Sunday, August 13, 2006

Looking for a guest blogger....

As you may already know from the time between my postings, I do not have time anymore! I am looking for a guest blogger to post to this site. If interested, please contact me via hhscsurvivalist@yahoo.com.

Looking for serious activists! I need help!

Celia Hagert: Want welfare? Don't count on Texas' new, inadequately staffed system for help

08:17 AM CDT on Thursday, August 3, 2006

Most of us have never had to think about how families in need sign up for public help such as health care and food stamps. Right now, however, an important debate is brewing in the Texas Capitol over the question: How should we sign up people for help?

Since the state's new system for determining eligibility was launched six months ago, more than 100,000 kids have lost their health insurance and the state has left thousands of families without food.

Two years ago, the Legislature told the Health and Human Services Commission to find a way to deliver help with less money. Lured by the private sector's promise of savings, the commission signed a five-year, $899 million contract with the Texas Access Alliance, a consortium of private companies anchored by Accenture LLP.

Under the contract, the private sector promised to modernize the system by using call centers and the Internet. The state told 2,000 of its employees they were losing their jobs and launched the new system in Travis and Hays counties.

The commission claimed that a modernized system run by private companies would reduce workload for staff and improve services to clients. Clients would benefit from state-of-the-art technology, and taxpayers would save hundreds of millions of dollars. This sounds good in theory, but the reality has been a disaster.

Public assistance has become harder to get, and claimed savings never materialized. In May, the state postponed extending the new system and begged a thousand state workers to stay on the job.

We certainly shouldn't go forward with the plan, but we probably shouldn't go back. We need a different direction altogether.

It turns out that signing up for public assistance is not like buying movie tickets on Fandango.

For many reasons, including a desire to hold down costs, the state has a complicated set of rules
about who is entitled to what. It also must verify eligibility.

No one opposes the vision of a state-of-the-art system that increases access to services while saving money. Both are worthy goals. But the state erroneously assumed that poorly trained, low-wage workers could do the jobs of highly trained, higher-wage state employees. In fact, the savings promised by the plan's backers came not from more efficient ways to help clients, but by cutting staff and paying less.

The state's old way of doing things also meant running this complicated system with too few people. Despite growing numbers of Texans in need, the Legislature cut eligibility staff by 40 percent between 1997 and 2004. This doubled workload and compromised services. Disruptions in benefits were common. No one was satisfied with the old way of doing things, which looks good only by comparison.

Whether you get help now might just as well be determined by rolling dice. It is morally reckless to gamble with the well-being of the 4 million Texans who depend on public services – mostly children, the elderly and people with disabilities.

No matter how the state divides duties between the public and private sectors, it needs enough trained staff. As citizens who want to ensure that those who need help get help, we have to be willing to pay for it.

Celia Hagert is a senior policy analyst at the Center for Public Policy Priorities in Austin. Her e-mail address is hagert @cppp.org

States Stumble Privatizing Social Services

Saturday, August 05, 2006

By Christine Vestal -

It sounds like a good idea: Replace state employees with a high-tech contractor to more efficiently screen thousands of applications for state support, and save taxpayers millions.

- That's what Texas and Indiana policy-makers thought. But early results of a privately run social services project in Texas and troubles with the bidding process in Indiana have caused both states to put their bold privatization plans on hold. Last year, Texas chose Bermuda-based high-tech consulting firm Accenture to run the entire eligibility process for Medicaid, food stamps, Temporary Aid for Needy Families (TANF), long-term care and Children's Health Insurance Program (CHIP). In January, the state launched a pilot privatization program in Travis and Hayes counties near Austin.The plan was to expand it county-by-county, with rollout completed by December 2006. But computer glitches and procedural problems cropped up immediately.

Some 27,000 kids in the pilot program inadvertently were dropped from health insurance coverage, and poor, elderly and handicapped applicants routinely were put on hold for more than 20 minutes, with more than half of all callers hanging up. Thousands waited longer than federal rules permit to find out whether they qualified for urgently needed state assistance, according to state officials.

And in a highly publicized gaffe, Accenture employees mistakenly faxed more than a hundred long-term care applications containing Social Security numbers and sensitive medical information to a Seattle warehouse.

Texas officials are optimistic they can correct the problems and eventually expand the project. But for now, expansion is off indefinitely.

"We recognize that modernizing a system of this size and complexity is never easy," Texas Health & Human Services Commissioner Albert 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.

