Carlos Guerra: Privatizing social services assistance hasn't been smooth process
Web Posted: 04/09/2006 12:00 AM CDT
San Antonio Express-News
In 2003, Texas lawmakers overhauled the state's social services, shuffling programs into newly created agencies and forming a new Health and Human Services Commission to oversee it all. Now we are seeing the impact as more kids land in emergency rooms and more people show up to neighborhood food pantries.
Driven by the mantra that "the private sector can do it better and cheaper," House Bill 2292 also reduced benefits provided by federal-state programs that assist the elderly, young, poor and disabled. It eliminated many benefits entirely and restricted eligibility for assistance while reducing the time one could receive help before having to reapply.
For example, residents of nursing homes, where depression and diabetes are rampant, had psychiatric and podiatric care cut, and annual insurance coverage was trimmed to six months — with a 90-day period of non-coverage to penalize those who miss the deadline.
But the big cost-saver, we were told, would come from privatizing functions performed by state workers. A private contractor might realize great savings for Texas if it was determined — scientifically — that a contractor at a price determined by competitive bidding could handle these functions more efficiently.
But quickly, it became apparent that outsourcing wouldn't be determined scientifically and bidding wouldn't be that competitive. The HHSC rushed out a very questionable study that anticipated almost $700 million in savings by privatizing eligibility functions and just as quickly awarded a contract to Bermuda-based Accenture for four call centers, the largest of which — coincidentally — is in House Speaker Tom Craddick's Midland district.
And soon after Accenture started replacing the 2,900 professional state workers with $7-an-hour call center operators, it became apparent that taking orders for a home shopping cable network isn't the same as navigating the minutia of federal regulations.
Test operations in the Austin-area counties, where there aren't that many benefits recipients, resulted in thousands of CHIP, Food Stamp and Medicaid enrollees vanishing from the rolls as complaints of unmailed and missing applications — and entire files that disappeared — were registered in the thousands.
As the call centers' rollout extended into nearby counties in accordance with a plan that will make their reach statewide by year's end, it became apparent that the new multimillion-dollar computer system on which call centers rely doesn't work and the call center operators are very poorly trained.
On April 3, an internal memo from HHSC officials to the remaining state workers noted that "due to processing issues, certification periods are being extended for some TIERS Food Stamp (recipients whose) current certification period is ending on March 31, 2006."
Translation: To avoid news of another embarrassingly large reduction of Food Stamp enrollees, just extend recipients wholesale, whether they deserve it or not, until we can get this damned thing to work.
Two days later, another e-mail said "technical and operational improvements need to be made before we roll out the new system in other areas," so the call centers will be put on hold for at least 30 days.
Isn't it time for Texas to join at least four states, the province of Ontario and the Marine Corps and just fire Accenture?