Nov. 2, 2006, 4:16PM
Bell seeks probe of health and human services chief
By LIZ AUSTIN PETERSONAssociated Press
TOOLS
AUSTIN — Democratic governor candidate Chris Bell asked the Texas Ethics Commission today to investigate whether the state's health and human services chief broke the law by sitting on the board of a nonprofit organization and failing to disclose it on his personal financial statements.
Albert Hawkins, the executive commissioner of the Texas Health and Human Services Commission, is a trustee for the Texas Health Institute. The nonpartisan organization is a subsidiary of the Texas Hospital Association, a trade group that represents about 85 percent of the state's hospitals and health care systems.
The institute has received more than $2 million in state contracts, mainly to help implement changes to mental health services. Gov. Rick Perry, who appointed Hawkins to his state post, has been a major advocate of such changes.
Bell, who hopes to unseat Perry in Tuesday's election, said Hawkins' involvement with a contractor violates a Texas law that prohibits state employees from participating in activities that could impair their ability to act independently. He said Hawkins also broke the law by failing to list the position on forms he submitted to the ethics commission.
Hawkins was not immediately available to comment but issued a statement through HHSC spokeswoman Stephanie Goodman saying he was the third state health commissioner to hold the same unpaid, honorary position. He filed an amended personal financial statement on Thursday.
He also released a letter he wrote to the institute's president on Oct. 27 in which he emphasized that he has not attended board meetings or participated in board actions.
"This is clearly someone trying to take an honorary position held by three health and human services commissioners and turn it into something it's not," Goodman said in the statement.
Filing a complaint starts a process that may include a preliminary review as well as informal or formal hearings. The commission could dismiss the complaint or impose a civil penalty.
Bell has been trying win votes by painting Perry and his administration as corrupt.
Independents Carole Keeton Strayhorn and Kinky Friedman and Libertarian James Werner
also are running for governor.
Perry spokesman Robert Black said Bell should stick to talking about his own record and proposals.
"Last time I checked, Albert Hawkins wasn't running for governor," Black said.
Strayhorn spokesman Mark Sanders declined to comment. Friedman's spokeswoman didn't immediately return a telephone call seeking comment.
The Texas Hospital Association lobbies for legislation that will benefit the state's hospitals and health care systems. The association's political action committee donated $10,000 to Perry's campaign in September, ethics commission documents show.
Bell filed the complaint that led the House Ethics Committee to admonish then-House Majority Leader Tom DeLay for ethics violations. It was one of a string of problems for the once-powerful Republican that eventually led to DeLay's resignation from Congress.
http://www.chron.com/disp/story.mpl/headline/politics/4306583.html
Saturday, November 04, 2006
Opinion: New Benefit System Suits More Texans
Albert Hawkins
Special to the San Antonio Express-News
5/31/2006
The San Antonio Express-News has published several news stories and columns about the state's plan to add new ways for Texans to apply for services such as Medicaid and food stamps.
But all have failed to include an important point of view - that of the client.
I understand the concerns of special-interest groups and employees worried about the loss of state jobs.
But my primary focus is on the millions of Texans who rely on our services.
We are listening to their voices, and they tell us they are ready for change.
A recent survey of more than 1,000 Texans enrolled in Medicaid and other health and human services programs found 80 percent of clients said they would be interested in applying by phone, and 82 percent want to be able to apply outside of normal work hours.
We recognize that some clients prefer to conduct business in person at a state benefits office.
While the Express-News is fond of saying the state "will shutter state offices," the truth is that we will maintain more than 200 offices across Texas.
San Antonio will continue to have four state benefits offices.
Two San Antonio offices will close - one is located on the same block as another benefits office and the other is within five miles of two other offices.
The project is not without its share of critics.
There are some who philosophically oppose outsourcing state functions to the private sector.
I appreciate that political position, but our approach has been driven by the statutory requirement to determine the most effective and efficient way to deliver services.
Our analysis found that contracting for call center services would generate more savings than state-run call centers.
All calls are answered in Texas, and one of the four call centers is located in San Antonio. The contract includes strict performance standards to ensure the state doesn't pay for services that aren't delivered, and we have identified several areas where improvements must be made.
In the meantime, we have delayed the rollout of the new system.
The Express-News recently ran an article about a letter signed by four members of the Texas congressional delegation opposing our efforts to expand the ways Texans can apply for state services ("Congressmen attack privatization plan," Thursday).
I was disappointed that the paper did not give equal attention to a letter signed by
20 Texas representatives in support of the project. As these leaders pointed out, there is a clear need for change.
Our system is badly out of date.
It uses a computer system built on a language that colleges no longer teach.
Its one-size-fits-all approach makes it especially difficult for the working poor - people who must take off work to go sit in an office.
We still send Medicaid letters to clients each month - at a cost of almost $750,000 for each mailing.
I understand and expect that a project of this magnitude will be closely watched by the public, legislators and the press.
We will continue to monitor the project's performance; act quickly and aggressively to improve shortcomings; and provide regular updates on our progress.
Certainly, we still need to improve the project's performance, but that is not an argument for maintaining an inefficient and outdated system.
We're still in the earliest phases of this project, but we remain committed to creating a system that works better and costs less.
Albert Hawkins is Health and Human Services executive commissioner.
Indiana Gov. Stirs Debate Over Welfare Privatization
Niki Kelly
Fort Wayne Journal Gazette
5/31/2005
INDIANAPOLIS - Gov. Mitch Daniels has inserted himself into the attempt to privatize the Family and Social Services Administration's eligibility operation.
In a response letter released Tuesday to AFSCME Council 62 - a state employees union - Daniels said the decision is an important one for the state, and "it will be made by me and me alone."
FSSA this year sought bids from outside companies that want to collect information from applicants and determine eligibility for Medicaid, food stamps, child-care vouchers, welfare and several other assistance programs.
The contract is estimated to be worth $1 billion over 10 years.
About 2,600 state employees perform those duties at county offices around the state.
