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.
Wednesday, February 28, 2007
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.
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.
Thursday, February 15, 2007
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.
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.
Sunday, January 28, 2007
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?
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.
Friday, January 26, 2007
TSEU Broadcast Update 01/26/07
TEXAS STATE EMPLOYEES UNION
EMAIL BROADCAST UPDATE TO MEMBERS January 26, 2007
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.
$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.
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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Tuesday, January 23, 2007
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.
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:
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?
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.
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.
Friday, January 19, 2007
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
Finding fabulous fares is fun.
Let Yahoo! FareChase search your favorite travel sites to find flight and hotel bargains.
Finding fabulous fares is fun.
Let Yahoo! FareChase search your favorite travel sites to find flight and hotel bargains.
Monday, January 15, 2007
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, December 30, 2006
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
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
Friday, December 29, 2006
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:
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 AndersonLet 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
Saturday, December 23, 2006
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.
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.
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.
Thursday, December 21, 2006
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
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
Executive Commissioner
Date: Dec. 21, 2006
Contact: Stephanie Goodman or Ted Hughes, (512) 424-6951
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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Saturday, December 16, 2006
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.
Thursday, December 14, 2006
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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Friday, December 08, 2006
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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