Public Benefits, Privatization Problems

The Texas Integrated Eligibility Redesign System – still fraught with challenges as privately run call centers struggle to handle thousands of needy clients – was the subject of a critical hearing before the House Government Reform Committee last week. The Austin-San Marcos area has served as the pilot area for the rollout of TIERS, which relies primarily on vendor call-centers run by the technology outsourcing firm Accenture, using common software to process new and renewing clients for a variety of social-service programs across various agencies. These programs cross both agency and computer platform, and the struggle to integrate has been mighty, according to both the agency and those critical of TIERS.

At last week's hearing, those critics – including current state employees who face imminent layoffs – labeled Accenture's integration of various programs as ill-conceived, and called the software slow, inadequate, and sometimes even inaccurate. Groups contracted to enroll children in the Children's Health Insurance Program, like Avance in the Rio Grande Valley, expressed frustration over the inability of Accenture's contracted workers to keep up with paperwork and handle phone calls.

Lawmakers, especially from those low-income areas where CHIP enrollment is heaviest, had a sharp warning for the Health and Human Services Commission, and Accenture. State Rep. Veronica Gonzales, D-McAllen, said it was simply unacceptable to see that the state was enrolling fewer children in CHIP than it did five years ago. And Chair Carlos Uresti, D-San Antonio, did not hide his frustration with the program, especially when it came to questioning the savings promised by Republican sponsors. "It's no secret that I've been a critic of the program and policy decisions that led up to the eligibility system. Today's hearing is not to revisit those debates," he said. "This is not a Republican or Democratic issue. This is a malfunctioning of a system that is taking its toll on the lives of the most vulnerable in our society."

The primary goals of TIERS, passed under HB 2292, were both greater efficiency and cost savings, primarily through closing offices and consolidating programs into a single application. The full rollout, however, has been in limbo as Accenture has tried to work out the snags in the software. Three years after the bill was passed, it's still unclear how much of the promised $640 million in savings the state will see over five years, though HHSC Executive Commissioner Albert Hawkins promised the savings would be "on course" once the model was implemented.

Hawkins and Deputy Commissioner Anne Heiligenstein spent about four hours on the hot seat, answering questions from lawmakers on everything from the abandon rate on phone calls (performance is getting better) to the notification of clients for renewal (three times, by letter) to the impact of new income standards and the six-month enrollment period for families in CHIP (a factor in declining numbers).

Already, with the full rollout delayed, the state has retained 1,000 staff members it expected to lay off and pumped another $56.1 million into the current system. Heiligenstein said it was unfortunate HHSC had to learn the lessons it had from TIERS, but those lessons are being absorbed, and addressed, in training and staffing.