Senator Eliot Shapleigh - El Paso, Texas

AUSTIN - The Texas Health and Human Services Commission has run out of the application forms parents use to make applications for CHIP and Children's Medicaid.

Some of the community-based organizations that help parents apply for the programs say the agency's failure to provide what are called TexCare colored application booklets is hampering efforts to get CHIP enrollments back to the levels they were at before the 2003 cuts.

"It's a total mess," said Luisa Saenz, project administrator for the Children's Defense Fund in the Rio Grande Valley. "When the cuts to vision and dental care were restored, we planned a major outreach strategy to get CHIP numbers back to where they were. Now, with these booklets being unavailable, we've hit a barrier again."

Saenz said CDF-RGV had applied for 30,000 application forms. In response, Saenz said she was told that there were only 7,000 for the whole of the state.

Saenz said non-profit groups could download the four-page application forms off the Internet, but that puts the burden and costs onto groups like hers. Saenz said that prior to the September 2003 cuts, the four-county Valley area had 46,208 children enrolled in CHIP. Since then, there has been a 41.5 percent drop in enrollment. "We need at least 25,000 application forms for us to get back to CHIP levels," Saenz said.

Confirmation that HHSC has run out of the application booklets came via an e-mail sent to non-profit groups by Kimberly Davis, the agency's manager for Medicaid and CHIP acute care policy development.

Davis said that in June, HHSC printed 100,000 colored application booklets, an amount based on historical ordering patterns and anticipated to last through November 30. That is the date HHSC switches contractors for CHIP administration, from ACS-CHIP to Texas Access Alliance, a subsidiary of Accenture.

"While we are currently out of the colored application booklets, this does not mean that a family cannot apply for children's health care coverage," Davis said. "If a parent calls the TexCare 1-800-647-6558 and starts an application, they will receive an application in the mail to complete and return."

Davis confirmed the agency had only 7,000 application forms in stock. She said HHSC was in the process of notifying everyone who had placed an order and whether or not the agency could fulfill the order.

"We were able to send 250 colored application booklets to 28 out of the 40 orders. We are currently working with the Office of Eligibility Services to identify options for additional printed applications until TAA is operational," Davis said.

Jennifer Harris, a spokeswoman for HHSC, said there were still many ways for parents to apply for CHIP.

"We are looking at possible short term options for additional printing of applications during this interim period as we transition to the new contractor," Harris said. "In the meantime, we're working with our contractors and community based organizations to ensure that CHIP families are well aware of the call center and web-based application availability."

Saenz said that asking parents to call a 1-800 number to make an application was problematic to many Valley residents. She also pointed out that very few CHIP families in the Valley have access to the Internet.

"Many of them do not have access to a phone, particularly in the colonias and the rural areas," Saenz said. "This is why we and the Children's Health Coalition of the Rio Grande Valley work through the school districts."

On Sept. 1, the first day of the restoration of key CHIP benefits, CDF-RGV announced a massive insure-a-kid school outreach program to increase the enrollment of eligible students in the Donna, Edcouch-Elsa, Edinburg, Mercedes, Mission, Pharr-San Juan-Alamo, and Weslaco school districts. Saenz said that through the insure-a-kid program, the seven participating school districts had identified over 26,000 uninsured students.

"We were told we could only order two boxes at a time in order to share with the rest of the state, with each box containing 280 application forms. For a school with 4,300 students, that is simply not going to work," Saenz said.

Saenz said parents were also complaining that ACS employees were referring applicants back to the non-profit groups. "They are getting very short and curt answers, almost to the point of being rude. We wonder if it is because ACS is about to lose its contract," Saenz said.

Davis said HHSC had instructed ACS not to refer families to non-profit groups, and asked that parents attempt to begin an application over the phone.

"If a family wants application assistance they will be referred to a CBO but told that it would be best to wait until the application from ACS-CHIP comes in the mail, which will have their account number and any information they have given already filled out," Davis said.