Father John has a number of links to stories about the current state of Health and Human Services privatization in Texas and how the influx of Katrina victims has affected their delivery of services. Two items to highlight, the first from Carlos Guerra:
Texas “point-of-time” enrollment figures for children receiving Medicaid indicate that almost 17,000 fewer children were covered in September than in August.
How is this possible, I asked José Camacho, head of the Texas Association of Community Health Centers, whose 52 member groups serve 560,000 people.
“Yes, we started getting reports of folks that had been on Medicaid, and they reapplied and got a rejection letter,” he said, before explaining that for children to be “recertified” for Medicaid, their parents must go through a face-to-face interview conducted by a certified state worker.
When the throngs of temporary Texans arrived, each of them also had to undergo a face-to-face interview, as required by law, to receive food stamps, so the remaining state eligibility workers were dispatched to help them.
The result was that when many parents seeking to renew their kids’ Medicaid applied, they were, of necessity, put off. “Even if they filled out the form, if it wasn’t entered (by a state worker), they didn’t reapply,” Camacho said.
This result of having fewer workers is, of course, a feature and not a bug. Fewer workers means less throughput on Medicaid renewals, which means the state has to spend less on this costly benefit. Say what you want about HB2292, there was a certain logic to it.
Item two is from the Austin Chronicle:
Based on a job-recruitment advertisement placed by one of the companies sub-contracted to provide a telephone eligibility “call center” in Midland, the prospective operators would be paid a starting wage of $8 an hour. At that rate (about $1,280 a month, gross), a single parent with one child, or a single-income family of three, would be eligible for food stamps. And should the company not provide affordable health insurance (as is likely), their new employees would also be eligible for Medicaid and the Children’s Health Insurance Program.
[…]
Under this new system, the new state workers hired at these sub-living wages will themselves be able to administer their own applications for food stamps, Medicaid, and CHIP. They can interview themselves, review their own meagre pay stubs, determine their own levels of eligibility, and sign and hand-deliver their own approval letters – saving an envelope and a stamp in the bargain.
Now that’s what I call eliminating the middleman!
Like I said, a certain logic.
On a semi-related side note, a task force of the U.S. Conference of Catholic Bishops, including Joseph Fiorenza, Archbishop of the Houston/Galveston archdiocese, has called upon federal leaders to not give aid to Katrina victims at the expense of existing services for the poor.
“It would be wrong to cut essential food, housing and health care for the poor while the rest of us make no real sacrifice and, in fact, benefit from recent tax cuts,” the letter states.
The letter noted the role of Catholic organizations and other non-government agencies to house, feed and provide medical care to victims.
But it also emphasized that these groups can’t fix the problems alone.
“The efforts of those motivated by compassion and charity in responding to the hurricanes’ devastation, while essential, cannot take the place of a strong federal commitment to just public policies and wise public investment,” the letter states.
Their letter was sent to every member of the US House of Representatives, but I think there’s a pretty clear relationship to what’s going on with THHSC as well.