TIERS for Medicaid

This can't be good.

State social services officials now plan to switch 1 million or more needy people in the next year to a different application process for benefits, including Medicaid and food stamps.

The state says it intends to shift 953,000 elderly and disabled Medicaid patients into its problem-plagued "integrated eligibility" system by September 2009 - on top of its previously stated goal of moving in 288,000 more food stamp recipients by August 2009.

The state's decision, tucked into an advance copy of Health and Human Services Commission chief Albert Hawkins' planned testimony to a legislative panel next week, caught advocates for the poor, state employee groups, and a veteran Democratic lawmaker by surprise Friday.

They expressed alarm that Mr. Hawkins would so greatly accelerate the rollout of TIERS - the Texas Integrated Eligibility Redesign System - to aid recipients statewide.

"I'm concerned that the commission is going to take one of the most vulnerable populations, the elderly and disabled, and convert these extremely complicated cases into TIERS so quickly," said Rep. Elliott Naishtat, D-Austin. He said the Medicaid recipients are "most likely to have problems" and there could be "dire consequences."

The Texas State Employees Union, which has said an old mainframe-based system works much better than TIERS, denounced the plan.

"It borders on irresponsible behavior," said union spokesman Will Rogers. "They haven't worked out all the bugs with TIERS. You're playing with people's lives by doing that."

Mr. Hawkins has said the mainframe computer used for Texas benefit applications is one of only seven of its type left in existence. The old approach is outmoded and costly, while TIERS is being improved, he has said.

My archives are still in a state of transition or I'd point you to a bunch of past postings on this subject. Suffice it to say that TIERS has been screwed up from the beginning - just read this Observer piece for the flavor of it - and that the more it gets used, the more pain it will cause. It's also not a surprise to me that this was sprung on people, since had more folks known it was coming, there would have been a huge fuss kicked up. This is about the only way you can do a bigger TIERS rollout, by stealth and subterfuge.

As it happens, for those of you who'll be in Austin tomorrow, there will be a Legislative Oversight Committee hearing on TIERS. See HHSC Employee for the details.

Posted by Charles Kuffner on July 13, 2008 to Budget ballyhoo