"The pilot program will continue, and most problems already have been corrected, says agency spokeswoman Stephanie Goodman. The 27,000 kids scheduled to lose CHIP coverage were reinstated before they lost service, telephone wait times have been cut to less than two minutes and state workers have taken over processing new applications to allow Accenture to catch up on its backlog, she said.

The state will cut Accenture's contract fee by approximately $50 million because of work not completed between January and June, Goodman said.

Meanwhile in Indiana, Gov. Mitch Daniels (R) put the brakes on his state's search for a social services contractor amid charges of favoritism.

Daniels took over decision-making authority for a proposed 10-year, $1 billion contract last month to quell accusations of preferential treatment by the state's Health and Human Services chief, a former employee of Dallas-based Affiliated Computer Systems, one of the bidding companies.

Indiana state employees complain that Daniels's call for privatization jeopardizes their futures, despite his promise that no state jobs will be eliminated. And advocates for the poor say the secret bidding process, initiated by executive order, leaves no opportunity for public comment and undermines public accountability.

Texas Gov. Rick Perry (R), up for re-election this year, has heard similar complaints.

Independent gubernatorial candidate and state comptroller Carol Keeton Strayhorn has called for a probe of Texas' privatization contract, and Democratic gubernatorial hopeful Chris Bell has joined a chorus of critics demanding a return to public welfare screening.

Since 1995, when the federal government revamped most welfare programs, states have been free to hire private firms to administer social service block grants and entitlement programs as a cost-cutting measure. But until now, states have given businesses only a limited role, such as providing debit cards for food stamps and developing computer systems to track welfare applications.

Advocates for the poor worry that putting too much responsibility in the hands of profit-motivated companies could endanger the vulnerable people the programs are intended to help.

Federal rules require state employees to make final decisions for some entitlement programs, but letting a private contractor make the initial eligibility cut could have a profound effect on welfare outcomes, they say.

Supporters of privatization argue that antiquated state eligibility systems no longer are cost-effective, and say improvements best can be accomplished by a high-tech, profit-motivated contractor with incentives to operate efficiently.

Texas policy-makers say their plan not only will save taxpayer dollars but modernize the social services eligibility process, allowing people to apply for support over the Internet, by fax, through call centers and at self-serve kiosks. Currently social services applicants must travel to their local social service offices during business hours and wait in line to talk to a caseworker.

Daniels, who left his post as Bush's top budget advisor to run for governor in 2003, grabbed headlines this year when he privatized an Indiana toll road, granting a 75-year lease to a foreign consortium for $3.8 billion.

Most agree that the state welfare eligibility process - with long lines, limited office hours and error rates in the 25 percent rage -- needs improvement. But advocates for the poor argue that the problems result from underfunding and understaffing, not lack of expertise.

"The only people with experience in the complex and sensitive work of determining welfare eligibility are state workers. Why would you hire a high-tech company to do that?" asks Stacey Dean of the Center on Budget and Policy Priorities, an advocacy group for the poor.

Other privatization critics argue that transferring public services to private companies has been plagued by quality-of-service problems for the last two decades. The concept makes sense and state policy-makers always are eager to save money, but in practice, privatization has failed more than it has succeeded, says Mildred Warner, a privatization expert at Cornell University.

In an analysis of privatization of state and local services over the last 20 years, Warner concluded that the majority of projects failed because of deteriorating quality of service. And in more than half the cases, the projects did not save taxpayer dollars, she said.

Send your comments on this story to

letters@stateline.orgletters at stateline dot org . Selected reader feedback will be posted in the Letters to the Editor section. Source: Contact Christine Vestal at

cvestal@stateline.orgcvestal at stateline dot org - © 2006 stateline.org

Good, tenured, caseworkers are now in tears!

Our workers, with years of experience and great stats, are now in tears over their jobs! They can no longer function with the stress at the offices caused by this TIERS boondoggle!

This month, supervisors were given the directive to 'do something about the leadtime' which was running at 28 days in some of the offices, more than 30 in others. Lead time is the time between when the application is actually received and the date we can get them scheduled. Not scheduled timely? Delinquent.

Hello? Is anyone home? Why, do they suppose the lead time is so high? Could it be because we are SHORT STAFFED?! So, the supervisors in one (possibly more) office decided that each worker- temps included - would get a stack of 40 1010's- some reviews, some pure apps- they get to figure out how and when those will get seen- whether it be on their workday- or after hours, or in between regular appts.....what? How the hell does one do that, when they are already overloaded?

