Black hole

Fate of 144 missing social service enrollment forms should mark a turning point for the state

By Editorial Board
Houston Chronicle

Not even the fiercest critics of Texas' social service privatization scheme envisioned it. For the past three months, according to Chronicle reporter Polly Ross Hughes, dozens of private health and financial forms faxed to the Health and Human Services Commission belched forth instead into the Take Care Store warehouse in Seattle.

No critic could predict the snafu, and no lawmaker - even those who pushed the disastrous privatizing of benefits screening - would wish it. A wrongly printed form, it turns out, may have given applicants the wrong fax number.

Knowing medical confidentiality laws, Seattle warehouse employee Shaun Peck promptly shredded many of the Texas documents he got. On May 9, an associate of Peck's company made a call and sent two e-mails to the Health and Human Services Commission to report the mix-up.

Unbelievably, no one there took action. Three weeks later, the Seattle warehouse fax machine was still spitting out Texas application forms.

The so-called "black hole" episode just adds to the damage already inflicted by Accenture, the new screening contractor that wrongly disenrolled numerous Texas children from health insurance for the working poor. The incidents worsen the effect of new enrollment policies, which make qualifying for that insurance harder.

The cumulative result: Since November 2005, Children's Medicaid and Children's Health Insurance enrollments have dropped by 128,000. The losers are not just the children. They're the citizens whose county taxes needlessly cover stratospheric emergency room fees for children who lacked access to routine visits to the doctor.

HHSC has shown chagrin over the latest mishap. Official Anne Heiligenstein pledged the agency will try to make "whole" those applicants affected when their paperwork vanished in Seattle. It will be hard, though, to establish who was affected, since so many papers were shredded.

There are some other signs HHSC grasps the magnitude of its privatization mess. The agency recently held a Houston enrollment fair to help working-poor families sign up for CHIP. HHSC now consults child advocates on how to improve enrollment.

But there's serious repair work to do. A coalition of child advocates, state hospitals and health plan organizers has devised a responsible proposal.

HHSC, they said, needs to:

* Stop further CHIP disenrollments until Accenture meets basic performance levels.

* Request that the 2007 Legislature reinstate 12-month eligibility for CHIP/Medicaid
enrollment. The current six-month rule churns out more paperwork for the state and dissuades some eligible families from re-upping.

*Suspend roll-out of the "integrated eligibility system" - which would expand the same privatized screening already in place for CHIP to other programs, including Medicaid and food stamps.

In short, no one else should be exposed to this privatization scheme until it works. Too many young Texans, and too many individuals' tax dollars, have already been dispatched into the void.