More HHSC-is-broken stuff

Another damning article on the lousy, screwed-up state of affairs in the Texas Health and Human Services Commission (THHSC) since the privatization effort began.

Problems include:

• State officials on Friday abandoned plans to drop 28,000 more children from the Children's Health Insurance Program, admitting they'd put in place unfair bureaucratic burdens that need revamping.


• A state computer designed for one-stop shopping when checking eligibility for multiple programs is seven years in the making but remains incompatible with the private contractors' systems.


• The federal government's independent checks and the state's official records have shown high rates of abandoned calls and long hold times as the initial call center in Midland started up.


• Clients, their advocates and state lawmakers say they've documented instances of no response to applications submitted, call center operators unable to locate submitted applications, notices of missing information when the requested information was not needed and incorrect denials or delays of benefits.


• State officials acknowledge problems with staffing shortages and loss of expertise in state eligibility offices and too few and inadequately trained staff at a privately run call center.

"This process we're going through is historic. No other state has tried this," Texas Health and Human Services Commission spokeswoman Gail Randall said. "The rest of the country is looking at us. It should rise or fall on its own strength or weakness. The state could either successfully end up with a good, cutting-edge service model or it doesn't work. We're going to find out. It's a tough thing."

The commission has estimated that over five years Texas could save $646 million in state and federal funds by relying more on the Internet and call centers for screening applicants for social services.

So far, because of repeated delays in rolling out the program, the plan has yet to save the state a penny.

Given the inevitable transition expenses in such a project, I'd say it's a cinch that the plan has been a net money loser for the state so far.

Liberal Democrats have long opposed the project, some of them fearing a nefarious hidden agenda to knock the poor and disabled out of social services.

And, as tough questions in legislative hearings and letters to Hawkins make clear, conservative Republicans are growing increasingly worried and skeptical about the economic implications of the state's $899 million, five-year privatization plan as well.

"I don't think anybody, regardless of party affiliation, wants to spend money on something that doesn't work," said Mary Katherine Stout, a health policy analyst at the Texas Public Policy Foundation, which advocates for limited government.

"The important thing in all of this is how expeditiously you act to solve the problems. The problems are serious," she said.

I'm glad to hear she thinks that. I just hope she feels that it's worth spending the money that will be needed to fix the problems. For better or worse, we're not going back to how it was before, so the only option is doing whatever it takes to get the new system running as efficiently and effectively as the original. In the meantime, every screwup, every lost application, every improperly denied set of benefits represents real pain for real people, many of whom are children. Whatever financial savings we hope to eventually get from this new system is going to have to make up for that.

(And bear in mind, there really wasn't anything wrong with the original system. It was replaced on faith, nothing more than that. Some day, all of the experience and accumulated knowledge can be replaced, but I have serious doubts that the replacement will be a genuine improvement.)

More on the recent actions by THHSC here, here, here, and here. Thanks to The Muse for the links.

Posted by Charles Kuffner on May 01, 2006 to Budget ballyhoo | TrackBack