AFSCME Executive Director David Warrick sent a letter May 18 to Daniels asking him to drop the privatization plan and work within the structure of state government to fix the system's problems or provide a cost-benefit analysis for the change.
"Providing welfare services requires dedicated and knowledgeable employees that understand the system and can help those most in need navigate the process," Warrick said. "In several states where privatization of these services has been attempted, inadequately trained workers have given applicants erroneous or contradictory information that has resulted in loss or refusal of benefits in which they are entitled."
And publicity about the two bidders hasn't been exactly positive. The lead company on the first bid is Accenture LLP, which had major problems on a similar project in Texas. The second bid is from IBM in conjunction with bidding partner ACS.
FSSA Secretary Mitch Roob worked for ACS from 2001 until he came to state government at the request of Daniels in early 2005.
Originally, the state agency had hoped to announce in May the company it would enter into final negotiations with, as well as release a proposed contract sometime in June with a public hearing on June 29. But in recent weeks, the Family and Social Services Administration has slowed the process.
"We are not going to rush the decision process based on some artificial deadline that we ourselves established," FSSA spokesman Dennis Rosebrough said. "Neither (bid) is a concern-free pick. But we are convinced, and the data is so compelling, that we need to fix this and we need to fix it now.
If there are some bumps - however they may occur - we are willing to accept that because we think the citizens of Indiana - both the applicants and the service recipients as well as taxpayers of Indiana - deserve a better more efficient system and it's worth it."
And while Roob was involved in the philosophical and policy discussion behind seeking bids from the private sector, Rosebrough said he has been removed from the decision-making process - both figuratively and literally because he will have back surgery today that will keep him out of the office for several weeks.
In his response letter, Daniels said that because of the gravity of the contract, he has added an extra step to the normal procurement decision process, which is usually handled by the agency seeking the contract and the Department of Administration.
In this case, the governor has established an interagency team to review the two bids and recommend whether to move ahead with negotiations with either company.
The team members include deputy chief of staff Earl Goode; Department of Administration Commissioner Carrie Henderson; Nate Feltman, chief of staff and general counsel for the Indiana Economic Development Corp.; Karl Browning in the Office of Technology; State Budget Director Chuck Schalliol; and Debra Minot, director of the State Personnel Department.
According to the letter, the proposals must "likely" meet six criteria,
including: reducing unacceptably high rates or error and waste in the welfare system; saving Hoosier taxpayer's money and ensuring that every state employee receives an offer either from the vendor at current wage rates and similar benefits or to stay with the state.
The team has already met twice and will visit county welfare offices soon to review responses to the bids.
"You've expressed concern that a new approach might not work perfectly and it may well not," Daniels said. "But it is hard to imagine a system that performs worse than the one we have now."
Warrick responded by saying AFSCME asked the governor to provide a cost-benefit analysis and Daniels has ignored that request.
"There is no evidence anywhere to think that using a private company will solve the error rates and waste. If there is, I wish the governor would show us and Hoosier taxpayers who will be footing the bill for this risky privatization scheme," he said.
"Until he provides real numbers and data, his assertions that privatization will cure all the ills in the welfare system is just rhetoric to justify selling off more state services to corporations looking to profit from those Hoosiers who most need our help."
Athens Call Center Still on Target
Cristin Ross
Athens Review
5/23/2006
Despite running into problems at its San Antonio center, Accenture is hoping to open the doors to its Athens office this summer.
Reports of unexpectedly long wait times and inadequately trained operators had the Health and Human Services Commissioner Albert Hawkins announcing in early April, the project would be postponed, but that won't affect the Athens center.
"I haven't heard anything on postponing the Athens center," Accenture spokeswoman Stephanie Goodwin said on Friday. "The problems we're having in San Antonio are more of a technical variety, and not as severe as first thought. We feel pretty confident we can work through those problems soon.
"With the volume of calls we have been getting, we still absolutely need the Athens center."
According to Accenture's Web site, www.accenture.com, the Bermuda-based company is "a technology consultant and systems integrator."
The company was recently chosen to privatize part of the state's social services, like the Children's Health Insurance Program, Medicaid, Food Stamps, Temporary Assistance for Needy Families and long-term care. The state announced plans last year to replace 99 of its 310 eligibility offices with four centers to be run by Texas Access Alliance.
These centers allows people to apply for various state program benefits over the phone, online and in person. Midland's center went on line in January - the same time several changes to the application process and in eligibility requirements went into effect.
The center in Athens has been in the works since December 2005, when the company chose Athens over three other cities, including Longview.
"This is wonderful for this community," Athens Economic Development Corporation Executive Director Herbert Gatlin said. "This caliber of company and its affiliates promises to bring good jobs with good pay to the area.
They are a first class group."
The AEDC helped bring the center to town by offering incentives like job incentives and helping fund the massive remodeling of the building on Corsicana Street that formerly housed the K-Mart retail store.
"The building is coming along nicely," said AEDC office administrator Mary Waddell, who toured the building last week.
Renovations aren't complete as yet, as officials said they still wanted to paint the building exterior to obliterate some graffiti on one side of the building.
"I think they want to wait on that until they put up the security fence,"
Waddell said.
Various manager and customer service representative positions are already being filled through the East Texas Workforce Center. Anyone interested in applying may contact the center, 903-677-3521, before June 5.
Albert Hawkins
Special to the San Antonio Express-News
5/31/2006
The San Antonio Express-News has published several news stories and columns about the state's plan to add new ways for Texans to apply for services such as Medicaid and food stamps.
But all have failed to include an important point of view - that of the client.
I understand the concerns of special-interest groups and employees worried about the loss of state jobs.
But my primary focus is on the millions of Texans who rely on our services.
We are listening to their voices, and they tell us they are ready for change.
A recent survey of more than 1,000 Texans enrolled in Medicaid and other health and human services programs found 80 percent of clients said they would be interested in applying by phone, and 82 percent want to be able to apply outside of normal work hours.
We recognize that some clients prefer to conduct business in person at a state benefits office.
