Sunday, March 18, 2007

Bitter Sweet Vindication for Carlos Guerra

From the very start of the Accenture/HHSC Privitization debacle, there has been one voice in the media that had this whole thing pegged -- Carlos Guerra of the San Antonio Express. Those who were watching things unravel from the inside had at least some consolation that someone with a voice in the main stream media "got it". I heard later that he was getting some grief at his paper, because he wrote so frequently on the subject... and then unfortunately the frequency of his commentaries on this subject declined sharply. He now has a new piece in which he get's to tell everyone he was right. I am happy for him in that respect, though it is clear that he takes no delight in the fact that so many people had to be hurt before the powers that be finally decided to change course.

This whole disaster was not only preventable, and predictable -- it was predicted by many many voices, my own included.

Here is Carlos Guerra's op ed:

Carlos Guerra: A contract that failed miserably, taking 200,000 Texas kids with it

Web Posted: 03/14/2007 11:01 PM CDT


Having first written in May 2003 about what was coming, I wasn't surprised Tuesday morning when Will Rogers of the Texas State Employees Union wrote to say that "Accenture and (the Texas Health and Human Services Commission) will jointly announce that the contract will be 'unraveled,' with each party 'going its own way.'"

Nor did I gag when HHSC and Accenture officials tried to put a positive spin on the dissolution of possibly the nation's largest contract to privatize a state's social services safety net.

I wasn't alone.

"I hate to say that I told them so, but I did — for four years," sighed state Sen. Carlos Uresti, D-San Antonio.

It began when the 2003 Legislature faced a $10 billion budget shortfall and the ideologues in charge were intent on rolling back taxes instead of raising any. So they opted to make up the shortfall largely on the backs of Texas' most vulnerable.

House Bill 2292 was a "reform" and "modernization" of Texas' health and human services safety net, they said, and it would save Texas hundreds of millions through privatization and by being more businesslike. After all, business does everything better than government.

A close reading of 132-page HB2292 revealed the massive reorganization of Texas' social services agencies really was a convenient cover for its more nefarious provisions.

Any real savings, I wrote then, will accrue from slashing or eliminating benefits, unconscionably stiffening eligibility standards and systematically making applying for benefits so frustrating that, needs notwithstanding, people will become discouraged and quit seeking benefits.

At the heart of HB2292 was authorization for HHSC to privatize enrollment for CHIP and Medicaid, and other critical safety net programs.

But a year later, HHSC insisted $177 million would be saved by contracting for four privately run centers to take applications by phone, fax or the Internet, and the firing of 3,377 of the state's 7,864 trained field workers and the shuttering of 217 of the 381 field offices.

Bermuda-based Accenture headed the consortium awarded the $899 million call center contract. But problems surfaced early on, such as interminable hold times and operators giving applicants incorrect information. Software broke down and documents were lost, some of which were inexplicably faxed to a Seattle warehouse.

The new system's roll-out repeatedly was postponed, the call centers' workers had to be retrained, and soon after the trained state workers started getting pink slips — by e-mail, no less — many had to be rehired.

"As (House) Government Reform chair, we had Accenture and HHSC testify, and they kept saying, 'It's getting better, everything is working great'" Uresti says, "when, obviously, that wasn't the truth, or 200,000 kids wouldn't have fallen off CHIP."

And it was shrinking CHIP rolls that set off the outcry that finally has resulted in Accenture getting the boot.

But that's hardly all that has gone wrong.

"This has done more damage to Texas than you can imagine," Uresti adds. "Everyone talks about CHIP and Medicaid because they recognize them; but this has also affected our seniors, our mentally retarded, our disabled, pregnant moms and on and on and on."

And aside from the human cost, this disaster may end up costing hundreds of millions after local indigent health-care costs are factored in.

But there also are lessons.

"We want to balance the budget, but you don't give out a $900 million contract — no company would — without having safeguards in place, without having performance measures and if they aren't met, we cancel the contract, instead of giving them more time," Uresti adds.

Details of what Texas will do now seem to be unknown.

But Uresti's characterization of this debacle is quite apt: "We put all our eggs in one basket, and they dropped the basket."