April 09, 2008
The DMN writes about the HHSC

From yesterday, a familiar litany.

Lawmakers are worried that a partly privatized system for determining who receives public assistance is still shaky and may not be salvageable.

Paperwork for applicants has been lost. Needy Texans have received little help from state workers when they've complained of mistakes. And all too often, Texans who should qualify for state-paid health care and other benefits have been refused because of such errors.

When one closely watched measure of the state's performance on aid requests plunged recently, lawmakers sharply questioned Health and Human Services Commissioner Albert Hawkins. He has announced several new initiatives this year to lure and retain state eligibility workers - and to train more of them on a computer system causing most of the delays.

But those steps haven't calmed lawmakers' nerves. They and advocates for the poor are skeptical he can quickly fix a system that's been in crisis for most of the five years since the Legislature and Gov. Rick Perry slashed the payroll of the state's welfare offices and ordered a shift of many screening duties to four privately run call centers.

State leaders acknowledge that promised cost savings haven't materialized and mistakes are common. Now, the system could be headed for more severe problems, as a jittery economy means more Texans may soon apply for public assistance.

The problems could also distract Texas officials as they separately seek to overhaul Medicaid, the nation's main health care program for the poor. Some advocates for low-income Texans fear that if Mr. Hawkins' agency remains preoccupied with fixing the eligibility system, it will be distracted just as it needs to focus on huge changes designed to cover more adults and improve preventative and dental care for poor children.

"These problems need to be resolved now - not in the next [legislative] session - because people's health is at stake," said Senate Health and Human Services Committee Chairwoman Jane Nelson, R-Flower Mound.

It's all stuff we've seen and heard before, though the bit about things getting worse as the economy sinks is a new concern. There's no way around the fact that this has been a fiasco of biblical proportions from the beginning - worsened service, increased costs instead of promised savings, the canning of the outsourcer, and so forth. It's failed in every possible way, with more to come as it continues to roll out because there's no return.

State officials acknowledge the failures but say there's no turning back. The new system is "a much more flexible system. It's modern, it's Web-based, and it allows us to provide Texans with a great deal of choice in how they apply for benefits," said Stephanie Goodman, a Health and Human Services Commission spokeswoman.

She said the promised savings and improved efficiency haven't materialized because the program ordered by lawmakers in 2003 hasn't been fully implemented. "But it's also incredibly difficult to modernize a system that 4 million Texans rely on every day. It's like trying to remodel a hotel that's full of guests," Ms. Goodman added.

I'm sure the old system was in need of an upgrade, and I know fully well how painful such transitions can be. But we compounded all of that woe by trying to do it on the cheap, with an inexperienced vendor instead of the people who knew what they were doing. It would be amusing in a "Dilbert" kind of way if it weren't for all the suffering that has resulted.

Anyway, read it and weep. And remember there will be more to come soon.

Posted by Charles Kuffner on April 09, 2008 to Budget ballyhoo