March 10, 2008
TIERS and problems go hand in hand

From the "Stuff I bookmarked then totally forgot to blog about because the primary was so crazy" comes this story about more trouble with the TIERS system.

To Texans applying for food stamps, it may not seem to matter whether their application goes through the state's old computer enrollment system or the newer one.

But new state data show that fewer than half of Texas food stamp applications processed using the updated computer system, known as TIERS, are completed within the 30 days required by the federal government. TIERS average of 48 percent of applications within 30 days is significantly lower than the 90 percent under the old system, SAVERR.

That 48 percent -- which is from December, the last month available -- represents a steady decline from last summer. The federal standard is 95 percent. See page 26 of this report. Timeliness is also an issue for Medicaid applications.

"If we are that abysmally low on meeting federal timeliness requirements," State Rep. Patrick Rose, D-Dripping Springs, told state health officials during a Capitol hearing today, "it makes sense to figure out what those kinks are before we begin to expand (TIERS) further."

But TIERS expansion is already under way. About 350,000 cases for programs such as food stamps and Medicaid are in TIERS, compared to about 150,000 a year ago, Rose said.

Timeliness isn't just an issue, it can be the difference between getting your application processed at all and having to do it all over again from scratch. The explanation is a bit complicated, but it goes like this:

Federal law requires HHSC to make a decision on a client's application within 30 days of it being filed. Because the unit of HHSC that is using TIERS is so far behind, it isn't even getting to schedule client interviews before the 40th day in many cases. That's bad (and against federal regulations), but it gets worse. Now if a client is missing anything for his application, he has an extremely small window to furnish it, because if the process is not completed within 60 days, it gets thrown out, and the client has to start all over again from scratch. Which generally means another six weeks or so of waiting for another appointment.

Part of the problem with this, of course, is that in the old days, clients did these applications at local branch offices of HHSC, which meant that any questions about what was needed and what might be missing could be easily and quickly answered, thus ensuring that the applications could get done right the first time. Now, in the consolidated-and-outsourced world, there are only a few of these locations, so a client may show up at an interview a couple hundred miles from home only to learn that some critical piece of information is absent, and there's no time to get it into the application before the deadline. Oops.

So the problems with TIERS, which is the root cause of all this, are causing needless hardships on people, and may be putting the state in violation of federal law. And this system is going to be expanded. Isn't that lovely? I hope that in the event of a Democratic takeover of the State House, that a thorough review and revision to 2003's HB2293 will be high on the priority list, because this is a travesty.

Posted by Charles Kuffner on March 10, 2008 to Budget ballyhoo