not being heard.

 

You can read the article HERE

 

and you can watch the TV Spot HERE.

 

I would imagine that if you are interested in doing something in your area, you'd contact the Union.

 

Wow.  Just wow.

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Let's Shake things up!

We've got quite an audience reading here guys....it's time to shake some of this up before the session starts in January.

 

Email me your stories.  I'm going to post them all on this blog- we are going to put this out there.  I think so far, employees who "complain" are doing so because of our "jobs".  We all know it's not that way.

 

Email me from an anonymous email address- I don't want to know your name.  I just want your stories.  The more, the better.  This blog is being read by representatives across the STATE!  Make your voices HEARD. 

 

All I ask is that you tell me your tenure- or a figure around your TENURE.

 

You don't have an anonymous email address?  It's easy to create one at Yahoo! or Hotmail. 

 

Tell me what kind of support you are getting.  How many appointments.  We must do this y'all.  We have to.  It's time.

 

Forward my blog to all your co-workers.  Tell them it's time to make a stand.

 

If you want to email me from your own email, and it has your name- know that I would never EVER under any circumstances EVER reveal where a story comes from. 

 

Let's shake it up.  We don't have long.

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Interviews per day

I'd like advisors reading (or anyone else who knows the answer) to tell me how many appointments you are seeing a day.

 

Do you get a workday or any worktime at all?

 

Is your office mandating interviewing on Saturdays?

 

What can we, as the remaining HHSC employees, going to do to make our voices heard?

 

Is there anything we can do?

 

What would YOU be willing to do to make your voices heard?

 

Do we need to all flood our local representatives with emails telling them that they are not getting the full and true story about what is going on in the local offices if they are depending on THE POWERS THAT BE to give them the info?

 

If someone reading has a good blanket statement would could all send to our reps, would anyone do it? 

 

If we come up with that, would you send the link of my blog to every coworker you have to get everyone on board?

 

WE MUST DO SOMETHING.

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Hits?

The blog has received many hits today from www.texasweekly.com.....

 

It's apparently accessible to paid "subscribers"- so I'm unable to see what everyone is coming here in reference to.

 

If you can shed some light, please email me!

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Letter to the Editor: Private doesn't equal good

Austin American-Statesman
12/1/2006

Re: Nov. 15 article, "Foster care plan under review":

We must stop blindly believing that anything done by government can be done better by the private, for-profit sector.

Some activities (prisons, medical care, public schools, military supply and enrollment for state benefits, as examples) are done better by government workers - at a lower cost.

Most work previously done by government and contracted to for-profit companies ends up costing more and providing less. Business owners spend less on training, wages and health coverage to increase profits.

Chairwoman Jane Nelson, R-Lewisville, was "the only senator to attend" last week's meeting of the Senate Health and Human Services Committee.

Assuming there are other committee members, where in bloody blue blazes were they?

Mack Waldrip
Austin

Opinion: Texas Medicaid seeks to improve women's health, save tax dollars

Staff EditorialHouston Chronicle12/5/2006

It's taken well over a decade. Other states have been doing it for years. But next month Texas will embark on an efficient plan to save as much as $430 million – and incalculable social costs – by averting unintended, Medicaid-paid pregnancies and many illnesses related to them.

Early in December, the federal government gave verbal approval to Texas ' request for a Medicaid waiver to give extensive health screenings and birth control to 1.5 million uninsured women. Under Texas ' five-year demonstration project, Medicaid will waive some of its ordinary eligibility rules.

In Texas , a single mother with two children can't make more than $308 a month and be eligible for Medicaid. That's about 14 percent of the federal poverty line. The new waiver allows women 18-44, who are at 185 percent of the FPL or less, to get a wide range of health screenings, family planning information and birth control.

The savings, both monetary and societal, should be enormous. In 2002, Medicaid paid for a staggering 52 percent of all Texas births. Each routine delivery cost about $9,000. Now consider this: In 2003, according to state officials, 45 percent of the documented 328,311 live births here were reported as unintended.

