Sunday, April 16, 2006

Carlos Guerra: USDA letter to state welfare bosses shows call centers' problems

Carlos Guerra: USDA letter to state welfare bosses shows call centers' problems

Web Posted: 04/16/2006 12:00 AM CDT
San Antonio Express-News

Just before closing time on April 5, Health and Human Services Commission head Albert Hawkins announced that Texas' new call centers — run by Bermuda-based outsourcing behemoth Accenture — wouldn't be rolled out as planned.

Callers were experiencing unexpectedly long wait times, Hawkins said, and some operators weren't adequately trained. The $899 million experiment also needs to resolve some technical issues, he said. So, until the flaws are fixed, expansion of the boiler-room operations will be put off indefinitely.

HHSC started rolling out the four-call-center system Jan. 20, when Accenture's Midland call center started screening applications from the Austin-San Marcos area for the Children's Health Insurance Program, Medicaid, Food Stamps, Temporary Assistance for Needy Families and long-term care.

The plan was that by year's end the call centers would be fully functional and doing the work of 2,900 state workers who will be fired as HHSC closes 99 of its 310 field offices.

About the same time that the call centers went online, however, a number of changes to the application process and in eligibility requirements also took effect.

The results were predictable.

There were widespread reports of botched and lost applications, and erroneous denials of benefits not only in the Austin-San Marcos area, but statewide. And enrollment in Texas' social services safety net programs plummeted, a precipitous drop still in progress.

Enrollment in CHIP, which once insured more than 500,000 kids from families that earn too much to qualify for Medicaid but still can't afford commercial insurance, dropped below 300,000. Even larger declines were reported for Medicaid, which insures Texas' poorest.

In three months, 21,000 children lost CHIP coverage, and an additional 79,000 lost Medicaid, prompting state officials to order reinstatement of CHIP benefits for at least 6,000 kids mistakenly dropped.

Now, it appears that delaying the rollout of Accenture's call centers wasn't entirely the doing of conscientious state officials.

On April 5, Hawkins received a scorching letter from the U.S. Agricultural Department's Food and Nutrition Services, which administers the Food Stamp Program that pumps billions of dollars into Texas grocery store registers.

"We believe you will agree ... that the following concerns give pause to expansion to the next rollout area without substantial improvements in system functionality," USDA Regional Administrator William Ludwig wrote. "Vendor performance is questionable as evidenced by the high percentage of cases that are returned to the vendor because of missing information and errors (40 percent), (and) case file documentation needs to be substantially improved to support program access and integrity."

A five-page attachment pointed out that instead of the 5 percent of callers HHSC expected would hang up, as many as 54.5 percent abandoned their phone calls because of interminable waits.

The feds' random review of call-center recordings also found that Accenture's operators were "sending clients to the wrong certification office; telling clients that applications would be processed in 30 business days; not providing information on the complaint process to clients who complained of rude treatment; clients were referred between (call centers) and local offices; and incorrect information (was given) about the appointment process."

This mess cannot be allowed to grow. Action is needed now.