So, because they did that- the 'lead time' looks like it's being 'taken care of'. That's just "fudging" the numbers, something the heads at HHSC seem to be very good at. But hey! Problem solved, right?

Workers are now giving up their family and personal time, just to work extra hours, weekends included, so they can try to stay on top of their jobs. NOT WORKING! There's still too much work to be done (DAMN YOU, TAA, ACCENTURE AND HHSC!)

This is occurring Statewide and is taking a serious toll....we have workers out on sick leave all the time, workers in tears when it just gets to be too much (which is everyday), workers who have always been dedicated to their jobs are now wanting to leave. After all, when you compare your health to the job...what do you think is more important!

Worker tells of training problems with state contractor

Accenture group failed to give her knowledge she needed, she claims

By Corrie MacLaggan
AMERICAN-STATESMAN STAFFFriday, August 11, 2006

When Amanda Morris started working at a private office that enrolls Texans in public assistance, she was trained to enter information into a computer about people who want to apply for benefits.

But she immediately found that most cases didn't involve signups. Clients needed to renew benefits, make changes to their accounts or update their address.

And she didn't know how to do that.

"I trained for three weeks and was put onto the floor with about 2 percent knowledge of how to do my job," said Morris, 21, who works for a temp agency and has been on assignment since March with the San Antonio office of state contractor Texas Access Alliance.

Problems with worker training are one of the reasons the state has indefinitely delayed statewide rollout of that contractor's new call-in system to enroll Texans in food stamps, Medicaid and Temporary Assistance for Needy Families.

Morris' account sheds more light on the problems. A former Texas Access Alliance employee in San Antonio, who asked that her name not be used because it might affect her current job, said Morris' story matches her experience.

The state is paying more than $800 million over five years to the Texas Access Alliance, a consortium of private companies led by Accenture LLP, for the system, which has been in a pilot stage in Travis and Hays counties since January. The privatization was intended to save the state money.

Since the contractor took over, benefits recipients have reported getting inexplicably dropped from public assistance, talking to customer service representatives who couldn't answer their questions and being asked for information they'd already provided.

In response, the private group has retrained its call center employees and overhauled training for new hires, spokeswoman Mindy Brown said this week. Texas Access Alliance "has turned a major corner," she said.

"Our training is intensive and depends on each employee's role," Brown said. "If an employee feels they need additional training to do their job correctly, all they need to do is to speak with their supervisor and additional instruction can be arranged."

Stephanie Goodman, a spokeswoman for the Texas Health and Human Services Commission, said the reports of improved quality is a positive sign but that the state has not yet evaluated that. "We'll measure the success of the training by how well the call-center representatives
respond to client questions and concerns," she said.

Morris, for one, said training sessions she's attended recently were just as ineffective as the original.

She admits she's bitter about her job: her boyfriend was one of several dozen people laid off from the San Antonio office earlier this summer, and she wishes she earned more than her $12-per-hour salary. But she says that as a former recipient of food stamps and Medicaid, she's concerned about the experiences of the 3 million Texans who receive public assistance.

"You have no idea how (messed) up this is getting," said Morris, who works with applications and renewals but does not take calls. "There's misorganization regarding documents. Information gets linked incorrectly or lost altogether."

For example, Morris said she recently found that a public assistance recipient had submitted an address change. But an employee flagged the file to indicate a change of state residency, instead. And another employee who handled the case didn't catch the error. So the family was sent a letter asking about their Texas residency, Morris said.

Morris attributes problems like this to a lack of training and co-workers who are "purposely lazy." In May, Health and Human Services Executive Commissioner Albert Hawkins announced that no new applications will be processed in the privately run San Antonio call center until the contractor improves.

Alton Martin, CEO of Customer Operations Performance Center, Inc., a New York-based call-center consultant, said the training problems aren't surprising.

When he asks call-center representatives at various sites whether they felt ready for their job, "about half the time they'll say training was really bad or nonexistent or not appropriate to the task."

Martin, whose company is not working with the Texas contract but has worked with Accenture on other projects, said that call center quality issues often stem from the contract.

"Maybe the state wasn't rigorous enough," said Martin, who works in Austin. "Lots of times people want to throw the vendor under the bus . . . (But) if you want a fast car, ask for a fast car."