What if Texas Medicaid hadn't had to finance so many unplanned deliveries? What if the low-income mothers who gave birth to those unplanned infants had had counseling, information about birth spacing and contraception to keep their families the size they desired?

Finally, what if more Texans could be born into families — and a community — better able to care for them, emotionally, physically and financially?

This was the vision the 2005 Legislature pursued when it finally authorized the state to seek the Medicaid waiver. Lawmakers had tried to pass previous versions of the bill since 1993 without success. During that time, more than a dozen other states successfully took advantage of this expanded health care opportunity.

Now Texas will be on board, starting in January. It's strictly a demonstration project: The federal government will only renew it if Texas can satisfactorily answer a set of evaluating criteria. Among them is the $430 million question: "To what extent did the waiver reduce the number of unintended pregnancies resulting in live births for women who are at, or below, 185 percent of the poverty level?" *Now, does everyone realize that these cases are going to be worked in TIERS statewide? That any woman that applies for this benefit will then become a "TIERS client"- no matter her location in the State? By doing so, any case she has from that point forward- Food Stamps, Medicaid for her children- will then also be in TIERS. Which means they get to call the "call centers" for certification. In other words, if 50% of our cases locally have a woman in that age group who will qualify for the new program will then be in that convoluted system? Good luck with that.

This will be a special challenge, as the Texas waiver does not include coverage of teens or emergency contraception, both of which could help the state meet its savings goal. Texas also has to keep the project budget neutral — for Washington and Texas both.

Luckily, the federal government is arming the state for success, paying $9 for every $1 Texas spends. The feds are willing to invest this because it's well-established that higher levels of poverty correlate to lower insurance and higher levels of unintended pregnancy and poor health outcomes.

The equation shouldn't have taken Texas so many years to add up. By finally taking advantage of this chance to improve women's health care, however, the Legislature will save Texas millions in Medicaid costs. What can't be quantified will be the corresponding benefit: families with fewer health problems and with children who are wanted, cared for and better prepared for adulthood.

Group says kids were wrongly denied Medicaid

Group says kids were wrongly denied Medicaid

Elizabeth Pierson
Valley Freedom Newspapers
12/5/2006

AUSTIN — About 3,800 Texans, most of them children, were denied health care through Medicaid during the first three months of a new federal rule that requires proof of citizenship, according to an advocacy group for families.

Medicaid applicants since July 2006 have had to show proof they are U.S. citizens, whereas previously they had only to say they were citizens. The result has been that thousands of eligible citizens who qualify for Medicaid have been rejected because they can’t access their birth certificates in other states, or because state officials aren’t confirming their births in this one, said Anne Dunkelberg, associate director of the Austin-based Texas Center for Public Policy Priorities.

The data Dunkelberg received from the Texas Health and Human Services Commission do not confirm how many of the 3,800 rejected applications came from illegal immigrants. She can’t say with certainty that none were illegal immigrants, but experience tells her the number was at most very low, she said.

“After 20 years of policy work on health, we have a hard time getting just families of non-U.S. citizens to come in and try to qualify,” Dunkelberg said. “There have never been large numbers of people coming in and trying to fake out the Medicaid system.”

Medicaid is the federal-state health care program for low-income adults and children. It serves 1.9 million children in Texas , including more than 200,000 children in the Rio Grande Valley , as of May 2006, the latest data available.

Officials at the Texas Health and Human Services Commission are looking into the numbers brought to light by the CPPP, said spokesman Ted Hughes. “I don’t know for sure yet whether we have such a number, where we could definitively say, ‘These people were denied because they couldn’t prove citizenship,’” he said.

Dunkelberg said the data she received from the state did not separate the 3,800 people by geographic region. It did show that two-thirds were children and 200 were infants younger than 1 year old. State rules require speedy enrollment of qualified babies born in Texas . Dunkelberg thinks many who were denied would have qualified but couldn’t have their birth certificates sent promptly from another state, she said.

Others may be victims of recent downsizing of state eligibility workers. State workers who are left processing applications may not know they can search Texas ’ electronic database of birth certificates to confirm whether a child was born here, Dunkelberg said.

