Demands crippled centers
March 19, 2007
A state effort to replace many welfare benefits offices with privately run call centers fell victim to unrealistic deadlines, budget cuts, stumbles by the contractor, a flawed public education campaign and mishaps with government-purchased computer software.
Written by Robert T. Garrett, Dallas Morning News
AUSTIN – A state effort to replace many welfare benefits offices with privately run call centers fell victim to unrealistic deadlines, budget cuts, stumbles by the contractor, a flawed public education campaign and mishaps with government-purchased computer software. The state announced last week that it has severed its relationship with the project's lead contractor, though it still intends for millions of low-income Texans to sign up for programs such as Medicaid and food stamps using the call centers in coming years. But as salvage operations began, testimony before a legislative panel and interviews by The Dallas Morning News with a dozen people who closely tracked the ambitious – and ambitiously named – "transformation" of Texas eligibility services underscored that it was never on track to work correctly. At issue is more than a policy dispute about how best to protect taxpayers from fraud and modernize a system under which many people had to take off from work to go to state offices, where it often would take several hours to apply for state assistance. For families like that of Carla Diez de Pinos of Laredo, the changes meant wrongfully being bumped from Medicaid, which has a rich blend of benefits, to the leaner provisions of a managed-care plan under the Children's Health Insurance Program. Carla, 4, has cystic fibrosis. Her father tried to protest that the family's income hadn't changed, but had problems getting through to the call centers, sometimes waiting as long as an hour. Only when he called a state ombudsman was the problem fixed. "Their story is not unusual," said Barbara Best, state director of the Children's Defense Fund, which seeks better health care for children. "They did everything right but they got denied because of the processing errors." State social services czar Albert Hawkins says critics ignore his accomplishment in running a social program signup system for $250 million a year less than it would cost if Texas still employed 12,000 state eligibility workers, as it did in 1996. If a statewide rollout that has been on hold for nearly a year is resumed, the new system will give low-income Texans "a real choice on how to apply for services" and "support more efficient business practices," he said. "There's much more to do, but we've made real progress," said Mr. Hawkins, whose nomination by Gov. Rick Perry to a third two-year term is on hold in the Senate, in part because senators have concerns about the call centers' checkered performance. Celia Hagert, senior policy analyst at the Center for Public Policy Priorities, which advocates for low-income Texans, says Mr. Hawkins should admit the project is fatally flawed. She said Mr. Hawkins should lay the shortcomings at lawmakers' doorstep, because they cut nearly 5,000 state eligibility worker positions from his budget in the past four years. "The Legislature set unrealistic expectations and that forced a premature rollout," Ms. Hagert said. She called on Mr. Hawkins to request significant increases in staff and "more resources" to attack increasing error rates and slower completion times in processing applications. Stephanie Goodman, a spokesman for Mr. Hawkins, said he would focus on "interim measures to take workload off the local offices," though they probably won't require an additional budget request. Some lawmakers, though, want to know if the state and its contractor properly tested all the systems needed to make the pilot program work before privatization went statewide. The system began Jan. 20, 2006, in Travis and Hays counties. The state and the contractor – a group known as the Texas Access Alliance, headed by Accenture L.L.P. of Chicago, the U.S. unit of Bermuda-based Accenture Ltd. – referred to the effort in NASA terms, describing launches and countdowns. The "go-no go decision" was made even though known problems hadn't been fixed, said Deputy Health and Human Services Commissioner Anne Heiligenstein. She said Accenture officials promised that "technical adjustments and fixes would be made in the very near future." But the dozens of "viable work-arounds" the state and contractor thought sufficient for problems such as how calls were handled never did the job, Ms. Heiligenstein said. Ms. Hagert said the dozens of work-around orders also put in doubt the plan's ambition to save the state $646 million by 2010 through efficiencies and modernization. The patches ranged from the merely cumbersome to the quite expensive. One instructed call center operators to remember, as they typed into their computers a caller's personal information, to manually enter the assigned case number as they progressed from screen to screen. The software by Maximus Inc., based in Reston, Va., didn't spit out the case number automatically, said company spokesman Jim McAvoy. Nor could the program exchange data as anticipated with an "integrated eligibility" software program the state had paid another vendor to design several years earlier. The failure forced Accenture to swiftly hire more than 100 workers at its San Antonio call center to keypunch applicants' information into both systems, said Mr. McAvoy and Ms. Goodman, the state spokeswoman. Rachael Rowland, a spokeswoman for Maximus, which customized the software, declined to comment. She noted that Maximus and Accenture went into arbitration in January to settle their differences. They include what Maximus has reported to the Securities and Exchange Commission were "unfounded assertions" by Accenture that Maximus failed to perform on the call center-related work. Accenture executive Dave McCurley testified to a House committee last month that software-related "inefficiencies" and an unexpectedly high number of calls pouring into the call centers early last year "combined to effectively break the camel's back." For callers, the chaos was obvious – wait times soared, so much that callers gave up at alarming rates. In other words, the system designed to make it easier to get state assistance made it only more frustrating. Accenture's Mr. McAvoy said that while the pilot was supposed to test the system for only aid applicants in the Austin-San Marcos region, people all over the state began indirectly phoning the call centers. They would dial 211, a service for linking people with local charities, and then hear that by punching "2" they could apply for state services. He said better planning and education efforts with nonprofit groups that run local versions of 211, such as United Way, could have reduced call volume, which he said was more than twice as heavy as projected. The state's Ms. Goodman responded: "We learned lessons." Alec Davis, a state employee who has been an eligibility screener for 14 years and works at an Austin call center, said he has seen private contractor employees make less than conscientious efforts to help aid applicants. "Their goal is to get the questions answered and get the client off the phone," he said. While Mr. Davis said he once had high hopes for the envisioned system, enough to relocate from East Texas so he could work at a call center, it's been mismanaged and there's a lot of rebuilding to do. "The job done over the years by the state workers has been a lot better than they give us credit for," he said.
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