While the Express-News is fond of saying the state "will shutter state offices," the truth is that we will maintain more than 200 offices across Texas.
San Antonio will continue to have four state benefits offices.
Two San Antonio offices will close - one is located on the same block as another benefits office and the other is within five miles of two other offices.
The project is not without its share of critics.
There are some who philosophically oppose outsourcing state functions to the private sector.
I appreciate that political position, but our approach has been driven by the statutory requirement to determine the most effective and efficient way to deliver services.
Our analysis found that contracting for call center services would generate more savings than state-run call centers.
All calls are answered in Texas, and one of the four call centers is located in San Antonio. The contract includes strict performance standards to ensure the state doesn't pay for services that aren't delivered, and we have identified several areas where improvements must be made.
In the meantime, we have delayed the rollout of the new system.
The Express-News recently ran an article about a letter signed by four members of the Texas congressional delegation opposing our efforts to expand the ways Texans can apply for state services ("Congressmen attack privatization plan," Thursday).
I was disappointed that the paper did not give equal attention to a letter signed by
20 Texas representatives in support of the project. As these leaders pointed out, there is a clear need for change.
Our system is badly out of date.
It uses a computer system built on a language that colleges no longer teach.
Its one-size-fits-all approach makes it especially difficult for the working poor - people who must take off work to go sit in an office.
We still send Medicaid letters to clients each month - at a cost of almost $750,000 for each mailing.
I understand and expect that a project of this magnitude will be closely watched by the public, legislators and the press.
We will continue to monitor the project's performance; act quickly and aggressively to improve shortcomings; and provide regular updates on our progress.
Certainly, we still need to improve the project's performance, but that is not an argument for maintaining an inefficient and outdated system.
We're still in the earliest phases of this project, but we remain committed to creating a system that works better and costs less.
Albert Hawkins is Health and Human Services executive commissioner.
Indiana Gov. Stirs Debate Over Welfare Privatization
Niki Kelly
Fort Wayne Journal Gazette
5/31/2005
INDIANAPOLIS - Gov. Mitch Daniels has inserted himself into the attempt to privatize the Family and Social Services Administration's eligibility operation.
In a response letter released Tuesday to AFSCME Council 62 - a state employees union - Daniels said the decision is an important one for the state, and "it will be made by me and me alone."
FSSA this year sought bids from outside companies that want to collect information from applicants and determine eligibility for Medicaid, food stamps, child-care vouchers, welfare and several other assistance programs.
The contract is estimated to be worth $1 billion over 10 years.
About 2,600 state employees perform those duties at county offices around the state.
AFSCME Executive Director David Warrick sent a letter May 18 to Daniels asking him to drop the privatization plan and work within the structure of state government to fix the system's problems or provide a cost-benefit analysis for the change.
"Providing welfare services requires dedicated and knowledgeable employees that understand the system and can help those most in need navigate the process," Warrick said. "In several states where privatization of these services has been attempted, inadequately trained workers have given applicants erroneous or contradictory information that has resulted in loss or refusal of benefits in which they are entitled."
And publicity about the two bidders hasn't been exactly positive. The lead company on the first bid is Accenture LLP, which had major problems on a similar project in Texas. The second bid is from IBM in conjunction with bidding partner ACS.
FSSA Secretary Mitch Roob worked for ACS from 2001 until he came to state government at the request of Daniels in early 2005.
Originally, the state agency had hoped to announce in May the company it would enter into final negotiations with, as well as release a proposed contract sometime in June with a public hearing on June 29. But in recent weeks, the Family and Social Services Administration has slowed the process.
"We are not going to rush the decision process based on some artificial deadline that we ourselves established," FSSA spokesman Dennis Rosebrough said. "Neither (bid) is a concern-free pick. But we are convinced, and the data is so compelling, that we need to fix this and we need to fix it now.
If there are some bumps - however they may occur - we are willing to accept that because we think the citizens of Indiana - both the applicants and the service recipients as well as taxpayers of Indiana - deserve a better more efficient system and it's worth it."
And while Roob was involved in the philosophical and policy discussion behind seeking bids from the private sector, Rosebrough said he has been removed from the decision-making process - both figuratively and literally because he will have back surgery today that will keep him out of the office for several weeks.
In his response letter, Daniels said that because of the gravity of the contract, he has added an extra step to the normal procurement decision process, which is usually handled by the agency seeking the contract and the Department of Administration.
In this case, the governor has established an interagency team to review the two bids and recommend whether to move ahead with negotiations with either company.
The team members include deputy chief of staff Earl Goode; Department of Administration Commissioner Carrie Henderson; Nate Feltman, chief of staff and general counsel for the Indiana Economic Development Corp.; Karl Browning in the Office of Technology; State Budget Director Chuck Schalliol; and Debra Minot, director of the State Personnel Department.
According to the letter, the proposals must "likely" meet six criteria,
including: reducing unacceptably high rates or error and waste in the welfare system; saving Hoosier taxpayer's money and ensuring that every state employee receives an offer either from the vendor at current wage rates and similar benefits or to stay with the state.
The team has already met twice and will visit county welfare offices soon to review responses to the bids.
"You've expressed concern that a new approach might not work perfectly and it may well not," Daniels said. "But it is hard to imagine a system that performs worse than the one we have now."
Warrick responded by saying AFSCME asked the governor to provide a cost-benefit analysis and Daniels has ignored that request.
"There is no evidence anywhere to think that using a private company will solve the error rates and waste. If there is, I wish the governor would show us and Hoosier taxpayers who will be footing the bill for this risky privatization scheme," he said.
"Until he provides real numbers and data, his assertions that privatization will cure all the ills in the welfare system is just rhetoric to justify selling off more state services to corporations looking to profit from those Hoosiers who most need our help."
Athens Call Center Still on Target
Cristin Ross
Athens Review
5/23/2006
Despite running into problems at its San Antonio center, Accenture is hoping to open the doors to its Athens office this summer.
Reports of unexpectedly long wait times and inadequately trained operators had the Health and Human Services Commissioner Albert Hawkins announcing in early April, the project would be postponed, but that won't affect the Athens center.