State workers routinely check the database, Hughes said. “It’s a standard practice to check that election database assuming there’s no other document offered,” he said.

Dunkelberg said the state has dealt well with the federal policy, for the most part. “I think they’ve done about as good a job that a state can do,” Dunkelberg said. “I think it’s an unfortunate federal policy that wasn’t well thought-out.”

Rant

It's been a while since I've "talked" about what's happening in the local offices.

I've noticed a few things lately. Namely, the first "wave" of people we lost (late last year, after the "pink emails" came out) were due to the layoff notice. Now, we are losing people who have TRIED to stick around but the workload and expectations have become too much.

Anyone, as I've said before, on the outside thinks that this job is easy. They think that all we do is push some paper around and give away all the taxpayer money while we sit back and laugh at all the money we make doing nothing.

Nothing, and I mean NOTHING could be further from the truth.

Sadly, the Agency that was DHS is gone- and the good work put out by said agency is gone as well. Quality is at an all time low. Let's not even talk about "timeliness". I'm sure if FNS came in and read a bunch of Food Stamp cases they'd find that most were probably wrong. Not because we all just don't care- but because we have people hired off the street, who have had 15% of the training that new hires USED to get and they are just flying by the seat of their pants. Tenured workers are getting loaded with more and more and more- and most of the TANF and it's just TOO. MUCH.

Clients are suffering. People are going WITHOUT basic needs because we don't have the staff to see anyone like we used to before. Our local office has 15% of the tenured workers we used to have. FIFTEEN PERCENT. The workload has NOT slowed down or stopped.

Sinking. Those who were trying to hold on are leaving now.

How scary.

Interesting

This was in comments, but I wanted to put on the blog so that more people might notice...any insight?

Actually, Albert is still lying. I did an open records request and have in
my possession the copy of the sole source justification dated 12/28/05 for over
1,000,000 dollars to the Texas Health Institute. I do not know why Al must
continue to lie, maybe because the truth in this case is not his friend.The sole
source justification essentially states--because we picked them to do it-- and
is unsigned.There is no RFP or award announcement that was ever made. It was a GIFT. A non-competitive retainer to pay this group to lobby for privatization.
The staff of this non-profit are mostly former staff to legislatos turned
lobbyist.BTW--the Chief Operating Officer at DSHS (Health) worked for Michael
Toomey(lobbyist for Philip Morris and Texans for Lawsuit Reform)and Maximus. In fact, he was in charge of the Maximus call-center project in California and came here to work during negotiations with Maximus for their contract for Texas call
centers at a 70,000 paycut. Interestingly, he worked here before as the CHIP
Bureau Chief, gave the CHIP eligibility contracts to Maximus, then went to
Maximus for a 75,000 raise. Cool.

Really, they must not know that at the Texas Hospital Association or they would surely have corrected their website. BTW--the Board of this group is mainly made up of THA members, including the THA president and several HOSPAC members. People who get what they want from Al Hawkins. Like Jim Springfield, THI Board Member, HOSPAC Board Member, Texas Association of Health Plans Board Member, and Perry Appointee to the Department of State Health Services Council. Also, as a matter of fact, the President of Valley Baptist Health System and beneficiary of an HHSC application to the Federal Government to restrict all non-emergency inpatient healthcare services for Medicaid recipients in Cameron County to his hospital system. This from Al-the big proponent of competition and choice?I have done my research really well. The stories will continue to be more incriminating--and accurate. There is alot of corruption needing to be exposed and it will continue to be until Al is gone, arrested, or exposed as dishonest and in collusion with lobbyists.

Happy Thanksgiving

Here's to all my fellow HHSC employees and everyone else who comes around this blog.....hope you have a very happy safe RELAXING Thanksgiving!

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Email to employees........Good Luck Williamson County

As you know, we have been evaluating the possibility of converting additional cases to TIERS. This will allow us to continue to move cases to a modern, upgraded system while work continues on improvements to the larger integrated eligibility system. Earlier this week, we completed the final readiness assessments and determined that we are ready to convert clients at our two Williamson County offices to the new computer system.

