Wednesday, December 28, 2005

Is TIERS ready?

The short answer is "No!"

For backgroud, click here.

Is TIERS ready?
Questions linger as state prepares to roll out a new computer application for public assistance eligibility.
By Corrie MacLaggan

Thursday, December 22, 2005

Peggy Maceo was surprised to receive a letter in October saying her sister's take-home Social Security benefits were being cut.

The $78 monthly Medicare insurance premium, normally paid by the state, would be deducted from each monthly check of about $500, the letter said.

Turns out the letter was a mistake: Nora Maceo, 50, who has a brain disorder called Huntington's disease and requires around-the-clock care at her Austin home, was one of almost 600 Texans affected by a computer problem as the state prepares to introduce a new benefits application system early next year. It was the most widespread of several problems that have affected public assistance recipients across the state during the transition.

State officials could not say precisely how many people have been affected but said a few thousand "may have had a discrepancy in benefits," according to Jennifer Harris, a spokeswoman for the state Health and Human Services Commission.

"This kind of thing is getting to the people who are most vulnerable — that's the worst part of it," said Peggy Maceo, 55.

The new computer system, Texas Integrated Eligibility Redesign System, or TIERS, is drawing criticism from state employees, advocacy groups and public benefits recipients who say it is not ready to roll out statewide next year.

"We're hoping the system will work," said Jesse Benavidez, a state employee who addresses bugs in TIERS at an Austin benefits office on Airport Boulevard. "But it's like, 'When will that happen?' "

Commission officials say that TIERS — which has been in a pilot stage in Austin and San Marcos since 2003 — is ready to go and that it is being unfairly blamed for problems that may be caused by human error or the old computer system. They point out that TIERS has a lower rate of defects than many major operating systems and software used in the public and private sectors.

TIERS is the backbone of the state's new almost $1 billion benefits eligibility system. The state will close some offices where people meet face-to-face with caseworkers to apply for public assistance, such as food stamps and Medicaid, and replace them with call centers managed by a private company and supported by TIERS.

About 3 million Texans receive public assistance, and the files of more than 140,000 recipients are now in the TIERS system. The new benefits eligibility system is expected to save $646 million over five years, although critics have questioned those numbers and complained about the closure of some offices and the elimination of 2,900 state jobs next year.

Harris said that when the files of about 40,000 recipients of long-term care benefits, such as Nora Maceo, were converted to TIERS in the spring, errors popped up in slightly more than 1 percent of those cases. After learning about the problem from benefits recipients, state officials tried to work quickly with federal authorities to identify and reimburse the recipients, Harris said.

They thought that the issue was resolved months ago, but problems lingered for some as the state encountered new computer problems.

Peggy Maceo, who first noticed a separate problem during the summer, when one of her sister's prescriptions was denied, was not reimbursed for all the money deducted from her sister's checks until Dec. 10.

Maceo, director of the Huntington's Disease Association of Texas, acts as an advocate for her sister. But she wonders what could happen to those who do not have people helping them.

Susan Zinn, manager of the health law team at Texas Rio- Grande Legal Aid, said her organization, which provides free legal services to the poor, has fielded calls from people who have had problems like Maceo's. She is worried about the statewide rollout.

"We're concerned that people's applications for benefits will not be handled in a timely manner, we're concerned that people will get lost in the system, and we're concerned that papers will get lost in the system," Zinn said from her office in San Antonio.

But Mary Katherine Stout, health policy analyst with the Texas Public Policy Foundation, which supports limited government, said the glitches found during the TIERS pilot program show the importance of that pilot in identifying and correcting problems.

"While there may still be bumps to work out, I am confident that in the longer term, the benefits of a more streamlined system, a more applicant-friendly system, and improvements and efficiencies from a modernized system will outweigh any initial problems," Stout wrote in an e-mail. The project has been in the works for almost a decade. In 1997, the Legislature decided to begin updating the computer systems that manage the state's eligibility services, which the state has used since 1978. The old system relied on a computer language now taught in computer history classes.

"It was a recognition that you've got a dinosaur, and you've got to start doing something else," said Stephanie Goodman, a commission spokeswoman.

In 1999, lawmakers allocated $300 million for the project; so far, they have spent $296 million.

Every three months since the TIERS pilot program began, the Web-based computer system has been updated based on user feedback, state policy changes or new federal requirements. Accenture Ltd., the company that will manage the call centers, took over TIERS in November.

As TIERS project director Leah Burton's group converts files from the old computer application into TIERS, errors left over from the old system arise in about 16 percent of files, she said. About half of those would affect people's benefits. The rest may involve a minor discrepancy in, for example, a name or address.

Burton has a team called the Benefits Corrections Unit that addresses errors found during the conversion.

As of this month, there were 186 defects associated with TIERS, down from about 330 at the end of October, state officials said. Some of those are actual bugs in TIERS; others are mistakes caused by human error. Some could affect benefits; others are "cosmetic problems" — for example, a user's screen does not display components in the preferred arrangement.

"Nine times out of 10, when people think there's a TIERS problem, it's just data entered incorrectly," Burton said.

The software industry measures the quality of a computer application in terms of, among other things, how many defects there are per 1,000 lines of code. TIERS has .074 defects per 1,000 lines of code, Harris said. The 2002 National Software Quality Experiment found a national average of 4.9 defects for every 1,000 lines of code, she said.

"There will always be defects, and that's not unique to TIERS," Harris said. "As long as a system is dynamic, and you have state and federal policy changes almost continuously, there may be items that need to be modified or fixed." Recently, at the eligibility office on Airport Boulevard, caseworker Cynthia Cerrillo helped DeAnna Benavides, 19, David Herrera, 18 and their 8-month-old daughter, Laelah, apply for food stamps and renew the baby's Medicaid benefits when the case hit a snag — the system wasn't showing the baby's Medicaid information. Apparently, when the file was converted into TIERS, Laelah was listed twice in the system. Cerrillo worked around the problem and finished the case, which took more than an hour.

"There are a lot of glitches still, but with any new program there will be," she said. "You just have to learn to work out the kinks."

But for those who depend on public assistance, the computer problems are not just an inconvenience.

"This is a lot more than a glitch," said Peggy Maceo, 55. "These little mistakes weigh heavily on the lives of people."