Federal officials, alarmed that a Texas computer system has been tardy in processing more than half the food stamp applications it was assigned in December, have asked the state to postpone rollout of the system to more of the state.

“We are not convinced that a continued rollout of [the system] is warranted,” William Ludwig, Dallas regional administrator of the U.S. Food and Nutrition Service, wrote the state last week.

Mr. Ludwig said his agency wants the state to undertake “strong measures to improve timeliness and ensure customer service, including call center performance.”

Spokeswoman Stephanie Goodman of the Texas Health and Human Services Commission said Monday that the state is trying to hire and retain more employees in its Office of Eligibility Services, which operates more than 300 field offices and assists four privately run call centers.

Ms. Goodman said the commission also will train more of its workers to use a Web-based computer system to sign up poor Texans for social programs. State officials say the system is still the best hope for the future, despite complaints that it is cumbersome to use.

Difficult to use and the best hope for the future! Sounds like an e-Slate voting machine.

Texas’ disaster with Accenture and the privatization of Health and Human Services intake programs is center stage as a case study at a new website, Need Over Greed. Here is some of what they had to say about the Texas debacle:

In 2005, four Texas counties signed a contract worth $899 million with Accenture, a Bermuda-based company, to outsource Food Stamp and Medicaid eligibility jobs to call center operators.

The results were disastrous. Experienced public employees were terminated and replaced with poorly trained, low-paid call center operators. Thousands of phone calls went unanswered. Even worse, 127,000 needy children were dropped from the health care roles between December 2005 and April 2006.

One child, a 13-year old boy from Houston with advanced kidney cancer, went four months without insurance and had to wait until bureaucratic mix-ups were straightened out before starting necessary treatments.

After an audit of the privatization scheme, former Texas Comptroller Carole Keeton Strayhorn, a Republican, stated that “the project has failed the state and the citizens it was designed to serve” and called the privatization effort a “perfect story of wasted tax dollars, reduced access to services and profiteering at taxpayers’ expense.”

The Accenture contract was cancelled. And now those who experienced the Texas disaster are warning others – particularly Indiana taxpayers – of the dangers of privatization.

Of course, all this arises within the context of a much bigger issue than Texas, and one that’s intertwined within the Farm Bill and across America:

In July 2007, the U.S. House of Representatives voted for language in the Farm Bill that prevents the Administration from allowing states to bypass the existing prohibition that prevents companies from taking over the process of deciding who is eligible for Food Stamps. Now the Senate must act.The Food Stamp program has its origins in the 1940s, as many American families struggled to put food on the table due to harsh economic conditions. Enacted into law in the 1960s, the modern Food Stamp program now enables as many as 26 million Americans each month to afford the nutritious food they need for good health.

To guard against corruption, federal law required that only qualified, merit-based civil service employees would determine who was eligible for Food Stamps. But in the mid-1990s, major corporations began lobbying for huge state contracts to take over most of the eligibility determination process for Food Stamp, Medicaid and other public welfare programs.

These efforts failed miserably in Texas. And despite the Texas disaster, Indiana Governor Mitch Daniels seems determined to force his State down the same road. So to protect accountability and the integrity of the Food Stamp program, a coalition of anti-poverty, anti-hunger, women’s children’s and labor groups created the Campaign to Protect Children’s Nutrition.

The campaign won a provision in the 2007 Farm Bill that bars the administration from allowing states to auction off nutrition for needy Americans to corporations. The House approved the language in August and the Senate will act soon. But big corporations are now doing all they can to strip the Farm Bill of the anti-privatization provisions.

Remember all of the Hell we had in Texas with Accenture and private contractors? Well, that could become a reality in other states, too.

Perhaps it is a good time for a trip down memory lane to remind ourselves just how terrible private contracting of HHS services has been in Texas:

Here are some of Capitol Annex’s posts on the subject:

Bad Subcontractor To Blame For Declining CHIP Enrollment?

What Went Wrong With The HHS Call Centers

More Accenture?

‘Permanent Wall’ Keeps Kids From CHIP Program (our personal favorite)

And here is the entire archive for the “HHS Boondoggle” category where most of our CHIP coverage resides.

Also, I’ll direct you to some CHIP coverage from the Dean of the Texas Blogosphere, Charles Kuffner, who has done an excellent job covering this issue from day one:

Those Who Do Not Learn From History Are Doomed To Hire Accenture Again

Strayhorn Releases Audit of Accenture

Fire Accenture!

We’re Stuck With Accenture

The CHIP Endgame

Know Your HHSC Contractors

State Finally Cuts Bait On Accenture

Accenture May Be Gone, But Privatization Lingers

Technorati Tags Accenture, Need Over Greed

A health program that covers low-income children grew more this month than predicted, mostly because a 90-day wait period for most new applicants has been eliminated.

Enrollment in the Children’s Health Insurance Program increased to about 327,000, a gain of more than 27,000 children over last month, state officials said Thursday.

Finally. You can thank Sylvester Turner (D-Houston) and a large number of Democrats for this.