 

We selected Williamson County for this conversion because 25 percent of the clients in those offices already are on TIERS, and many of the workers have experience using the new system. ART workers will fill in at the Williamson County  offices while the rest of the staff receives training. In addition, ART workers will be on hand to assist with the transition.

 

The actual case conversion will take place over the weekend. As part of the conversion process, each case is examined to ensure that the benefits calculation in the new system matches the previous calculation to the penny. A team of 19 ART workers will review any cases that do not match exactly and resolve any issues before cutoff next month.

 

We’ll begin processing all new cases in TIERS on Monday. The transition should be seamless for clients, and state workers will continue to process all cases. The conversion will provide Williamson County clients with the ability to check the status of their case by phone or apply online.

 

If you have questions or concerns, please let your supervisor know. One of the keys to any computer conversion is to identify and address issues quickly. You are on the front lines, and we need and value your input to make the transition successful.

 

Thank you for all your hard work and your commitment to our clients.

 

Anne Heiligenstein

Deputy Executive Commissioner for Social Services

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Houston Chronicle Article.......leave your thoughts in the comments

Software glitch snarls state's checks for fraud
Audit's findings add to concerns of inadequate staffing at public assistance call centers

By JANET ELLIOTT

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A couple of posts down, the letter from Brent Connett is posted- and in comments, an anonymous commentor did some research (thanks!) and came up with the following:

When you google Brent Connett and see that he is a "policy analyst" for the
Texas Conservative Coalition Research Institute, it all is clear. One would
think that the definition of a conservative is a person who abhors waste of tax
dollars, yet here we have a "conservative" who will support a global profiteer
like Accenture even as tax dollars are drained away from the tax payers and from
the poor people we are supposed to be serving. It just shows how hypocritical
they are. We know Accenture is profiting even as they delay and incorrectly
providing federal benefits. It's just nuts.

I was checking some more on Brent Connett and see that his boss at the TCCRI is Tom Delay's indicted buddy John Colyandro. A little more looking and guess what? The TCCRI was instrumental in writing HB2292 for Arlene Wohlgemuth who was (I am not sure if she still is) on the board of directors for them. In 2003 she wrote a big old thank you to them for being so instrumental in providing the framework for 2292. So it makes sense that they get a little defensive when the facts get in the way of their little masterpiece.

I just thought that tidbit of info was interesting enough to post in case anyone missed the comments.

CPPP article

OfftheKuff posted yesterday about an article that the Center for Public Policy Priorities (CPPP) just released....."Updating and Outsourcing Enrollment Public Benefits: The Texas Experience".

 

Off the Kuff gives a good synopsis of it.......

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Albert Hawkins gives HIS spin on recent allegations and questions regarding his ethics....

This following was posted on the Employee Intranet on November 6th. Spin in Mr. Hawkins. Spin it.

Staying Focused on Our Work

Recent media stories have reported that gubernatorial candidate Chris Bell
has filed an ethics complaint against me. I want to assure you that any
allegations of corruption or misconduct are utterly without merit. Perhaps
the explanation of the circumstances below will establish some
context.

When I became HHSC Commissioner in 2003, I was asked to assume the post
held by the two previous HHSC Commissioners on the board of the Texas
Health Institute. The Texas Health Institute is a non-profit organization
devoted to health policy research. I considered the position to be
honorary and agreed. I think that it is important to note that I have
never attended a meeting of the board, never participated in any board action
and never exercised any fiduciary duty on behalf of the board or the
Institute. I have received no financial benefit of any kind and have no
financial ties to the Institute. Unfortunately, because I never considered
this post as anything other than honorary, I overlooked it when I filed my
personal financial statement with the state Ethics Commission. I have
submitted a corrected statement.

While the Institute has received a competively awarded contract
through the Department of State Health Services, I had no prior knowledge of or
involvement in the procurement or contracting decision at State Health
Services.

