Needy Texans' applications faxed into a 'black hole'

Date: June 02, 2006

Misprinted form leads many to send info meant for the state to a puzzled company in Seattle
By Polly Ross Hughes
Houston Chronicle AUSTIN -

Three months ago, dozens of documents from Texas containing highly confidential financial and health information began arriving over a fax machine at a Seattle warehouse.

Shaun Peck, a clerk at the warehouse, searched through the mysterious documents - revealing Social Security numbers, medical evaluations, income tax forms and pay stubs - and wondered why they kept coming and where they should be going instead.

Back in Texas, frustrated elderly, disabled and poor people have long wondered why they sent applications for benefits to the state only to be told they never arrived.

Peck didn't know it, but he had discovered the much-rumored "black hole"eating up Texas applications for Medicaid, the Children's Health Insurance Program, food stamps and Temporary Assistance for Needy Families.

The snafu is just the latest example of confusion during the state's transition this year from public to private screening of health and welfare applicants under an $899 million contract with outsourcing giant Accenture LLP.

At least 144 of the faxes, and possibly many more destroyed in a shredder or manually disconnected, were intended for the Texas Health and Human Services Commission or its private contractor in Midland but landed instead at the Seattle warehouse.

But, despite a call and two e-mails from Seattle to the state agency more than three weeks ago, misdirected faxes still arrived at the Seattle warehouse this week from applicants apparently clueless that a problem existed.

"I have not heard anything back from them. Nothing at all," said Cindy Sandford of Seattle, who alerted Texas officials May 9 about the wayward faxes at the request of the warehouse manager.

It wasn't until Wednesday - the day the Houston Chronicle raised questions - that the agency and its private contractor actively began checking into and fixing the mistake.

"It is unfortunate. It is an error on our part that it did not go further in that regard," HHSC spokeswoman Gail Randall said Thursday, referring to the agency's lack of greater follow-through early on. "I know they've been working on this since yesterday."

However, the mystery of the bad fax number is finally unraveling. It turns out a Midland call center run by Accenture mistakenly listed the wrong fax number on a document sent to a state agency handling benefits for the elderly and disabled.

Wrong number

Under its Texas Access Alliance letterhead, Accenture and its subcontractors listed the call center's Midland address, the state's 2-1-1 hot line for needy Texans and two fax numbers.
If information was faxed to the first one, 877-HHSC-TEX, no problem. But if it was sent to the second fax number, 800-447-2839, private documents landed in Peck's hands at the Take Care Store warehouse in Seattle.

"There was a black hole in Seattle, Washington," Peck told the Chronicle.

"People send us check stubs. They send us bills. We've gotten letters from people asking why they haven't been approved for food stamps yet. They were faxing in their personal information."

Exposure of clients' identities and personal information raises questions about state and federal privacy laws, said Celia Hagert, policy analyst at the Center for Public Policy Priorities, an Austin-based think tank advocating for low-income Texans.

Federal law and regulations generally require any state public assistance agency to safeguard personal information against unauthorized use or disclosure. This includes such things as names, addresses, amount of assistance, wages, medical data and Social Security numbers.

The wrong-number snafu comes amid widespread complaints about contract performance at Accenture's private call center in Midland, plunging enrollments for children's health insurance programs and complaints of lost applications for food stamps and other programs handled at the center.

"I think this is a screw-up. Everything that can go wrong with this transition (from state to private benefit screeners) has gone wrong," said Anne Dunkelberg, a health policy analyst at the Austin think tank. "This is something we didn't even dream of. Who knows what happened to these people's benefits?"

Peck said he was shocked when the faxes with Texas area codes began arriving and was perplexed about what to do. Attempts to call the return fax numbers often turned up large office and print centers that couldn't identify which customer had sent the fax, he said.

He isn't sure how many benefit applications and supporting documents have arrived at the store warehouse, roughly guessing a dozen a week or perhaps 144 in three months.

But, they are still arriving, including a 10-page fax seeking children's health insurance and food stamps late last week with copies of a Social Security card and bank statement, said Sandford, who manages the Take Care Store's Yellow Pages account and agreed to help the warehouse get to the bottom of the misdirected faxes.

