May 11, 2006
The state takes over again at HHSC

And the great boondoggle outsourcing of the Texas Health and Human Services Commission (THHSC) to Accenture takes failure to another level.

Effective immediately, state workers again will be responsible for processing applications for assistance programs such as food stamps and Medicaid after myriad problems resulted with the private company hired to do the job.


The switch comes about as state Health and Human Services officials acknowledge flaws with several components of the system, which is supposed to help applicants compile the information that's used to determine eligibility for public assistance programs.

State workers will continue to make the determination of whether an applicant qualifies.

Advocates for children and the poor have been critical of Accenture's work, attributing to the company a steep decline in the rolls of the Children's Health Insurance Program and a drop in the number of children covered by Medicaid.

The commission says the problems must be addressed and corrected, although it doesn't have a time frame by which it expects the problems to be fixed.

Among the problems:

Accenture workers have inadequate training and as a result are giving erroneous or contradictory information to applicants.

Program software is incompatible, causing delays in application processing and forcing workers to manually input information.

State eligibility offices are understaffed because of the departure of thousands of state workers who feared they would lose their jobs when Accenture took over.

Those understaffed state offices now will be required to deal with thousands of cases that are to be transferred out of Accenture's control.

"If the contractor is not able to do the job it promised it could do, (the task) is going to again fall on state workers, who are already working in understaffed offices ... which means their already unmanageable caseloads just got bigger, which means more (people) will suffer or not get the benefits they are entitled to," said Celia Hagert of the Center for Public Policy Priorities, an Austin-based nonprofit agency that researches issues affecting low-income Texans.

Let me recommend at this point that instead of reading this article directly, you go to HHSC Employee and HHSC Survivalist, both of whom give you a fully annotated version. Read this HHSC Employee post, too, which discusses the issue of call times as described in this article about "wait times and hold times, and call abandonment". Speaking as a former help desk employee, HHSC Emp is right on. The crucial missing dimension in these metrics is how many calls were successfully handled by the first-line employees who took them. On our internal help desk, we aimed for 80%. I at least woud expect a higher number from this group, but whatever their benchmark is, you can't judge their success without knowing where it's set and how well they're doing in comparison to it. Period.

And what's the one way that all of this can get worse for Accenture? How about an audit of their contract by the Comptroller?

At the request of three lawmakers, Comptroller Carole Keeton Strayhorn plans to investigate the contractor in charge of processing applications for Texas' low-cost insurance program for children and running the state's new benefits eligibility system.

The contractor, Texas Access Alliance, is a group of companies led by Accenture, a Bermuda-based technology consulting firm.

Strayhorn, who hopes to unseat Republican Gov. Rick Perry in November, said Wednesday the review will be a top priority for her staff.

"The Accenture contract to me appears to be the perfect storm of wasted tax dollars, reduced access to services ... and profiteering at the expense of taxpayers," she said.

Democratic Sen. Eliot Shapleigh of El Paso asked her Wednesday to conduct a comprehensive audit and performance review, saying it could "shed some light on the ongoing problems that are negatively affecting tens of thousands of Texans."

Later in the day, Democratic state Rep. Carlos Uresti of San Antonio and Republican state Rep. Carter Casteel of New Braunfels said in a letter to Strayhorn that they're "deeply concerned about the viability of the agency's plans" for its new eligibility system.

"Hundreds of millions of taxpayer dollars are funding a problem-plagued plan that threatens the health and safety of our citizens," they said in the letter. "Our taxpayers and vulnerable citizens deserve to know how they will be affected by these questionable policy changes."

This could get ugly, and deservedly so. This fiasco has to be on the short list of biggest policy disasters in recent history. Whatever merits the case for privatizing HHSC may have, the implementation was botched from the get go, in ways that anyone with a lick of sense could see coming a mile away. Go back to that first story, for example, where it talks about "Program software is incompatible" - that's the still-not-working TIERS system, which was a failure in Colorado before its adoption in Texas. Everything that could go wrong did, and it wasn't a case of beggar's luck. This was a self-inflicted wound, and the sooner there's some real oversight of this mess, the better. Thanks to The Red State for the SAEN link.

Posted by Charles Kuffner on May 11, 2006 to Budget ballyhoo | TrackBack