The debate over whether Texas can better deliver social services is currently centered on the state's contract with the Texas Access Alliance, whose lead contractor is Accenture. Under the contract, the state is piloting a new eligibility system that allows applicants and beneficiaries to enroll in state health and human services programs the traditional way (showing up at a state office), and by telephone, mail, fax or the Internet. By allowing telephone, mail, fax and Internet communications, HHSC moves into 21st Century customer service, and makes it easier for working and parenting Texans to gain access to needed services. Some want to return to the old system of requiring face-to-face visits to a state office. Under that old bureaucratic model, Texas was spending about $700 million per year – with approximately 10,000 state workers and 500 state locations - just to determine eligibility for health and human service benefits. The cost of returning to 2002 levels of inefficiency would be more than $500 million dollars for the next biennium. The old model required needy Texans to take time off work or away from family to go to a state office, wait in line and meet with a state employee. The new system aims to increase convenience and save time and money for beneficiaries and taxpayers. Here are the facts surrounding HHSC and the new customer eligibility service model:
- Since 2001, Health and Human services biennial funding has increased $18.3 billion, which amounts to 29 percent over that period of time and included an additional $4.5 billion during the 2005 Legislature.
- State leaders and the Texas Legislature approved changes to the state’s health and human services program eligibility determination system to increase customer service, efficiency, and reduce fraud and abuse.
- CHIP eligibility has always been performed by a private contractor through call centers.
- Currently, only two counties (Travis and Hays) are included in the pilot project. This means the pilot project has had no affect in programs, such as Food Stamps, Medicaid and TANF in other areas of the state.
- This major undertaking has been difficult. Changing eligibility systems, technology and services will generate some problems and glitches. The state is holding contractors accountable to fix problems and improve enrollment services for needy Texans.
- The eligibility system is improving. In July, the most recent month that statistics are available, average telephone wait times were only 65 seconds for CHIP enrollees, and 16 seconds for other services (food stamps, Medicaid, TANF).
Currently, Texas boasts one the strongest economies in the country. The unemployment rate has dropped eight-tenths of a percentage point to 5.1 percent in the past year with the creation of 153,500 non-farm jobs. More than 600,000 Texas jobs have been added in the past 34 months. - With families earning better incomes and more people active in the workforce, the demand lessens for low-income programs, such as CHIP and Medicaid.
- In fact, between 13 and 20 percent of CHIP families were not re-enrolled because their families passed the maximum allowed income of $40,000 per year (for a family of four) or did not qualify for similar reasons needed to continue coverage.
- Additionally, new job creation has allowed many past dis-enrollees to obtain private or employer-sponsored health insurance or Medicaid. New York, Florida and Ohio have also experienced downturns in their CHIP caseloads over the past year.
The facts speak for themselves: - The project has answered 3 million calls, and more than 1.9 million social service applicants and beneficiaries have received application materials.
- Users have voiced a high degree of satisfaction with the new options for applying for benefits. Many are thankful for easier access because it saves them a trip to the office.
- The new CHIP enrollment fee costs no more than $25-$50 for 6 months coverage.
- The $25-$50 enrollment fee is not a per child amount, but rather per family. Therefore, a family with three or more children would be paying less than $3/month per child.
- The Legislature remains committed to maintaining CHIP for eligible children and hopes parents will continue to look after the vital needs of their children by taking advantage of the benefits available to them.
- For TANF, Food Stamps and Medicaid, the privatization effort only includes the input and collection of applications. Eligibility determinations remain in the hands of state eligibility workers. It was never the goal of this project to change that facet.
Safety Net Protection: - HHSC negotiated a contract with Texas Access Alliance that has significant protections for the state and for users of the new system.
- Estimates already show the contractor will earn less funds as a result of the early poor performance.
- The Legislative Budget Board approved an estimated $56 million in May primarily to retain an additional 1000 state eligibility workers to assist in handling the increased workload associated with the conversion, to meet statewide demand, and comply with federal requirements for the transition.
- Clients may still go to field offices, all of which are still in operation. No offices have been closed due to the new eligibility system, and those that are scheduled to close are within close proximity to other existing offices. When the new eligibility system is fully rolled out, there will still be more than 200 local offices.
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