While this is clearly a personal distraction, I do not want it to detract
from the work you perform for the people of this state. I remain focused on
taking care of the business of this agency, the HHS enterprise and the State of
Texas .

Albert Hawkins — Nov. 6, 2006

Few new things of interest.....

Welch goes from comptroller's office to HHSC

Texas Weekly11/10/2006

Ken Welch, the funds management guru at the comptroller's office (the guy who actually does know where all the state's money is at any given time), left that agency for the Health and Human Services Commission, where he's the new budget and fiscal policy director.

HoustonChronicle.com
http://www.chron.com/disp/story.mpl/editorial/outlook/4312101.html
Letters: No horror story on CHIP

THE Chronicle's gratuitous insults directed at the state's effort to modernize its social service eligibility system and the company that won the bid to help with that process, Accenture, should be retracted(see the Oct. 29 editorial "Horror story").

Ever since the overhauling of the system began, the Texas StateEmployees Union has led the effort to derail the program and to undo the social service reforms passed by the 78th Legislature. Part of its strategy has involved tarring the reputation of the firm that is helping the state implement the new system. And now the Chronicle appears to have bought into the misguided efforts of TSEU, referring to Accenture as "Bermuda-based," as if where it was incorporated has any bearing on its work for the state *doesn't it? Why would taxpaying Texans want a company based in BERMUDA (because they ARE based in Bermuda) taking care of the poor in Texas? Why else, other than make a profit on the poor, would Accenture even WANT this job?*. In fact, Accenture employs 27,000 people domestically, including more than 3,000 in Texas , and pays federal and state taxes. The editorial tossed a vile canard at the company by calling it "aspin-off of disgraced Arthur Andersen," even though Accenture was incorporated more than a decade before Andersen's implosion. In covering the eligibility system and the Children's Health InsuranceProgram, the Chronicle pushes anecdotal accounts of processing errors as the main cause of declines in the size of CHIP, when, in fact, the following are the leading reasons for CHIP disenroll-ment (based on October 2006 data available on the Health and Human Service's Website):

"45 percent didn't return renewal packet" *packets they never got? packets they received and turned in more than once? Hmmmm.*
"19 percent exceeded CHIP income limits"
"17 percent were Medicaid eligible"
"11 percent didn't pay the renewal fee" *renewal fees that clients never got a notice about until AFTER the fee was due and the case was already closed?*
"5 percent aged out of the program

The Chronicle would do well to leave off the wild allegations and join an essential program to bring Texas ' social services into the 21stcentury.

BRENT CONNETT Austin *Do you work for Accenture?*

More great press....

Foster care privatization on hold
E-mail raises questions about whether one bidder for $500 million state deal had inside information.

TSEU Broadcast Email

TEXAS STATE EMPLOYEES UNION EMAIL BROADCAST UPDATE TO MEMBERS November 2, 2006

STOP ANOTHER HIGH-TECH BOONDOGGLE: PRIVATIZATION OF STATE AGENCY I.T. THREATENS TAX DOLLARS, AGENCY EFFICIENCY, JOBS

Last year the Texas Legislature passed HB 1516, which authorizes the consolidation and privatization of the information technology (IT)/data center departments of 27 state agencies.

The plan will merge much of the IT functions ofthe agencies into one or two data centers, one of which must be located in SanAngelo, and then contract out operation of the data center(s) to a private contractor. This plan will be yet another high-tech boondoggle, like the Accenture/eligibility services and the Convergys/AccessHR projects that have wasted vast sums of money and reduced the ability of state agencies to fulfill their missions. Over 500 agency positions are due to be eliminated or transferred to a contractor under this proposal. A list of the agencies to be affected follows, below the list of DIR Board members. According to the current schedule, a contractor is to be selected in December2006. This date would make it much for difficult for the Texas Legislature to look at this plan again. Many suspect that the date was chosen to make this plan a "done deal" before the Legislature has a chance to reconsider it.