"I haven't heard anything on postponing the Athens center," Accenture spokeswoman Stephanie Goodwin said on Friday. "The problems we're having in San Antonio are more of a technical variety, and not as severe as first thought. We feel pretty confident we can work through those problems soon.
"With the volume of calls we have been getting, we still absolutely need the Athens center."
According to Accenture's Web site, www.accenture.com, the Bermuda-based company is "a technology consultant and systems integrator."
The company was recently chosen to privatize part of the state's social services, like the Children's Health Insurance Program, Medicaid, Food Stamps, Temporary Assistance for Needy Families and long-term care. The state announced plans last year to replace 99 of its 310 eligibility offices with four centers to be run by Texas Access Alliance.
These centers allows people to apply for various state program benefits over the phone, online and in person. Midland's center went on line in January - the same time several changes to the application process and in eligibility requirements went into effect.
The center in Athens has been in the works since December 2005, when the company chose Athens over three other cities, including Longview.
"This is wonderful for this community," Athens Economic Development Corporation Executive Director Herbert Gatlin said. "This caliber of company and its affiliates promises to bring good jobs with good pay to the area.
They are a first class group."
The AEDC helped bring the center to town by offering incentives like job incentives and helping fund the massive remodeling of the building on Corsicana Street that formerly housed the K-Mart retail store.
"The building is coming along nicely," said AEDC office administrator Mary Waddell, who toured the building last week.
Renovations aren't complete as yet, as officials said they still wanted to paint the building exterior to obliterate some graffiti on one side of the building.
"I think they want to wait on that until they put up the security fence,"
Waddell said.
Various manager and customer service representative positions are already being filled through the East Texas Workforce Center. Anyone interested in applying may contact the center, 903-677-3521, before June 5.
State Representative Garnet F. Coleman
Dear Friend,
The Dallas Morning News had a story yesterday about some deceptive talk from Rick Perry and Republicans around the state about the Children's Health Insurance Program (CHIP). As someone who cares deeply about children's issues and public health, the kind of misleading campaign-year rhetoric about CHIP is almost as frustrating as the consequences of the cuts the Republican-led legislature and governor made in 2003. I've included here the newspaper article as well as a release from my office on CHIP. I would encourage you to read them both and remember that providing quality health care for our children starts with electing leadership who make that a priority.
Sincerely,
Garnet F. Coleman
State Representative District 147
Foe disputes Perry on CHIP
Bell backer says funds unused, enrollees down; GOP aide defends plan
08:22 AM CDT on Wednesday, October 25, 2006
By ROBERT T. GARRETT / The Dallas Morning News
AUSTIN – A Democratic lawmaker Tuesday accused Gov. Rick Perry and Republican candidates of spreading "lies and half-truths" to disguise their rollback of children's health coverage.
The governor and some of the GOP's House candidates have made "bogus" statements about government health insurance for children, said Rep. Garnet Coleman, D-Houston.
He disputed a Perry campaign spokesman's comments last week that enrollment of young Texans in the Children's Health Insurance Program and Medicaid is up and that the state has "fully funded" CHIP and not let federal matching dollars slip through its fingers.
"Frankly, they think people are stupid," said Mr. Coleman, a key House health-care policy writer when Democrats ran the chamber and a supporter of Democratic gubernatorial hopeful Chris Bell.
Perry campaign spokesman Robert Black stood by his statements and defended recent changes as necessary to prevent abuse of CHIP by undeserving families.
"Garnet Coleman is a typical liberal Democrat who does not care one bit about spending taxpayer funds wisely," he said.
Mr. Coleman said the two health programs that cover poor children made strong gains early in Mr. Perry's tenure but have been crippled by budget cuts in 2003 and last year's switch of contractors who enroll families in CHIP.
Among the "Republican myths" cited by Mr. Coleman:
•Enrollments are up. The Perry campaign chooses 1999 as a starting point, to say the number of youngsters covered "has increased by over 1 million."
But CHIP, designed for children of working-but-poor adults, didn't crank up until 2000. Since Mr. Perry and lawmakers cut CHIP in 2003, combined enrollment in it and Medicaid has declined by about 130,000 children.
•"The CHIP program is fully funded," Mr. Black said last week, rebutting a Bell TV spot.
Mr. Coleman said that's technically true but misleading. He said lawmakers last year set aside
enough money for children expected to enroll, but it is a much diminished program with enrollment down 41 percent because of changes in CHIP eligibility and enrollment rules made in 2003.
•"No federal funds go unused," Mr. Black said.
"Ridiculous," Mr. Coleman said. "We're not using all the federal funds allocated to Texas, and those are going to other states."
Depending on which years one looks at, both could be right.
Independent analyses of federal data show that from 2000 to 2005, Texas passed up $832 million of federal funds it could have spent on CHIP.The pile of unspent federal funds is likely to grow, after Texas reports data for the budget year that ended Aug. 31.
Mr. Black insisted Texas soon will "use up our remaining federal funds." It's possible, though only for this and future budget years.
Ted Hughes of the Health and Human Services Commission said state use of federal CHIP matching money will surge if a new initiative to have the program cover costs of prenatal and after-birth care begins in January, as scheduled.
E-mail rtgarrett@dallasnews.com
FOR IMMEDIATE RELEASE Contact: Phillip Martin
October 23, 2006 (512) 463-0524
Rep. Coleman: Perry Created Permanent Wall for CHIP Families
CHIP Policies enacted in 2003 make it impossible for CHIP enrollment to increase
( Austin )--State Representative Garnet F. Coleman (D-Houston) announced today that Governor Perry and the Republican leadership purposefully enacted policies to strip away children's health care for thousands of Texas children. The budget cuts in House Bill 1 and the policies implemented in House Bill 2292 during the 78th Regular Session created obstacles that automatically disqualify hundreds of thousands of children from ever receiving coverage under CHIP.
