Back to The Struggle to Streamline

The Mess With Texas

The Lone Star State fired its human services provider. Is the new replacement doing any better?

By JONATHAN WALTERS

It's been just over a half a year since the Texas Health and Human Services Commission cancelled its $900 million, five-year contract with Accenture to run four call centers that would handle social services intake and screening over the phone. In the aftermath of the Texas contracting debacle, both the state and advocates have been working to pick up the pieces. Not surprisingly, though, state officials and advocates for children and family have a fairly divergent view of how it's going right now.

According to Jodie Smith, public policy coordinator with the children's advocacy group Texans Care For Children, the contractor that picked up where Accenture was booted off — Maximus Corp. — hasn't done much to improve performance. Smith says, for example, that clients who've selected one managed health care plan inexplicably are sometimes assigned a different plan; there continue to be random denials of coverage, long waits for phone interviews, and poor rates of benefits renewals, generally. "Same book, different cover," says Smith.

Ted Hughes, spokesman for the Texas HHSC says Maximus has significantly beefed up staffing at the call centers, and that state staff have been given a larger role in monitoring contractor quality standards. For example, according to contractor performance reports, fewer than 3 percent of calls went unanswered before a caller hung up (the contract standard allows for 5 percent). Average hold time was 49 seconds (contract standard says hold times can not exceed 120 seconds). And 80 percent of calls scored 85 or higher on state's quality assurance test, which is 5 percent better than contract standard.

As for complaints about wrongly assigned policies and low renewal rates, Hughes says that clients who don't choose an eligible managed care provider are assigned a default provider. Meanwhile, he says, the state is working hard to help families comply with renewal rules and that HHSC also notifies families if there coverage is about to lapse. "We have increased training for call center staff to ensure that they are giving families accurate renewal information."

Hughes adds, "We notify everyone whose coverage is about to lapse. If they do not respond, we follow that up. The community organizations that partner with us in our outreach efforts also call many of the people who have not responded to our notifications. In 2006, of those who said they chose not to renew, 25 percent said they planned to get other insurance. About the same percentage (23 percent) said they let their coverage lapse because they forgot or did not get around to doing the required renewal paperwork."

© 2007, Congressional Quarterly, Inc. Reproduction in any form without the written permission of the publisher is prohibited. Governing, City & State and Governing.com are registered trademarks of Congressional Quarterly, Inc.