Transcript Slide 1

House Committee on Government Reform
Staffing and Training Challenges
in the IE&E System
July 26, 2006
Celia Hagert, Senior Policy Analyst
[email protected]
Center for Public Policy Priorities
www.cppp.org
Overview
• Why modernize? What are the
challenges? What are the risks?
• Staffing and training issues in the
IE&E System
• Recommendations for future IE&E
rollout
Center for Public Policy Priorities
www.cppp.org
Why Modernize?
Goal # 1: Make it easier for workers to
administer benefits
Goal #2: Make it easier for clients to access
benefits
Goal #3: Improve efficiency to lower costs
Center for Public Policy Priorities
www.cppp.org
What are benefits of modernization?
•
Better technology (e.g., TIERS, “AVR,” paperless system) eases
workload, improves accuracy, increases access, enhances program
integrity
•
Simpler application process (e.g., fewer office visits, less
documentation required of clients) eases workload, increases access
•
Flexible enrollment process (e.g., call centers, online application,
extended business hours) increases access, particularly for working
families
•
Integration of rules across programs where possible (e.g., same
documentation requirements, one asset test) supports automation
process, eases workload, may increase eligibility for benefits
•
If successful, modernization may lower costs and produce long-term
savings
Center for Public Policy Priorities
www.cppp.org
What are the challenges of modernization?
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Requires an up-front commitment of new
resources -- automation is expensive and timeconsuming, especially when developing new
computer system; testing and evaluation are
critical
States may resist policy changes critical to
simplifying and automating processes
Shifting the burden of the application process to
clients and local communities may compromise
client rights and customer service and potentially
alter the mission of nonprofit organizations
More remote application process, less face-toface assistance could create barriers for hard-toserve (seniors, persons with disabilities, persons
with language barriers)
Center for Public Policy Priorities
www.cppp.org
What are the risks of modernization?
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Modernization may further overwhelm systems already
struggling from a lack of resources, as is happening with
IE&E
Pressure to achieve savings may lead to premature
deployment of new system/features – Testing is critical
Modernization may reduce workload and achieve
savings in the long-run, but no system can function
without an adequate number of well-trained staff
Harm to clients,
Financial liability to state
Center for Public Policy Priorities
www.cppp.org
The Importance of Well-Trained staff
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Eligibility determination is a complicated process that
requires in-depth knowledge of program rules to ensure
timely service to eligible applicants and maintain program
integrity.
The rules governing each program vary considerably,
which makes determining eligibility even more difficult
Constant policy changes at the state and federal level:
workers face a constantly moving finishing line in the
mastering of program rules
The people who qualify for these benefits are not easy to
serve: the majority of clients have incomes below the
poverty level; many are elderly, have disabilities, or
grapple with language barriers.
Center for Public Policy Priorities
www.cppp.org
Training and Retention Are Critical
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Effective training and retention strategies are
critical to maintain an adequate number of quality
staff
Though the amount of training varies by program,
it can take months to train a Food Stamp worker
and up to two years to train someone to process
Medicaid eligibility for Long-Term Care services.
Constant retraining of existing staff is as
important as training new staff
Poor training can lead to high turnover which can
negatively affect program access and program
integrity
You need to maintain an adequate number of
seasoned staff while training new staff
Center for Public Policy Priorities
www.cppp.org
Staffing Shortages Hurt The “Old” System…
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Prior to IE@E, the number of workers were cut
40% from 1996-2004 from almost 12,000 to fewer
than 7,000
Caseloads dropped from 1996-2000, but
applications continued to grow and work grew
more complicated
Caseloads rebounded in 2000 with sharp
increases in Food Stamp and Medicaid
enrollment
The workload per worker doubled, growing from
approx. 350 recipients per worker in 1996 to
approx. 680 in 2004. The workload per worker
in 2006 is almost 1,000 recipients per worker.