"Governor Perry and the Republican leadership outlawed children's health care for two-hundred thousand Texas families," Rep. Coleman said. "They built a permanent wall to ensure that hundreds of thousands of hard-working Texas families that had received CHIP coverage prior to 2003 could never receive CHIP coverage again."
The "permanent wall" built in 2003 created restrictive requirements -- including a new "assets test," a more frequent enrollment process, an enrollment fee, the elimination of certain deductions, and more -- that made it harder for families to stay on CHIP and made it difficult for any new family to enroll in CHIP.
Much has been made of Governor Perry's awarding an $899 million contract to Accenture to allow them to, among other things, take over processing CHIP applications. However, prior to Accenture taking over, more than 184,000 children had already lost their CHIP coverage since the Republican policies were enacted in September 2003. Today, 200,000 fewer children are enrolled in CHIP than in September 2003.
"It's campaign season, and they want to create an illusion that everything is okay," Rep. Coleman said. "But numbers don't lie. In the last year alone, the state has allowed a lmost $400 million in state funds appropriated for CHIP & Medicaid to go unspent. That extra money -- which is now just sitting in the state's bank account -- would have easily covered every Texas child that lost CHIP coverage since May 2002."
"The only reason Texas has more uninsured children than any other state in the country is because Governor Perry and the Republican leadership don't consider our children's health a priority."
Please find the following supporting materials in this packet:
A chart detailing CHIP enrollment figures from May 2000 through October 2006
A detailed chart on the policies enacted during the 78th Regular Session in 2003, including an explanation of the restrictive "assets" test
A fact sheet on the FY 2006 CHIP and Medicaid funds that went unspent
A fact sheet on the amount of dollars the state has lost by not fully funding CHIP, as well as information debunking Governor Perry's claims about CHIP
Republicans' Failed Policies Create Permanent CHIP Barrier for Hard-Working Families
The legislation enacted during the 78th Regular Session in 2003 permanently cut hundreds of thousands of children from the Children's Health Insurance Program.
Since the cuts enacted by House Bill 1 and House Bill 2292 took effect on September 1, 2003, over 200,000 children have lost their health care coverage.
Though increased outreach spending and firing Accenture would help, over two-hundred thousand children will never be able to regain access to CHIP until the legislation signed by Governor Perry and the Republican leadership is repealed.
Chip Enrollment Figures from May 2000 - October 2006
High Point , 5/02: 529,271
9/03: 507,259
12/05: 322,898
10/06: 300,685
Source: Health and Human Services Commission and Center for Public Policy Priorities.
Changes in CHIP Enrollment Policies Made in 2003
Policy
Pre-September 2003
September 2003 - Present
New Restriction
Policy prior to Republican Changes
Policy with Republican changes
How the change added restrictions
Renewal Rates
Apply for renewal annually
Apply every 6 months
Families automatically kicked off if they forget to renew annually.
Income Requirements
Income requirements based on "net" income calculation. Allowed for reductions such as child care and work-related expenses.
"Gross" income assessed, which doesn't account for income deductions such as child care costs.
Eliminating deductions automatically disqualified thousands of needy children.
Family Asset Test
None
Assets test for families with incomes of 150% FPL with a limit of $5000 in liquid assets which includes any bank accounts and vehicles.
Working families are punished for attempting to save money for college, retirement.
Proof of Income
Submission of proof of income required only if there was a change in income; single box to check on application, renewal form.
Submission of proof of income and deductible expenses at every renewal by submitting pay stubs from employer.
New requirement not clearly explained
Waiting Period to Enroll Child in CHIP
No waiting period
90-day waiting period. If child enrolls after the 15th of the month, then the waiting period does not begin until the first of the next month, extending wait to 105 days.
Limits children's access to health care for an additional 3-4 months.
Enrollment Fees
No enrollment fees
Enrollment fees up to $50 per 6-month period; co-payments for doctor services and medications.
Stricter cost sharing policies make it more difficult, expensive.
Application
Length of instructions less than half a page
Application is much more cumbersome, w/ 3 pages of instructions and notices
Increases difficulty to enroll/renew at every step.
Renewal Forms
Renewal forms were pre-populated with previously submitted information and only required the family to cross out inaccurate information and make corrections.
Renewal forms are blank so the entire application must be completed anew every 6 months, including income, vehicle information, and bank balances.
Increases difficulty to enroll/renew at every step.
Defining the "A ssets Test"
A family with a gross monthly income greater than 150% of the federal poverty level (FPL) must own $5000 or less in countable liquid assets and excess vehicle value combined to be eligible for CHIP.
CHIP is meant to assist working families that can't afford health insurance for their children. These restrictive policies -- put in place in 2003 -- punish families that attempt to put money away in a savings account, even if it's for their children's college tuition, for personal retirement, or to purchase a home.
Should a family that already owns a vehicle come into ownership of any additional vehicle over $4,650 -- even if it's given to them by a friend or inherited from a deceased relative -- that family would be kicked off the CHIP program.
· Liquid Assets:
o cash on hand
o cash value of checking and savings accounts
o money remaining from the sale of a homestead
o cash value of stocks, bonds and savings certificates
· Excess vehicle value calculated:
o Countable vehicles include any operable and licensed automobile, truck, motorcycle, SUV, van, boat or motor home (including campers and RVs).
o The value of the vehicle will be based on the Hearst Corp./NAR Division Black Book.
o The family can exempt the first $15,000 of the highest valued vehicle and $4650 of the value of each additional vehicle.
Fact Sheet: CHIP, Medicaid Budget Funds Left Unspent
Almost $400 million in unspent CHIP & Medicaid funds would have covered every Texas child that lost CHIP coverage since May 2002, and covered those that lost Medicaid coverage in FY 2006.