Goodman, though, said the state has set a high bar and is doing its own quality checks.

The private call centers — located in San Antonio, Austin, Midland and Athens — are expected to replace some state offices where Texans sign up for public assistance. The new system gives Texans more ways to apply for public assistance — mail, fax, Internet and phone — as well as in person.

Mary Katherine Stout of the Texas Public Policy Foundation, which advocates for limited government, said those who argue for the state to resume public assistance enrollment overlook problems with the outdated state system.

She recently visited a state benefits office in Fort Worth and found that despite having appointments, Texans were waiting hours. One public assistance recipient told Stout she has a rule of thumb for visiting the state office: pack a lunch.

cmaclaggan@statesman.com; 445-3548.

Wait Taken Out of Welfare, But Critics Just Aren't Happy

Note from Blogger: I have read articles by this twit in the past. She went into the office with her opinion already formed and failed to ask the right questions.....Like, maybe, why they had to wait so long? Maybe because we no longer have the staff available to do the job?

Visit to welfare field office demonstrates why change is desperately needed

By Mary Katherine Stout
Published: 07-31-06

Six months ago the state launched an ambitious plan to overhaul the way applications for government assistance are handled. But the plan has taken a pummeling at the hands of the state employees union and advocates for bigger government; they have relished the bad news and missteps dominating news reports of the new system.

Like the blacksmiths of a previous age facing the advent of the automobile, critics are calling for it to end before it can begin. (It's already begun - and it does not work!)

By making use of modern tools – such as the Internet and phone that have become standard conveniences today – the new system is designed to control costs, increase efficiency and greatly improve client accessibility. Rather than relying on in-person interviews in a field office with limited hours of operation, the new system allows applicants extended hours by phone, and 24-hour access online.

On July 10th, 30 House members sent Texas Health and Human Services Commissioner Albert Hawkins a letter, expressing support for the new system and its promise to “bring administration of human services programs in Texas into the 21st century.”

Two days later, 60 other members of the Texas House sent an entirely different letter to Commissioner Hawkins urging him to cancel the state’s contract for this new, privatized health and human services eligibility system. They asked him to “commit the remaining resources to rebuild the human services eligibility system that, as little as two years ago, was among the best in the country.”

The contrast in positions could not be more stark.

One side claims the old way is best and should be rebuilt, while the other believes privatization will modernize the system.

Of course, the old system – this “best in the country” system – is still largely intact and serves most recipients of the state’s health and human services programs, since the new system isn’t available statewide. (NO, it is it not intact! Most offices are operating at less than 50% staffing, and that's quoting a high percentage. Some offices don't even have stafff anymore!)

And as critics pan the new system, they seem to hold a romanticized notion of the old ways. Perhaps they should consider what the “old” system looks like.

I drove to a field office outside the “pilot” area to see this old system in action.

I sat for two hours in a room with dozens of people, many of whom arrived long before I did, and would remain long after I left.

One man had been in the same office the day before, only to be told that his application couldn’t be finished before the end of the work day, and he would need to return the next day. On day two he arrived 50 minutes early for an 11 o’clock appointment, but was not seen until after 4 p.m.

As one woman waited for more than three hours for her appointment, she said the rule of thumb for these appointments was to “pack a lunch.” Not long after, she learned her name had been called while stepping outside, missing her “appointment.” She was instructed to return the next day, despite protests she had other state-required appointments to keep and difficulty in finding transportation.

Considering her instructions to return the next day, perhaps she will also begin taking a sleeping bag.

Waiting clients were called for their appointments by name, without regard to privacy. (That's not nearly as bad as TAA mailing a client someone else's COMPLETED application! Or providing a fax number to a warehouse in Seattle!)

We sat in a waiting room with white walls and no reading material; no information on finding a job, getting a degree, locating community resources, getting parenting guidance or child care. Some of those waiting attended to their children. Many talked on their cellular phones.

Most people spent hours just waiting – unproductively.

Perhaps I went to the one office in the state, on the one day of the year, for the two hour period, where things were just terribly wrong, but I doubt it.

While many would argue this is the result of short-staffed offices, the reality is that there is no excuse for a horse-and-buggy system when considering the technology now available.
A system that treats people with such lack of dignity, and with no respect for their time, is simply indefensible. (Wouldn't have to have been that way had that office had enough workers to do the job!)

