Senator Shapleigh's office was recently contacted by a constituent who followed all guidelines and rules issued by HHSC, whose child was found to be eligible for CHIP, but who was still unable to navigate the system successfully. The constituent not only turned in all of the information by the appropriate deadlines, but saved all written correspondence and kept a chronicle of the dates, times, and names pertinent to his case. He followed the rules, and here is his story.

After not being able to get his daughter's prescription filled, the constituent contacted the CHIP call center for an explanation. Initially, he was told that there was no record of the payment of his enrollment fee. When the constituent stated that he had the cancelled check showing that the check had been cashed, the call center operator said that she would personally walk his check to the finance department so they could remove the incorrect payment deficiency. The operator also stated that the constituent should call back to make sure that everything was taken care of.

He later called back and spoke to a Ms. Martinez, the manager of the Midland call center. She stated that the payment deadline was actually two weeks earlier than the one stated in his letter. However, that would mean that the deadline was a mere two days after the date the letter was sent. Therefore, although his check was received and cashed, it was considered late, and thus his daughter was not enrolled. Thereafter, Ms. Martinez failed to return any of the constituent's phone calls. His child was dropped from CHIP because Accenture and TAA dropped the ball and gave him the wrong deadline.

Lapsed coverage is serious business for a young family. During the nearly two months that his children's coverage lapsed, the father had to cross the Border into Mexico in order to get their prescriptions filled. Additionally, his daughter recently suffered a second-degree burn, after which her school refused to accept her without a note from her doctor. However, he could not get it until his coverage was reinstated. Cases like this are a nightmare, and I fear that other families across the state are suffering through similar indignities.

Had the constituent not tried to use the CHIP services, he would never have known that his children were not enrolled. Many other families undoubtedly have and will find themselves in similar situations. How many families will think to call our office so that their case may be escalated through the HHSC chain of command? How many of them will have a perfect paper trail after saving all of the documentation?

After the system fails these families, many will simply give up and not seek services or, without anywhere else to go, will end up in our already crowded emergency rooms at local taxpayers expense.