$394.9 Million Left Unspent in FY 2006 Medicaid and CHIP
$4.8 billion in state funds was appropriated for Medicaid in Senate Bill 1
$328.3 million in state funds appropriated for Goal B (Medicaid) for fiscal year 2006 was left unspent and has been carried forward into fiscal year 2007
$199.9 million was appropriated for CHIP Services in Senate Bill 1
$66.6 million in state funds appropriated for Goal C (CHIP Services) was left unspent and has been carried forward into fiscal year 2007
71,412 Fewer Children Enrolled in Medicaid During FY 2006
· September 2005 - 1,980,389 children enrolled
· September 2006 - 1,908,977 children enrolled
35,027 Fewer Children Enrolled in CHIP During FY 2006
September 2005 - 326,557 children enrolled
September 2006 - 291,530 children enrolled
State Dollars Left Unspent Could Have Paid for Health Care Coverage for Medicaid and CHIP Children that Were Kicked Off the Rolls
Number of children that lost CHIP coverage from May 2002 - Today 228,406
Average state dollars needed to cover a child on CHIP: x $450
Amount of state funds needed to cover all children that
have lost CHIP coverage since May 2002 ( #1) $102,782,700
Number of children that lost Medicaid coverage in FY 2006: 71,412
Estimated state dollars needed to cover a child on Medicaid: x $700
Amount of state funds needed to cover all children that
lost Medicaid coverage in FY 2006 ( #2) $49,988,400
Amount of unspent FY '006 state funds for Medicaid and CHIP: $394,000,000
Cost in state funds of restoring CHIP ( #1) - $102,782,700
Cost in state funds of restoring Medicaid ( #2): - $49,988,400
Total Amount of Unspent State Dollars,
after CHIP and Medicaid coverage is restored: $241,228,900
Source: HHSC Response to Inquiries made by the Office of State Representative Garnet Coleman
Fighting the Myth: The Truth About CHIP
Election season campaign announcements from Governor Perry and the Republican leadership cannot cover up three years and nine legislative sessions of neglect. Here's a sampling of lies and half-truths purported by Governor Perry and the Republican leadership:
Republican Myth
Truth About CHIP
CHIP is 100% fully funded at the state level.
CHIP is fully funded at the rate set by the Republican leadership in the 79th Regular Session. Since 2003, the Republican leadership has cut state funds for CHIP by over $50 million, and cut all general revenue funds by over $150 million.
We aren't losing federal funds, or any money, from CHIP or Medicaid.
$1 in net cuts in funding for Medicaid and CHIP results in1:
$3.66 in total health care funding losses
$13.18 in total expenditure losses
$4.80 in personal income losses
$6.92 in gross state product losses
$1.59 in increased insurance premiums
$1.81 in retail sales losses
$0.58 in local government cost increases
$1.52 in out-of-pocket and other private health care costs
New $3.5 million outreach shows commitment to CHIP
Prior to 2003, the state was spending $9.9 million on outreach to assist families that were enrolling and renewing for CHIP.
Hurricane Katrina evacuees have inflated the numbers
9,805 children that are Hurricane Katrina evacuees have enrolled in children's Medicaid (1% of total enrollment).2
316 children that are Hurricane Katrina evacuees have enrolled in CHIP (1% of total enrollment).3
1 Source: The Perryman Group. " The Perryman Report: Special Report. An Assessment of the Impact of the Health Care Sector on the Texas Economy, with Emphasis on the Situation Confronting Hospitals and the Effects of Medicaid and Children's Health Insurance Program (CHIP) Funding Reductions." February, 2005.
2 Source: Health and Human Service Commission response to inquiries made by the Office of State Representative Garnet Coleman. October 16, 2006.
3 Source: Health and Human Service Commission response to inquiries made by the Office of State Representative Garnet Coleman. October 20, 2006.
This e-mail was not sent at state expense.
This CoolerEmail was delivered to you by State Representative Garnet Coleman. You can take your email address off State Representative Garnet Coleman's email list, or update your preferences and/or send comments to State Representative Garnet Coleman. If you request to be taken off State Representative Garnet Coleman's email list, State Representative Garnet Coleman will honor your request pursuant to CoolerEmail's permission-based email terms and conditions. Postal address: 1231 NW Hoyt, Suite 301, Portland, OR 97209 Powered by CoolerEmail
Dear Friend,
The Dallas Morning News had a story yesterday about some deceptive talk from Rick Perry and Republicans around the state about the Children's Health Insurance Program (CHIP). As someone who cares deeply about children's issues and public health, the kind of misleading campaign-year rhetoric about CHIP is almost as frustrating as the consequences of the cuts the Republican-led legislature and governor made in 2003. I've included here the newspaper article as well as a release from my office on CHIP. I would encourage you to read them both and remember that providing quality health care for our children starts with electing leadership who make that a priority.
Sincerely,
Garnet F. Coleman
State Representative District 147
Foe disputes Perry on CHIP
Bell backer says funds unused, enrollees down; GOP aide defends plan
08:22 AM CDT on Wednesday, October 25, 2006
By ROBERT T. GARRETT / The Dallas Morning News
AUSTIN – A Democratic lawmaker Tuesday accused Gov. Rick Perry and Republican candidates of spreading "lies and half-truths" to disguise their rollback of children's health coverage.
The governor and some of the GOP's House candidates have made "bogus" statements about government health insurance for children, said Rep. Garnet Coleman, D-Houston.
He disputed a Perry campaign spokesman's comments last week that enrollment of young Texans in the Children's Health Insurance Program and Medicaid is up and that the state has "fully funded" CHIP and not let federal matching dollars slip through its fingers.
"Frankly, they think people are stupid," said Mr. Coleman, a key House health-care policy writer when Democrats ran the chamber and a supporter of Democratic gubernatorial hopeful Chris Bell.
Perry campaign spokesman Robert Black stood by his statements and defended recent changes as necessary to prevent abuse of CHIP by undeserving families.
"Garnet Coleman is a typical liberal Democrat who does not care one bit about spending taxpayer funds wisely," he said.
Mr. Coleman said the two health programs that cover poor children made strong gains early in Mr. Perry's tenure but have been crippled by budget cuts in 2003 and last year's switch of contractors who enroll families in CHIP.
Among the "Republican myths" cited by Mr. Coleman:
•Enrollments are up. The Perry campaign chooses 1999 as a starting point, to say the number of youngsters covered "has increased by over 1 million."