At one time many of the new system’s critics would have agreed. For years they were quoted in newspapers pointing to the inconvenience of going to a field office for an in-person interview, highlighting the virtues of one-stop shopping, and demanding change based on reports of dissatisfaction. Dissatisfaction with the system they now claim is superior to all others.
Reports of real problems in the new system cannot be taken lightly, and taxpayers should demand efficiency for every tax dollar. But calls to end the rollout and return to the old way are simply insufficient.

To ignore the opportunity to deliver services more efficiently for taxpayers and more conveniently for the recipients, despite having the resources to do so, is unacceptable.

The state must move forward using well-established technologies that deliver better efficiency for taxpayers, along with greater convenience for the recipients of state benefits. (Should we do this at the expense of the client's need for their benefits? New technology would have been welcomed by state workers years ago....why did we have to enable TAA / Accenture to profit from the "new technology plan"???? Now they are making money, our state workers are killing themselves to get the job done and our clients are doing without benefits!)

Mary Katherine Stout is the director of the Center for Health Care Policy Studies at the Texas Public Policy Foundation, a non-profit research institute based in Austin.

Letter to Austin American Statesman & reply

DEAR SIRS:

I AM A DISABLED TEXAN, UNDER THE AGE OF 65, YET STILL RECEIVE BENEFITS FROM THE STATE OF TEXAS IN THE QMB AND FOOD STAMP PROGRAM. BECAUSE I AM DISABLED, IT IS VERY HARD FOR ME TO TAKE THE REQUIRED TIME TO UTILIZE THE NEW AND "IMPROVED" PROGRAM. I HAVE HAD MAJOR NECK AND BACK SURGERY THIS YEAR ALONE, WITH SERIOUS LIFE THREATENING COMPLICATIONS WITH THE BACK SURGERY I AM STILL TRYING TO RECUPERATE FROM. I DO NOT SEE WHAT WAS WRONG WITH THE SYSTEM THAT IS TRIED AND TRUE. WHY FIX SOMETHING THAT IS NOT BROKEN?

SINCERELY,

xxxxxxxxxxxxxxxxxxx

*****************************************

Thank you for your insight. I'm sorry to hear about your difficult situation. Sounds like for you things would have been better the old way. Thanks again for writing.

Sincerely,
Corrie MacLagganHealth and human services reporter
Austin American-Statesman
305 S. Congress Ave.Austin, TX 78704
512.445.3548
FOR IMMEDIATE RELEASE FROM TEXAS STATE EMPLOYEES UNION
July 18, 2006 CONTACT WILL ROGERS@ 512/448-4225 OR wrogers@cwa-tseu.org

Ample reasons to fire Accenture
Austin-The Texas State Employees Union today said that failure by Accenture to carry out terms of its call center contract with the state Health and Human Service Commission provides ample grounds for canceling the contract.

"Accenture, for example, was supposed to train call center staff to process applications for services and to have integrated key software components that were essential to making the call centers work, but it failed to do either," Gross said. "These failures and others caused thousands of people to not get services or to experience unacceptable service delays."

The Austin American Statesman reported today that an HHSC attorney said that he couldn't find "anything that I've seen that represents something that in my opinion would require termination."

TSEU conducted a quick review of one portion of one section of the contract and found two serious breaches.

According to Section 10.03 (A), Accenture prior to implementation of call center pilot was supposed to have trained Texas Access Alliance (the call center subcontractors) personnel, but either didn't do so or did a very poor job.

Since the call centers have been put on hiatus, call center staff have been sent to local state eligibility offices for on-the-job training. Essentially, HHSC is now doing what it contracted with Accenture to do.

According to Section 10.03 (B), Accenture prior to implementation of the pilot was to have completed "integration of TIERS and MAXe3," two software applications whose integration was supposed to have made it possible for information gathered at the call centers to be seamlessly transferred to HHSC computers.

However, this integration is still not complete, and failure to complete this integration caused delays in providing services to people in need and in some cases caused eligible applicants to not receive services.

"We found these two major violation of the contract after a cursory review of just one small section of the contract" Gross said. "I'm sure this is just the tip of the iceberg."

Gross reiterated that TSEU supports the call made last week by a bi-partisan group of 60 state House members to cancel the Accenture contract and to use the money earmarked for it to rebuild the state's health and human services delivery capacity, which has atrophied since HHSC decided to privatize eligibility services.

To date, HHSC has paid Accenture more than $100 million even though the company has been unable to deliver the services stipulated in the contract that it signed last summer.