Capitol Annex has obtained a copy of Brian Flood’s resignation/farewell letter as HHSC Inspector General. It’s here [.pdf].

But, for a governor trying to distance himself from an appointee, Perry isn’t exactly doing a bang-up job:

“The Office of the Inspector General has become a model for states across the nation,” Perry said in a statement concerning Flood’s resignation. “These accolades and accomplishments are a result of hard work and quality leadership and staff throughout the agency.”

Um hum. If he’s so damned good, why dump him?

Texas doctors are turning away poor women who are eligible for digital mammograms because they say the state Medicaid program won’t pay for the procedure, although officials claim the program does.

Texas health officials said in December 2005 that they would use state-administered Medicaid money to pay for mammograms that use new digital technology. But the state admits that it has failed to give doctors a clear way to bill for the procedure.

The result is that doctors across the state who have switched to digital mammography have been refusing to examine Medicaid patients, saying they believed they would not be paid.

You have got to be kidding. Women are going without mammograms because the state cannot get its act together concerning billing procedures?

This is sadly typical of the state’s overall failure to appropriately manage and administer essentially all of its Health & Human Service programs.

And, like many other HHS debacles, this one is ripe for litigation which could cost the state millions. How many women denied mammograms could have caught cancer early? Who knows?

There is more:

The confusion over whether Medicaid will pay for digital mammograms is complicating efforts by health officials to increase the number of women in the state who have regular breast cancer screening. Texas ranks 42nd in the nation in mammogram rates, according to data from the federal Centers for Disease Control and Prevention.

The majority of mammograms in Austin are digital, and hospitals with older equipment are planning to convert within the next few years.

Texas health officials declined repeated requests by Cox Newspapers to be interviewed. But a spokesman for the Texas Health and Human Services Commission said in a statement that although “digital mammography is a covered benefit in the Texas Medicaid program,” the state did not give doctors a clear method for billing for the procedure. The statement also said the government is trying to correct the problem.

It is unclear how many women trying to get a mammogram have been turned away by doctors, but Medicaid officials say they rejected more than 6,000 claims last year because they were for digital mammograms.

So, they claim they are trying to correct the problem. And, 6.000 people have been denied mammograms.

How hard can it be to correct this problem? A letter to every physician accepting Medicaid in the state? That’s easy to do. Fixing a computer program? That’s easy, too.

So, why hasn’t the state fixed the problem?

Reportedly, DHS says this was a group of kids who were held onto the program that supposedly had information missing in their files or applications, and were being held until that came in.

However, it is also reported that most of these disenrollments were in error. Furthermore, these families reportedly got a letter on Saturday telling them they’d be disenrolled on Monday. This is terrible.

That means that, since the 2003 budget cuts, we’ve had 197,000 kids knocked off chip thanks to the cuts and privitization. Consider that Reliant Stadium in Houston holds 70,000 people. You could fill that thing more than twice with the kids who have been knocked off CHIP.

The new social services computer system that the state has spent six years and $425 million developing is slower, less accurate and more difficult to use than the old system it is supposed to replace, according to an audit released Wednesday by the Health and Human Services Commission’s inspector general.

The Texas Integrated Eligibility Redesign System, or TIERS, was supposed to improve access to state benefits by reducing operating and maintenance costs and improving the accuracy and timeliness of eligibility and benefit decisions. The system was implemented in Travis and Hays counties in 2003 and rolled out into Williamson County last year.

TIERS was paired with another new program that aimed to allow people to apply for benefits online, over the phone or by fax through the use of four new call centers run by a private contractor.

Should this be a surprise? No. No matter how much HHS seems to spend on new systems, they never can get it right, or, at least, the private contractors can’t.

This is one of those pieces that little more can be said about than is already in the piece.

I highly recommend you read this piece.

SAN ANTONIO –(Business Wire)– June 27, 2006 — Accenture (NYSE: ACN) is opening a delivery center in San Antonio, Texas, that will provide business process outsourcing services to clients in Texas and around the world.

The center will employ approximately 350 professionals, bringing the number of Accenture employees in Texas to nearly 3,500. The company currently has offices in Dallas, Austin and Houston.

“The city of San Antonio provides the perfect environment for Accenture to expand its global delivery network, and we look forward to building upon our existing business in the state,” said Kevin M. Campbell, Accenture’s senior managing director-Business Process Outsourcing. “The strong experience and skills of the local workforce will enable the San Antonio center to play a key role in delivering world-class business process outsourcing services to our clients.”

How on God’s Green Earth Accenture can say that they “play a key role in delivering world-class business process outsourcing services” to their clients after the HHS debacles in Texas is beyond me. It’s laughable, in fact.

Luckily, thanks in part to the CWA/Texas State Employees Union, further call centers are on hold.

However, with the announcement of this new facility in San Antonio, one might just wonder how long they are on hold for?

Accenture already turned over 12,000 cases back to HHS, and the backlogs of other cases is terrible, according to CWA/TSEU.

But, I have a hard time beliving that Accenture would start a new facility in Texas if they didn’t think they had a better than 50/50 chance of ending up with more work from HHS.

Only time will tell.