But CHIP, designed for children of working-but-poor adults, didn't crank up until 2000. Since Mr. Perry and lawmakers cut CHIP in 2003, combined enrollment in it and Medicaid has declined by about 130,000 children.
•"The CHIP program is fully funded," Mr. Black said last week, rebutting a Bell TV spot.
Mr. Coleman said that's technically true but misleading. He said lawmakers last year set aside
enough money for children expected to enroll, but it is a much diminished program with enrollment down 41 percent because of changes in CHIP eligibility and enrollment rules made in 2003.
•"No federal funds go unused," Mr. Black said.
"Ridiculous," Mr. Coleman said. "We're not using all the federal funds allocated to Texas, and those are going to other states."
Depending on which years one looks at, both could be right.
Independent analyses of federal data show that from 2000 to 2005, Texas passed up $832 million of federal funds it could have spent on CHIP.The pile of unspent federal funds is likely to grow, after Texas reports data for the budget year that ended Aug. 31.
Mr. Black insisted Texas soon will "use up our remaining federal funds." It's possible, though only for this and future budget years.
Ted Hughes of the Health and Human Services Commission said state use of federal CHIP matching money will surge if a new initiative to have the program cover costs of prenatal and after-birth care begins in January, as scheduled.
E-mail rtgarrett@dallasnews.com
FOR IMMEDIATE RELEASE Contact: Phillip Martin
October 23, 2006 (512) 463-0524
Rep. Coleman: Perry Created Permanent Wall for CHIP Families
CHIP Policies enacted in 2003 make it impossible for CHIP enrollment to increase
( Austin )--State Representative Garnet F. Coleman (D-Houston) announced today that Governor Perry and the Republican leadership purposefully enacted policies to strip away children's health care for thousands of Texas children. The budget cuts in House Bill 1 and the policies implemented in House Bill 2292 during the 78th Regular Session created obstacles that automatically disqualify hundreds of thousands of children from ever receiving coverage under CHIP.
"Governor Perry and the Republican leadership outlawed children's health care for two-hundred thousand Texas families," Rep. Coleman said. "They built a permanent wall to ensure that hundreds of thousands of hard-working Texas families that had received CHIP coverage prior to 2003 could never receive CHIP coverage again."
The "permanent wall" built in 2003 created restrictive requirements -- including a new "assets test," a more frequent enrollment process, an enrollment fee, the elimination of certain deductions, and more -- that made it harder for families to stay on CHIP and made it difficult for any new family to enroll in CHIP.
Much has been made of Governor Perry's awarding an $899 million contract to Accenture to allow them to, among other things, take over processing CHIP applications. However, prior to Accenture taking over, more than 184,000 children had already lost their CHIP coverage since the Republican policies were enacted in September 2003. Today, 200,000 fewer children are enrolled in CHIP than in September 2003.
"It's campaign season, and they want to create an illusion that everything is okay," Rep. Coleman said. "But numbers don't lie. In the last year alone, the state has allowed a lmost $400 million in state funds appropriated for CHIP & Medicaid to go unspent. That extra money -- which is now just sitting in the state's bank account -- would have easily covered every Texas child that lost CHIP coverage since May 2002."
"The only reason Texas has more uninsured children than any other state in the country is because Governor Perry and the Republican leadership don't consider our children's health a priority."
Please find the following supporting materials in this packet:
A chart detailing CHIP enrollment figures from May 2000 through October 2006
A detailed chart on the policies enacted during the 78th Regular Session in 2003, including an explanation of the restrictive "assets" test
A fact sheet on the FY 2006 CHIP and Medicaid funds that went unspent
A fact sheet on the amount of dollars the state has lost by not fully funding CHIP, as well as information debunking Governor Perry's claims about CHIP
Republicans' Failed Policies Create Permanent CHIP Barrier for Hard-Working Families
The legislation enacted during the 78th Regular Session in 2003 permanently cut hundreds of thousands of children from the Children's Health Insurance Program.
Since the cuts enacted by House Bill 1 and House Bill 2292 took effect on September 1, 2003, over 200,000 children have lost their health care coverage.
Though increased outreach spending and firing Accenture would help, over two-hundred thousand children will never be able to regain access to CHIP until the legislation signed by Governor Perry and the Republican leadership is repealed.
Chip Enrollment Figures from May 2000 - October 2006
High Point , 5/02: 529,271
9/03: 507,259
12/05: 322,898
10/06: 300,685
Source: Health and Human Services Commission and Center for Public Policy Priorities.
Changes in CHIP Enrollment Policies Made in 2003
Policy
Pre-September 2003
September 2003 - Present
New Restriction
Policy prior to Republican Changes
Policy with Republican changes
How the change added restrictions
Renewal Rates
Apply for renewal annually
Apply every 6 months
Families automatically kicked off if they forget to renew annually.
Income Requirements
Income requirements based on "net" income calculation. Allowed for reductions such as child care and work-related expenses.
"Gross" income assessed, which doesn't account for income deductions such as child care costs.
Eliminating deductions automatically disqualified thousands of needy children.
Family Asset Test
None
Assets test for families with incomes of 150% FPL with a limit of $5000 in liquid assets which includes any bank accounts and vehicles.
Working families are punished for attempting to save money for college, retirement.
Proof of Income
Submission of proof of income required only if there was a change in income; single box to check on application, renewal form.
Submission of proof of income and deductible expenses at every renewal by submitting pay stubs from employer.
New requirement not clearly explained
Waiting Period to Enroll Child in CHIP
No waiting period
90-day waiting period. If child enrolls after the 15th of the month, then the waiting period does not begin until the first of the next month, extending wait to 105 days.
Limits children's access to health care for an additional 3-4 months.
Enrollment Fees
No enrollment fees
Enrollment fees up to $50 per 6-month period; co-payments for doctor services and medications.
Stricter cost sharing policies make it more difficult, expensive.
Application
Length of instructions less than half a page
Application is much more cumbersome, w/ 3 pages of instructions and notices
Increases difficulty to enroll/renew at every step.
