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Health and Human Services Commission

The food banks pitch in

It’s great that they’re making such a difference. It’s a crime that it took so long and that the problem got to be so bad before they were called in to help.

Last year, food banks had to step up to help hundreds of families when the recession and a meltdown of Texas’ food stamp application process caused them to miss out on months’ worth of benefits.

Now, food banks and pantries in Dallas, Fort Worth, Houston and San Antonio are doing it again as the state works, under federal orders, to reduce backlogs and improve service at the offices where it determines if Texans are eligible for aid.

The need is still evident. Hungry, desperate people are flocking daily to Metrocrest Social Services, a food pantry in Carrollton’s central business district.

[…]

One of every eight Texans is receiving food stamps. The onslaught of need walloped a state food stamp application process already listing from hurricanes, a failed privatization effort and cuts to the state eligibility workforce five years ago.

Texas Health and Human Services Commissioner Tom Suehs took over last fall, when rapid turnover and chaos at state offices thwarted thousands of eligible Texans from getting benefits, often for months at a time. He seized on a 4-year-old arrangement, under which the food banks take applications. The initial case work being done by food banks’ outreach workers was pretty good, Suehs said, so why not pay them to do more?

Read the whole thing. First, kudos to Tom Suehs for making as much progress on this as he has, in just over a month. Frankly, we’d probably be no further along if it weren’t for Suehs and for the threat of federal sanctions for the state doing such a lousy job of this. And read that first sentence in the penultimate paragraph again. When Rick Perry talks about how well Texas is doing compared to other places, he’s not speaking to or about those one-in-eight people. Lord knows, he did nothing to help them.

Who will administer Texas’ health insurance exchange?

As we know, one of the provisions of the Affordable Care Act is the creation of health insurance exchanges for those who are currently uninsured and need assistance in getting it. The states are supposed to operate these exchanges, and that means some kind of action needs to be taken to get it up and running. In particular, some entity needs to be responsible for it. State Rep. John Zerwas, the chair of the House Select Committee on Federal Legislation, thinks that a new agency may need to be created for this purpose.

Zerwas, of Richmond, said he was not sure yet if the new entity would be a commission or an independent agency or something else.

But he said he does believe an organization other than the state Department of Insurance or the Health and Human Services Commission will be needed because neither agency has the capacity to take on the task.

Because of so many unknowns, Zerwas was unable to say how much money and how many people would be needed.

Zerwas added that one model could be the authority that handles a health insurance exchange in Massachusetts, the only state that currently requires residents to buy insurance.

Massachusetts Health Connector, an independent state agency that helps residents find health care coverage, opened in 2006 with $25 million in seed money appropriated by the Massachusetts Legislature. It has about 50 employees and generates its own revenue, spokesman Dick Powers said.

In Texas, legislative action would be needed to create an entity to oversee an exchange , Zerwas and other lawmakers said.

“I would be receptive to being the author,” Zerwas said.

Zerwas was an unconvincing critic of the health care legislation as it was being crafted and debated, but I have no reason to think he’d do anything but a good job figuring this out; State Rep. Garnet Coleman is also on this committee, which is an even stronger reason for optimism. I don’t have a preference at this time for how this should be approached, but with any Texas agency, the main concern is always oversight. The list of state agencies that have demonstrated that they cannot be trusted without strict supervision is a long one, and though that’s more than partially the fault of the guy who picks the heads of these agencies, this isn’t exactly a new problem. So let’s please try to get this right.

Making money on both ends

I’m glad to hear that the food stamp backlog should be cleared up soon. I’m not so glad to hear that one of the guys who bears responsibility for getting us into that mess in the first place now stands to benefit from the work to get us out of it.

Gregg Phillips was the state’s No. 2 social services official several years ago, and he led a push to hire a private company to evaluate applications for public assistance.

Now his Austin-based company, AutoGov Inc., has received $207,500 since November to help the state eliminate errors in deciding whether an applicant gets food stamps or other aid and how much recipients get. AutoGov was hired without other companies having a chance to bid for the work.

Health and Human Services Commission spokeswoman Stephanie Goodman said that the agency’s commissioner, Tom Suehs, and his predecessor, Albert Hawkins, agreed that the company’s software might alleviate the problem.

“They both faced the same problem – high error rates – and thought it offered a potential solution,” Goodman said.

State laws on former employees lobbying or contracting with agencies would not prohibit such an arrangement, given that Phillips had been off the state’s payroll for several years. But critics of the deal say it’s troubling that a former employee is getting paid to try to fix problems spawned by an idea he helped hatch.

