Under Charles Smith, the longtime ally of Gov. Greg Abbott picked to lead the state’s Health and Human Services Commission, Texas’ government health care infrastructure is hemorrhaging veteran employees and facing criticism for its response to the humanitarian crisis caused by Hurricane Harvey.
Dozens of experienced senior staff members have left the agency since Smith took over last year. Current and former employees attribute the exodus to widespread dissatisfaction with the executive commissioner, who they say lacks technical knowledge of the agency and pushes a political agenda backed by the governor.
Interviews with 11 current and former long-serving health commission staff, ranging from senior executives to mid-level managers, paint a picture of a state agency in disarray, with veteran staff clashing regularly with Smith and his supporters in the governor’s office. The internal conflict has spurred a wave of resignations, leaving the agency with a void of talent that critics say is hampering the state’s ability to aid victims of Hurricane Harvey.
“It’s hard to watch,” said one former high-ranking health commission official, who spoke on the condition of anonymity because of an ongoing professional relationship with the health commission. “Anybody with any knowledge or experience is not going to stay.”
Critics point to the agency’s actions in the month after Hurricane Harvey as evidence of its dysfunction.
Specifically, sources inside and outside of the commission told the Tribune that the agency was slow to act in providing guidance and assistance to Texans affected by Harvey who qualify for public programs such as food stamps and Medicaid.
Doctors have complained that basic information, such as whether displaced Medicaid patients could seek care outside of their insurance network or get prescription medications refilled, was slow to emerge from the agency, and advocates for low-income Texans were frustrated to see a flurry of revisions to information posted on the agency’s website as victims sought government assistance.
Others pointed to the delay in rolling out disaster food stamps benefits. Hurricane Harvey made landfall in Texas on Aug. 25, and the health commission began rolling out disaster food stamps on Sept. 13, nearly three weeks later, but only in some counties. Houston, Corpus Christi and other areas that suffered some of the most extensive damage from the storm were not included in the initial rollout.
By comparison, when Hurricane Ike struck Galveston in 2008, then-Executive Commissioner Albert Hawkins announced the agency would provide emergency food stamps five days after the storm made landfall.
“When I see the response to Harvey, I am quite concerned about the level of expertise in the agency,” said one former commission official who has closely followed the hurricane response. “This stuff is not rocket science. We’ve had disasters before. There are templates for this.”
The Texas State Employees Union said this week that falling employee morale and a shortage of workers has hampered the state’s ability to provide recovery after Hurricane Harvey. Union officials say the health commission has lost nearly 11 percent of its eligibility operations staff — the workers who help connect Texans with public benefits.
In a statement for the union, Rashel Richardson, a caseworker in Houston, asked, “How are we supposed to work this much forced overtime week after week while our homes have been destroyed? How are we supposed to concentrate and get people services when we need services ourselves? It’s as if the state has no sympathy for workers who lost everything.”
There’s more, so read the whole thing. Not that there’s ever a good time for such a large agency that affects so many people to be dysfunctional, but in the aftermath of a huge natural disaster that has done so much damage? That’s a really bad time. Of course, HHSC has been a problem child for a long time, so none of this should be a big surprise. On the other hand, the HHSC under Greg Abbott has been particularly hostile to women’s health, so it’s all good as far as he’s concerned.