US: Private contractor dropping eligible Texas kids from health coverage

The contract with Texas Access Alliance, headed by outsourcing giant Accenture LLP, is part of a major overhaul of eligibility screening of social services for children, the elderly, disabled and poor.

While lawmakers once were told the project would save the state $646 million over five years, that's now in doubt. The state recently decided to slow the project, beef up training and fix an array of technical and operational problems.

"I think each and every one of us are pretty disappointed with how this has turned out," Rep. Dan Gattis, R-Georgetown, said at the meeting of the House Appropriations Subcommittee on Health and Human Services.

"We're watching," Gattis told Texas Health and Human Services Commissioner Albert Hawkins, who signed the contract with Accenture. "I'm going to tell you, we as a body are going to hold accountable companies that are taking taxpayer dollars to do things for our state."

Dave McCurley, senior executive of Texas Access Alliance, issued a statement noting that the agency reports clients want to use the screening call centers and that call center performance improved dramatically in April.

"In fact, last week nearly 19,000 calls were received with callers waiting on average only 45 seconds before they were connected to a customer service representative," he said.

The Midland call center currently is screening eligibility of children in the state's poorest families for Medicaid health insurance. It is also screening other low-income applicants for the Children's Health Insurance Program.

But as of last week, 30,000 children had been dropped from CHIP since the contractor began running the call center in December, and the state issued stricter income and asset rules for applicants.

Rep. Sylvester Turner, D-Houston, said he finds the plunging CHIP rolls alarming, noting the number of children served has fallen from 500,000 in 2003 to fewer than 300,000 now.

"It is tanking. Whether we want to deal with it or not, I think we have reached a crisis state with the CHIP program, and I am not a big fan of the contractors we are using," Turner said. "I speak for me, but if I hired them, I would fire them."

The call center also began screening adult clients Jan. 20 in Travis and Hays counties for Medicaid, food stamps, long-term care and cash welfare under Temporary Assistance for Needy Families.

Rep. Dawnna Dukes, D-Austin, said her staff is spending all its time trying to remedy application problems within the pilot area, including 90 minutes on hold with the call center Friday.

"That's a call from a legislative office -- truly unacceptable," Dukes said.

Anne Heiligenstein, HHSC's deputy executive commissioner for social services, told Dukes she agrees but added the agency is monitoring call center operations to see if corrective actions are working.

The pilot was scheduled to expand to 17 counties in the Texas Hill Country later this month and to the Houston area by August, but Hawkins has delayed further rollout until problems are resolved.

Dukes warned that lawmakers in the rest of the state will not be "happy campers" when it comes time to appropriate money next biennium if their offices go through the turmoil hers has in helping constituents.

She complained that one constituent sent four applications, two by certified mail, but the call center said they were not received.

She asked Hawkins to provide her with a timeline of how long the state is willing to work with the Accenture team if the call center problems persist.

• 187 Privatization