Wrong number removed

Commission spokeswoman Randall said Thursday that the incorrect fax number has now been removed from the private contractor's memos to the Department of Aging and Disability Services and there is no sign it was ever printed on letters to clients. It is possible, however, that people have inadvertently misdialed since 877 and 800 are both toll-free prefixes, she added.

Sandford, frustrated when Texas faxes kept coming to Seattle, contacted Accenture's Texas Access Alliance directly on May 25 and sent the private contractors a copy of their cover sheet containing the erroneous fax number.

"Please do not ignore this fax," she began. "Please change your cover sheet immediately and notify everyone who has a copy of this incorrect information."

Accenture issued a statement to the Chronicle on Thursday. It said as soon as it became aware that faxes were going to a wrong number, it began a thorough investigation leading to actions that should stop faxes from landing in Seattle.

"We found out about it yesterday," said the company's spokeswoman, Jill Angelo of Public Strategies Inc. in Austin. The company also noted that 215,000 other faxes were sent to the correct number this year.

----------------NOW READ THIS------------------------------

PROOF THAT HHSC WAS AWARE OF THIS PROBLEM BACK IN JANUARY, NOT "YESTERDAY"

-----Original Message-----
From: O'Brien,Taylor
Sent: Wednesday, January 04, 2006 8:35 AM
To: O'Brien,Taylor; Adame,Mary Margaret; Alvarez,Joe T; Arbuckle,Bob;
Barker,Shaun; Brown,Patricia Ann; Cox,Kathy; Doan,Mary; Forcade,Mari; Heflin,Robert; Knoll,Debbie; Maxie,Carolyn F; Moser,Grace L; Semien,Stephanie Ann; Wallace,Jerry; Cleveland,James N; Wade,Jenice L; Gamboa,Ramon
Cc: Wade,Charolette Ann; Barker,Shaun; Jumper,Kirsten; Forcade,Mari;
Wallace,Jerry; Andrews,Kemia Rae; Armstrong,Gayle; Balthazar,Ellen L; Benson,Janet Lea; Creamer,Teri L; Escarciga,Angie; Haney,Shenaz; Leschber,Susan; Osuna,Mary E; Rios,Brenda; Schneider,Debra; Speed,Jan; Narro,Benito M; Smith,Tammerriol J; Torres,Mando; Rubio,Lily; Vera,Cynthia I; Rodriguez,Martha; Jumper,Kirsten; Dingman,Kari; Barker,Shaun; Knoll,Debbie
Subject: Urgent - Additional Information / Important Reminder --
Address and Fax Number for Kids Meds Apps

Good morning all -
Please share this information immediately with all local office staff.
Fax one Kids Med Application at a time.


Important Information to Remember:
We must remember that these faxes are received on a "fax server" and are not printed out at the "receiving fax". Instead, each fax job received contains
all information from that specific transmission. Therefore, each fax
transmission must consist of one application only.
Thanks for your assistance
Taylor O'Brien
State Operations - Office of Eligibility Services Health and Human Services Commission
office: 512.206.5658 cell: 512.297.6211
pager: taylor1.obrien@my2way.com <mailto:taylor1.obrien@my2way.com>


-----Original Message-----
From: O'Brien,Taylor
Sent: Tuesday, January 03, 2006 10:39 AM
To: O'Brien,Taylor; Adame,Mary Margaret; Alvarez,Joe T;
Arbuckle,Bob; Barker,Shaun; Brown,Patricia Ann; Cox,Kathy; Doan,Mary;
Forcade,Mari; Heflin,Robert; Knoll,Debbie; Maxie,Carolyn F; Moser,Grace L;
Semien,Stephanie Ann; Wallace,Jerry
Cc: Wade,Charolette Ann; Barker,Shaun; Jumper,Kirsten;
Forcade,Mari; Wallace,Jerry; Andrews,Kemia Rae; Armstrong,Gayle;
Balthazar,Ellen L; Benson,Janet Lea; Creamer,Teri L; Escarciga,Angie;
Haney,Shenaz; Leschber,Susan; Osuna,Mary E; Rios,Brenda; White,Donald;
Schneider,Debra; Speed,Jan
Subject: Updated Information -- Address and Fax Number for
Kids Meds Apps
Importance: High
Good morning all - we have received clarification on the fax number
for Kids Meds Apps

FAX number: 1-877-542-5951

Good afternoon all -
Below is the address to send Kids Meds apps to if you choose
to mail instead of fax.