As Greg says, you know the state's plan to privatize the Texas Health and Human Services Commission is way out there when the federal government is publicly questioning its ability to deliver services to those who need them.
Until this week, Texas officials were confidently moving forward with the private call-center plans with no federal approval, conditional or otherwise.
This month the state began shifting an existing call-center contract for the Children's Health Insurance Program to Accenture. In January, Accenture's new call center in Midland will begin processing applications for children's Medicaid.
The major impact of privatized screening will be felt between April and December next year, when officials close 100 eligibility offices, including Houston's Harwin office next summer.
Of the 211 eligibility offices that will remain open, only 167 will be open full time.
"Texas' project entails a major change in the configuration of service delivery that merits special oversight," William Ludwig, regional administrator for the U.S. Agriculture Department, wrote to Hawkins in a letter dated Nov. 7.
Ludwig called for very close federal oversight in the next three months and extra care to make certain the elderly and disabled are not disadvantaged by call centers. If remaining issues can be resolved in the next 30 days, the USDA will approve $23 million in federal administrative dollars for the first three months.
Ludwig stressed, however, that any future federal dollars for administration will depend on "demonstrated success" of initial phases of the call-center project.
"It remains to be seen whether this is going to be a real pilot or whether the state is going to get more money in three months," said Celia Hagert, an analyst at the Center for Public Policy Priorities in Austin.