A leader of a state employees union complained that Hawkins and Suehs – both appointees of Gov. Rick Perry – again have sought high-tech, low-cost fixes for the loss of experienced state workers.

Mike Gross, vice president of the Texas State Employees Union, also said he’s troubled that Hawkins approved a vendor subcontract with two of his former aides – Phillips and AutoGov’s chief executive, Rose A. Hayden, Hawkins’ former chief of staff. The company is paid as a subcontractor to the larger firm that the state hired to run the system.

“The whole thing smells very bad,” Gross said. “We’re now hiring the guy who got us in the mess in the first place. It is absolutely stunning.”

The Gregg Phillipses of the world are like cockroaches. You can never get rid of them. I suppose after all this time I shouldn’t be surprised. The DMN story has a lot of background, and you can get more here.

Food stamp application backlog to be cleared by April

Here’s a little bit of good news.

Texas’ food stamp application backlog is now expected to be cleared by the end of April, Health and Human Services Executive Commissioner Tom Suehs told lawmakers today.

[…]

The commission had projected it would clear the backlog by February. That didn’t happen. Though the backlog disappeared in the Tyler, Beaumont, Austin, El Paso and Edinburg areas, there were still 16,000 applications in February for which decisions were past due, Suehs said. About 90 percent of that backlog was in the Houston and Dallas areas.

Suehs now expects the Lubbock, Abilene and San Antonio regions to clear the backlog by the end of March, he told members of a joint Senate-House panel overseeing the state’s system for enrolling Texans in programs such as food stamps and Medicaid. And he expects the Dallas and Houston areas to be back on track by the end of April.

Getting food banks involved has helped, as you might expect. The problem was shameful and inexcusable, the resolution has taken far too long, but at least it’s imminent. That’s a good thing.

Food banks to help with food stamps interviews

This sounds like a good idea.

Houston’s food bank will begin helping qualify eligible Texans for food stamps on Monday under special authority from federal officials designed to shorten long wait times.

The waiver will allow food banks in Houston, San Antonio, Dallas and Fort Worth to handle food stamp applications directly. Food bank officials in those cities will have access to state computers to make sure applicants are eligible and not already receiving food assistance.

The interviews that food bank employees conduct with applicants no longer will have to be repeated by state employees.

The interviews take about 30 minutes. The San Antonio Food Bank expects to handle up to 3,000 applications per month, which would save the state staff roughly 1,500 hours. Houston Food Bank officials said they do not have as many applicants — Bexar County has a more sophisticated outreach program — and they expect to process 500 applicants per month, which would save state employees about 250 hours.

“It’s a natural fit for us to be able to help those needy get food stamps, so we think this is potentially very big,” said Brian Greene, president and CEO of the Houston Food Bank. “This should have a significant impact both on the number of families who are eligible to receive food stamps and reducing the waiting time for the families.”

Every little bit helps, and this is a sensible solution that can help right away. We still need to fix the underlying problems, but anything that gets more people the assistance they need faster is worth doing.

State to audit food stamp delivery process

Better late than never.

Health and Human Services Commissioner Tom Suehs has asked [state auditor John] Keel to audit the food stamp program to improve accuracy and efficiency.

“We must fix our system so that it works for everyone. I’m asking the state auditor to help us identify both immediate and long-term solutions to make sure all Texans are able to get their cases processed on time,” Suehs said.

Keel assigned a team to start the review as soon as he got Suehs’ letter on Tuesday.

“It’s an audit that needs to be initiated immediately,” Keel said Wednesday. “We’re going to study the process and look for efficiencies. We do want to look at other states.”

Employee recommendations also will be considered, said Keel, who would not speculate on how long the audit would take.

I’m sure it will take months, because there’s got to be a ton to find that needs fixing. I feel certain that there’s only so much that can be improved without legislative action, perhaps spurred by a lawsuit verdict, an infusion of money, or a trip through the time machine to prevent the disastrous privatization scheme that has decimated HHSC from ever occurring, but this is not a stone that should be left unturned, so kudos to Suehs for taking the step.

Another food stamp lawsuit

Back in August, a federal lawsuit was filed over the interminable delays that food stamp applicants face in Texas getting their forms processed. That suit was dismissed in October by Judge Sam Sparks on the grounds that the federal law didn’t allow for suits, so now the same lawyers as before have refiled in state court.

The suit, filed in state district court in Travis County, asked that the Health and Human Services Commission be ordered to comply with the rules, which require decisions on non-emergency food stamp applications to be made within 30 days.

Last month, the commission processed about 58 percent of applications statewide on time – in North Texas, it was 41 percent.

