AUSTIN - Sen. Eliot Shapleigh, D-El Paso, quizzed Health and Human Services Commissioner Albert Hawkins over the performance of his agency in providing basic health care services Wednesday.

“Because of incompetence 200,000 children lost CHIP coverage. Here in Texas, HHSC is the functional equivalent of FEMA,” Shapleigh said, referring to the federal agency that was blasted for its handling of Hurricane Katrina relief efforts.

Shapleigh later told the Guardian that Hawkins had “mismanaged” the privatization of the CHIP and Medicaid eligibility screening process.

He pointed out that since 2002, 200,000 children have lost CHIP coverage because of a series of errors, including software malfunctions, rule changes, and, in one case, applications misdirected to a warehouse in Seattle.
 
First appointed to run HHSC in January 2003, Gov. Rick Perry reappointed Hawkins on February 7. The Senate must confirm the nomination, hence Hawkins’s appearance before the Nominations Committee.

Many Republican members of the committee questioned Hawkins over his position on Perry’s Executive Order mandating vaccinations against human papillomavirus (HPV) for all girls entering the 6th grade in Texas public schools.

Shapleigh, however, focused more on the privatization of call centers that handle eligibility determination for the CHIP and Medicaid programs.

Under HB 2292, passed in 2003, HHSC was asked to undertake a comprehensive review of the eligibility determining processing. Unless it was not cost effective to do so, the legislation required HHSC to outsource a lot of the work.

Hawkins awarded an $898 million contract to Accenture, with 10,000 health and human service state employees being moved to the private sector and ten face-to-face call centers being closed across the state. Hawkins believed increased computerization would help bring about the savings the Legislature demanded.

Shapleigh quizzed Hawkins on why the state had to “carve back” $358 million, after HHSC determined that the private contractor could not do its job.

Shapleigh reminded Hawkins that he sent him a letter in 2004 outlining his concerns over the privatization plan. Shapleigh said El Paso had thousands of high skilled, bilingual, workers who understood their job in processing requests by CHIP and Medicaid clients.

Shapleigh asked Hawkins if privatizing the eligibility determination process had caused him a headache. “There are continuing challenges with it every day,” Hawkins responded.

A bill from Rep. John Davis, R-Houston, to revert back to a one-year enrollment period for CHIP applicants, will be heard by the House Human Services Committee. Before HB 2292, applicants were required to enroll every six months.

Hawkins told the Nominations Committee that to go back to one-year enrollment for CHIP would cost $83 million per biennium. He said it would cost $284 million if the state did the same for Medicaid.

Hawkins was also asked if he had adequately budgeted for the state’s loss of a federal class action lawsuit, Frew v. Albert Hawkins, Health and Human Services Commissioner. Some lawmakers believe the case could cost the state an additional $5 billion a year.

The case centers of the state’s efforts to avoid compliance with federal Medicaid requirements. U.S. District Judge William Wayne Justice has said Texas must comply with an 11-year-old agreement to expand health care to thousands of low-income children.

Hawkins said his agency had not made an exceptional item budget request because another hearing in the case is scheduled for April. At Shapleigh’s request, Hawkins said he would give lawmakers cost estimates for the case.

Shapleigh also asked about another lawsuit the state has lost involving the provision of in-home medical services for disabled children. Here, Hawkins said his budget proposal included $149 million.

Susan Zinn, a San Antonio attorney and lead counsel in the case, said South Texas and the border would benefit significantly from the lawsuit. Zinn estimates that the number of children who have not received the medical checkups they were entitled to has increased from 941,000 in 1993 to nearly 1.5 million in 2005.

“About one third of our state’s children have Medicaid. If they don’t get care when they need it, their health will suffer. They won’t be able to achieve their full potential in school or later as adults,” Zinn said.