Editor’s note Friday, Dec. 8 12:07pm: This story has been updated to correct errors and to include information provided by HHSC after publication. All changes are immediately followed by an asterisk. Corrections are detailed at the bottom of the story.
For the last three years, workers at the Texas Health and Human Services Commission have worked mandatory overtime of 20 hours per month. Now, U.S. Rep. Lloyd Doggett has obtained an internal email from HHSC leaders urging employees to work even longer and harder – just in time for the holidays.
“During the month of December, [we] will be hosting the Holiday OT Blitz(en) to bring our lead days down!” the email reads. “You can work as much voluntary overtime as you want to in December beyond the mandatory overtime.”
“We are also encouraging you to spread the joy and share your daily experiences and highlights with your … teammates. [We] will be sharing some of your heartwarming stories and festive photos.” – Email from HHSC management
The HHSC email goes on to introduce “The 6 Days of Merry Service Challenge.” Employees who work at least 55 hours from Dec. 4 to Dec. 9 will be entered into a drawing for “amazing” but unspecified prizes. “We are also encouraging you to spread the joy and share your daily experiences and highlights with your … teammates,” the email says. “[We] will be sharing some of your heartwarming stories and festive photos.”
The 6 Days of Merry Service Challenge comes as HHSC has become a hostile work environment, according to a group of anonymous whistleblowers. Since July, the whistleblowers have sent a series of letters to Gov. Greg Abbott asking that he step in and fix dysfunction at HHSC. “With every passing day, the situation continues to decline,” said the most recent letter, released two days before Thanksgiving. “We are still experiencing major morale [and] communication issues and a gross lack of leadership.”
HHSC helps coordinate food and medical care for at least 6 million Texans – 1 out of every 5. It organizes and approves applications for Medicaid, the government program overseen by the Centers for Medicare & Medicaid Services that provides affordable health care for low-income citizens. And it organizes food assistance through SNAP, the Supplemental Nutrition Assistance Program overseen by the U.S. Department of Agriculture.
Early this year, the federal government announced that with the end of the COVID pandemic it would stop automatically reenrolling people on Medicaid.* It gave the states a year – from April 2023 through* April 2024 – to return to their standard practice of reviewing and approving applications for the programs.
Advocates say Abbott should have realized that the end of automatic re-enrollment would cause a major increase in work for HHSC employees, but he did not recommend the hiring of more permanent positions, though the legislature appropriated funds for raises and 600 temporary positions.* State leaders decided to work quickly, with HHSC processing the lion’s share of the applications (76% of the Medicaid population) in six months (between between April 1, 2023, and Oct. 8, 2023), HHSC told the Chronicle. Advocates including Stacey Pogue, Senior Policy Analyst at Every Texan, say the uneven approach contributed to the backlog.* Hundreds of thousands of people were erroneously kicked off their health care and food assistance, according to the Kaiser Family Foundation, though HHSC identified only 100,000 individuals who were denied improperly.* Still, the errors required HHSC to go through the applications manually to fix the improper cancellations. Almost immediately, a backlog in approval for the programs developed. It is now taking more than six months from the time applicants apply for SNAP to when their application is reviewed by HHSC, according to whistleblowers. HHSC disputes this, saying 74% of SNAP applications were processed within 30 days in November, while the time to process combined SNAP and Medicaid applications could be up to 120 days.*
Doggett is criticizing Abbott for “offer[ing] a raffle rather than a solution.” He says the governor should hire more workers and put effective leadership in place at HHSC. “Disadvantaged Texans shouldn’t have to win a raffle to secure needed health care, and going hungry is hardly ‘Merry,'” Doggett said in a statement. “Thousands of Texas children, seniors, the disabled, and others are the victims of two wrongs: Governor Greg Abbott’s Administration’s blatant violation of federal Medicaid rules, and CMS failure to use its oversight authority to protect them.”
Errors were as follows: We stated Gov. Abbott “did not recommend the hiring of more people or make any plan” to address application processing; while he did not recommend the hiring of more permanent positions, the legislature appropriated funds for raises and 600 temporary positions. We stated that Medicaid delays are unknown; HHSC says Medicaid applications are taking an average of 31 days to complete, and the time to process combined SNAP and Medicaid applications could be up to 120 days. We stated that the federal government announced it would stop automatically re-enrolling people on Medicaid and SNAP; the continuous coverage requirement did not apply to SNAP. We stated HHSC had one year, April 2023 to April 2024, to complete applications; HHSC says they have to May 2024, so we changed “to April 2024” to “through April 2024.” We stated state leaders decided to process re-enrollments over eight months instead of 12; HHSC processed 76% of the Medicaid population in six months. The Chronicle regrets the errors.
This article appears in Gift Guide 2023.