“Some of these people have been waiting for six months. It’s ridiculous,” said Robert Doggett, an attorney with Texas RioGrande Legal Aid in Austin. “We’re asking for a judge to order the department to make these decisions timely.”

We’ll see if they have any better luck there. You can read more about the food stamps saga here.

Food stamps fail

News item: Budget board denies request for more food stamps workers.

The Legislative Budget Board has denied a request from the Health and Human Services Commission to hire about 650 state workers to relieve the state’s food stamp enrollment system, which is struggling with backlogs and errors.

The additional workers could help address both of those problems, now-retired Health and Human Services Executive Commissioner Albert Hawkins told the budget board and the staff of Gov. Rick Perry in an August letter.

This week was the deadline for the budget board or the governor to decide on the request; if they did nothing, the request would be automatically approved.

[…]

Celia Hagert of the Center for Public Policy Priorities, which advocates for low- and middle-income Texans, said that waiting to hire the workers isn’t fair to families waiting for food stamps.

“We have hundreds of thousands of Texans needing help affording food and caring for their families,” Hagert said. “The clock has run out for these families.”

News item: Federal officials: Texas could lose food stamp funds if problems aren’t fixed.

Federal officials have warned Health and Human Services Executive Commissioner Tom Suehs that unless Texas fixes serious problems with its food stamp enrollment system, it could lose federal funds.

“The current status of (food stamp) administration in Texas is unacceptable and actions must be taken immediately,” says the letter from the U.S. Department of Agriculture’s Food and Nutrition Service, which administers the food stamp program.

Specifically, the letter says, the state is not complying with federal law on processing applications on time. Applications must be processed within 30 days, but the state is failing to process more than a third of applications by the deadline, according to state data. Processing in the Dallas and Houston areas is especially slow, and in Austin, it’s better than the rest of the state.

Celia Hagert of the Center for Public Policy Priorities, which advocates for low- and middle-income Texans, called the letter “a warning sterner than we’ve ever seen before” from federal officials.

Great timing by the LBB, eh? Reading this, I’m struck by the thought that the feds don’t really have any leverage to make Texas do the right thing. Yeah, sure, they can withhold funds, but all that does is further injure the people who are already being hurt by Texas’ manifest failures. And pardon me for saying so, but taking care of the needy isn’t exactly an issue for GOP primary voters, so it’s not like there’s a political incentive for Governor Perry to clean things up, or for Senator Hutchison to inveigh against him. Maybe, given that Texas is violating the law here, there needs to be some kind of legal accountability for it. If the ultimate remedy were the garnishment of Tom Suehs’ wages, or tossing him in jail, till a satisfactory remediation plan were being executed, I bet that would get a swift response. But turning off the federal spigot? I hope it works, but color me skeptical.

The stimulus and the budget

State Rep. Jim Dunnam, who is the chair of the ad hoc committee that is charged with disbursing federal stimulus funds, gave an update on their proceedings. Among other things, the federal money may free up some state revenues.

Normally, the federal government pays about 60 percent of Texas’ Medicaid expenses, a contribution known as the Federal Medical Assistance Percentage (FMAP). Under the stimulus law, the federal government would pay around 66 percent of the expenses, which would, according to Health and Human Services commissioner Albert Hawkins, free up about $4.6 billion in general revenue. Some of it would go to make up for the Medicaid shortfall, but the rest would be free to be appropriated.

The stimulus law says a state is not eligible for in increase in its FMAP funding if any of the increase ends up, directly or indirectly, in a state’s reserves or rainy day fund.

“There’s a question as to what that means,” Dunnam said. He said the committee did not yet know whether maintaining the rainy day fund at its current level would result in the feds revoking the FMAP funds. At the beginning of the session, comptroller Susan Combs reported the state had a $9.1 billion budget shortfall, and it seemed to make ends meet, legislators would have to dip into the state’s reserves.

“It was very, very clear that if not for the stimulus money that we were going into the rainy day fund,” Dunnam said.

The committee hasn’t discussed what to do with the freed general revenue, but it seems like Dunnam would be in favor of spending it. He said the stimulus funds were intended to stimulate the economy. If Texas were to use federal funds where state funds are usually spent, and keep state funds, then, he said, “you haven’t complied with the intent of the act.”

I feel confident there will be some pushback on that, mostly from Governor Perry. Which is why the more that he can be reduced in influence, the better. I hope that the end result of all this is a realization that we do have more money in the budget than we first thought, and should re-evaluate our assumptions about how we appropriate accordingly. If that means it takes a little longer than usual to bring HB1 to the floor, then so be it. Better to get it right than to rush.