Renewal Forms
Renewal forms were pre-populated with previously submitted information and only required the family to cross out inaccurate information and make corrections.
Renewal forms are blank so the entire application must be completed anew every 6 months, including income, vehicle information, and bank balances.
Increases difficulty to enroll/renew at every step.
Defining the "A ssets Test"
A family with a gross monthly income greater than 150% of the federal poverty level (FPL) must own $5000 or less in countable liquid assets and excess vehicle value combined to be eligible for CHIP.
CHIP is meant to assist working families that can't afford health insurance for their children. These restrictive policies -- put in place in 2003 -- punish families that attempt to put money away in a savings account, even if it's for their children's college tuition, for personal retirement, or to purchase a home.
Should a family that already owns a vehicle come into ownership of any additional vehicle over $4,650 -- even if it's given to them by a friend or inherited from a deceased relative -- that family would be kicked off the CHIP program.
· Liquid Assets:
o cash on hand
o cash value of checking and savings accounts
o money remaining from the sale of a homestead
o cash value of stocks, bonds and savings certificates
· Excess vehicle value calculated:
o Countable vehicles include any operable and licensed automobile, truck, motorcycle, SUV, van, boat or motor home (including campers and RVs).
o The value of the vehicle will be based on the Hearst Corp./NAR Division Black Book.
o The family can exempt the first $15,000 of the highest valued vehicle and $4650 of the value of each additional vehicle.
Fact Sheet: CHIP, Medicaid Budget Funds Left Unspent
Almost $400 million in unspent CHIP & Medicaid funds would have covered every Texas child that lost CHIP coverage since May 2002, and covered those that lost Medicaid coverage in FY 2006.
$394.9 Million Left Unspent in FY 2006 Medicaid and CHIP
$4.8 billion in state funds was appropriated for Medicaid in Senate Bill 1
$328.3 million in state funds appropriated for Goal B (Medicaid) for fiscal year 2006 was left unspent and has been carried forward into fiscal year 2007
$199.9 million was appropriated for CHIP Services in Senate Bill 1
$66.6 million in state funds appropriated for Goal C (CHIP Services) was left unspent and has been carried forward into fiscal year 2007
71,412 Fewer Children Enrolled in Medicaid During FY 2006
· September 2005 - 1,980,389 children enrolled
· September 2006 - 1,908,977 children enrolled
35,027 Fewer Children Enrolled in CHIP During FY 2006
September 2005 - 326,557 children enrolled
September 2006 - 291,530 children enrolled
State Dollars Left Unspent Could Have Paid for Health Care Coverage for Medicaid and CHIP Children that Were Kicked Off the Rolls
Number of children that lost CHIP coverage from May 2002 - Today 228,406
Average state dollars needed to cover a child on CHIP: x $450
Amount of state funds needed to cover all children that
have lost CHIP coverage since May 2002 ( #1) $102,782,700
Number of children that lost Medicaid coverage in FY 2006: 71,412
Estimated state dollars needed to cover a child on Medicaid: x $700
Amount of state funds needed to cover all children that
lost Medicaid coverage in FY 2006 ( #2) $49,988,400
Amount of unspent FY '006 state funds for Medicaid and CHIP: $394,000,000
Cost in state funds of restoring CHIP ( #1) - $102,782,700
Cost in state funds of restoring Medicaid ( #2): - $49,988,400
Total Amount of Unspent State Dollars,
after CHIP and Medicaid coverage is restored: $241,228,900
Source: HHSC Response to Inquiries made by the Office of State Representative Garnet Coleman
Fighting the Myth: The Truth About CHIP
Election season campaign announcements from Governor Perry and the Republican leadership cannot cover up three years and nine legislative sessions of neglect. Here's a sampling of lies and half-truths purported by Governor Perry and the Republican leadership:
Republican Myth
Truth About CHIP
CHIP is 100% fully funded at the state level.
CHIP is fully funded at the rate set by the Republican leadership in the 79th Regular Session. Since 2003, the Republican leadership has cut state funds for CHIP by over $50 million, and cut all general revenue funds by over $150 million.
We aren't losing federal funds, or any money, from CHIP or Medicaid.
$1 in net cuts in funding for Medicaid and CHIP results in1:
$3.66 in total health care funding losses
$13.18 in total expenditure losses
$4.80 in personal income losses
$6.92 in gross state product losses
$1.59 in increased insurance premiums
$1.81 in retail sales losses
$0.58 in local government cost increases
$1.52 in out-of-pocket and other private health care costs
New $3.5 million outreach shows commitment to CHIP
Prior to 2003, the state was spending $9.9 million on outreach to assist families that were enrolling and renewing for CHIP.
Hurricane Katrina evacuees have inflated the numbers
9,805 children that are Hurricane Katrina evacuees have enrolled in children's Medicaid (1% of total enrollment).2
316 children that are Hurricane Katrina evacuees have enrolled in CHIP (1% of total enrollment).3
1 Source: The Perryman Group. " The Perryman Report: Special Report. An Assessment of the Impact of the Health Care Sector on the Texas Economy, with Emphasis on the Situation Confronting Hospitals and the Effects of Medicaid and Children's Health Insurance Program (CHIP) Funding Reductions." February, 2005.
2 Source: Health and Human Service Commission response to inquiries made by the Office of State Representative Garnet Coleman. October 16, 2006.
3 Source: Health and Human Service Commission response to inquiries made by the Office of State Representative Garnet Coleman. October 20, 2006.
This e-mail was not sent at state expense.
This CoolerEmail was delivered to you by State Representative Garnet Coleman. You can take your email address off State Representative Garnet Coleman's email list, or update your preferences and/or send comments to State Representative Garnet Coleman. If you request to be taken off State Representative Garnet Coleman's email list, State Representative Garnet Coleman will honor your request pursuant to CoolerEmail's permission-based email terms and conditions. Postal address: 1231 NW Hoyt, Suite 301, Portland, OR 97209 Powered by CoolerEmail
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