Center for Public Policy Priorities
www.cppp.org
Staffing Shortages Hurt The “Old” System…
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Staffing shortages affected services to
clients, frustrated workers, led to lawsuits
Texas’ eligibility system fails to reach many
needy individuals and families:
– Less than half of eligible households receive
food stamps
– It is estimated that at least 700,000 children –
representing half of the uninsured child
population in Texas – are eligible for public
health insurance but not enrolled in either
CHIP or Medicaid
Center for Public Policy Priorities
www.cppp.org
Impact of Staff Reductions on Workload
14000
800
12000
700
600
10000
500
8000
400
6000
300
4000
200
2000
100
0
Number of recipients per worker
Number of eligibility staff
Downsizing of Eligibility Workforce Increased Workload
1996-2004
0
1996
Number of staff
Center for Public Policy Priorities
2003
2004
Average workload per worker
www.cppp.org
Staffing Continues to Fall Short of Needs
• Since 2004, the number of state staff has
dropped 27%, from 7,573 to 5,550
• The number of temporary staff has
increased from less than 2% of total staff to
19% of total staff
• The loss of staff has affected every region
of the state
• The loss of staff is due to attrition, largely
the result of HHSC’s IE plans and the
announcement
of
layoffs
in
October
2005
Center for Public Policy Priorities
www.cppp.org
Staffing and Caseloads Changes
4,000,000
14,000
3,500,000
12,000
3,000,000
10,000
2,500,000
8,000
2,000,000
6,000
1,500,000
4,000
1,000,000
Eligibility Staff
Caseloads (recipients)
Staff* and Caseload Changes, 1997-2007
2,000
500,000
0
0
1997
Food Stamps
2004
Medicaid
2007
TANF
Total Staff
* Number of staff in 2007 is based on HHSC estimate at the time
IE&E contract was awarded and includes both state and contract
staff
Center for Public Policy Priorities
www.cppp.org
Permanent vs. Temporary FTEs
Change in Permanent vs. Temp. FTEs
8,000
6,826
6,213
5,491
6,000
FTEs
4,494
Permanent FTEs
4,000
Temporary FTEs
2,000
756
424
94
1,056
0
Oct 04
1
Apr 05
Center for Public Policy Priorities
Oct 05
May 06
www.cppp.org
Change in FTEs by Region
Region
FTEs, October 2004
Region 1 - Lubbock - High
269
Plains
Region 2/9 - Abilene –
422
Northwest/West Texas
Region 3 - Grand Prairie 1291
Metroplex
Region 4 - Tyler - Upper East
365
Texas
Region 5 - Beaumont 297
Southeast Texas
Region 6 - Houston - Gulf
1352
Coast
Region 7 - Austin - Central
765
Texas
Region 8 - San Antonio - Upper
711
South Texas
Region 10 - El Paso - Upper
450
Rio Grande
Region 11 - Edinburg - Lower
1052
South Texas
Austin Call Center
0
Centralized Units
0
Total
6974
Center for Public Policy Priorities
FTEs, May 2006
Decline
212
21%
310
27%
974
25%
286
22%
242
19%
1042
23%
492
36%
554
22%
374
17%
808
23%
69
187
5,550
20.4%
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Problems Related to Staffing
Shortages in IE&E Pilot
• Shortages of both state and contractor staff have caused
problems
• Pre-existing backlog of thousands of cases, dating back
to September 2005, complicated transition to IE
• Delays in benefits to thousands of applicants since
January 2006 (More than 7,000 food stamp applications
were delayed as of May 2006)
• Caseload declines across programs
• Poor customer service
• Long hold times/high call abandonment rates at call
center
Center for Public Policy Priorities
www.cppp.org
Problems Related to Poorly
Trained Contractor Staff
• Clients given incorrect information
• Clients asked to provide unnecessary
documentation
• Delays in application processing
• High percentage of cases returned by state staff
to vendor because worked incorrectly
• Could see spike in error rates (incl. incorrect
benefits issued, improper denials, and ineligible
applicants given benefits)
• High turnover and difficulty recruiting staff is
complicating these problems
Center for Public Policy Priorities
www.cppp.org
Problems Will Persist Without an
Increase in Staff
• IE promises to reduce workload, but until it
does, the number and caliber of staff must
be increased to 2004 levels.
• Until technical problems are fixed,
resources and staff will continue to be
diverted to pilot area -- services to clients
in other parts of your state will suffer
without enough resources to keep the
“old” system going
Center for Public Policy Priorities
www.cppp.org
Public or Private: Reevaluating the Contract
• Can $7-9/hr employees do the job now assigned to
them? Can TAA retain an adequate number of
adequately trained staff at this low pay?
• Constant retraining takes time and money. You need to
have an adequate number of staff answering calls while
training new recruits
• Can TAA provide a career ladder and incentives to staff
to stay? (State offers longevity pay, good retirement,
good benefits, and a career ladder)
• Many people enter the eligibility system with a social
work background; they stick around because they see
the job as part of their professional commitment to help
people. How important is this element to retention?
• Can TAA offer a mission-charged environment that
convinces $8/hour employees not to leave after 6
weeks to go work for the call center next door?
Center for Public Policy Priorities
www.cppp.org
Recommendations
1. Increase total staff (not just in the pilot area but
also in non-pilot areas of the state) AND
2. Reevaluate division of labor between public and
private employees (giving state staff more
responsibility and restricting duties of private
staff),
OR
Reevaluate pay and qualifications of private
contractor staff so they are easier to recruit,
train, and retain
Center for Public Policy Priorities
www.cppp.org
Recommendations
3) Revise training to include on-the-job training for
new TAA staff that is comparable to the OTJ
training given state staff now
4) Before each rollout phase check for existing
backlogs in that area and deploy staff PRIOR to
rollout to process backlog
5) Once problems are resolved, test system again
in Travis/Hays for at least 3 months to ensure
“fixes” are working before adding new
areas/clients
Center for Public Policy Priorities
www.cppp.org
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