TSEU believes that our recent experience with high-tech outsourcing contracts should be a warning, and that this plan should be cancelled. At a bare minimum, the speeded-up implementation should be slowed down to allow the Texas Legislatureto reconsider the plan. Several legislators have expressed these concerns, and have suggested that, at a minimum the implementation schedule should be slowed downto give the Texas Legislature a chance to look at it again. Rep. Jim Pitts, of Waxahachie, is the chair of the House Appropriations Committee.

He would have the power to call for a slowdown in the roll-out of this plan.

TIME IS CRITICAL: DIR is scheduled to select a contractor in December.

TAKE ACTION TODAY to save tax dollars, quality services, and state jobs.

Slow down the headlong rush into another boondoggle that will put millions of tax dollars, and the operating efficiency of 27 state agencies, at risk.

1. Get involved. Contact Mike Gross at TSEU (mgross@cwa-tseu.org, or (512)448-4225)

2. Get state agency IT employees involved. Do you know a state worker in anagency IT/Data Services department? Have them contact TSEU to get involved

3. Call your state legislator ASAP. Ask him/her to: A. Contact Rep. Jim Pitts, chair of the House Appropriations Committee, and askhim to call for a delay in the roll-out of this plan. B. Contact Governor Perry. Ask him to direct that the plan be delayed. C. Contact members of the DIR Board and ask them to call for a more thorough analysis of this project, and a delay in the roll-out schedule to allow legislative review.

For information on how to contact your legislator, go this link on the TSEUwebsite: http://www.cwa-tseu.org/hhsc_fdstmp_contact.html

DIR BOARD MEMBERS
William L. Transier, DIR Board Chair Co-Chief Executive Officer, DirectorEndeavour International Corporation, HoustonTerm: 02/01/2003 to 02/01/2009, Appointed by the Governor

The Honorable Charles Bacarisse Harris County District ClerkHarris County, Houston Term: 07/17/2006 to 02/01/2007, Appointed by the Governor

M. Adam Mahmood, Ph.D.Professor of Computer Information Systems & Business AdministrationThe University of Texas at El Paso, El PasoTerm: 02/01/2001 to 02/01/2007, Appointed by the Governor

The Honorable Debra McCartt MayorCity of AmarilloTerm: 02/01/2006 to 02/01/2011, Appointed by the Governor

P. Keith Morrow CIO & Vice President of Information Systems 7-Eleven, Inc., DallasTerm: 03/07/2005 to 02/01/2011, Appointed by the Governor

Cliff P. MountainManaging MemberAccent Capital, LLC, Austin Term: 02/01/2003 to 02/01/2009, Appointed by the Governor

Bill Wachel Principal/Owner The Wachel Group, DallasTerm: 02/01/2003 to 02/01/2009, Appointed by the Governor

Robert L. Cook Executive Director Texas Parks and Wildlife DepartmentTerm: 02/01/2005 to 02/01/2007, Ex officio

Brad Livingston Executive Director Texas Department of Criminal JusticeTerm: 02/01/2005 to 02/01/2007, Ex officio

Adam Jones Associate Commissioner for Operations and Fiscal Management Texas Education AgencyTerm: 02/01/2005 to 02/01/2007, Ex officio

AGENCIES TO BE AFFECTED

Department of Criminal Justice
Department of Information Services
Department of Licensing and Regulation
Department of Public SafetyGeneral Land OfficeDept. of Aging and Disability Services (DADS)Dept. of Assistive and Rehabilitative Services (DARS)
Dept. of Family and Protective Services (DFPS)
Dept. of State Health Services (DSHS)
Health and Human Services Commission (HHSC)
Office the Attorney General
Public Utility Commission
Railroad Commission
Secretary of State Alcoholic Beverage Commission
Building and Procurement Commission
Commission on Environmental Quality
Dept. of AgricultureDept. of Insurance
Dept. of Transportation
Texas Education Agency Higher Education
Coordinating Board Parks and Wildlife
Library and Archives Commission
Workforce Commission
Youth Commission
Water Development Board

Today's News

Bell files ethics complaint against Perry appointee