Transformation - Projects - Integrated Eligibility, Public Hearings
New System Will Improve Access to Services
The Texas Health and Human Services Commission (HHSC) is creating a menu of options for consumers applying for state services, including Medicaid, food stamps, the Children's Health Insurance Program, Temporary Assistance for Needy Families and long-term care. In the new system, Texans will be able to apply for services in person, by phone, over the Internet and by fax or mail. Field offices will be strategically located across the state for consumers who are required or choose to handle part of the application process in person.
What services will be affected by these changes?
HHSC's plan will expand the ways people can apply for services, but it does not change the actual service or the standards that determine if someone is eligible to receive that service. The new system will determine which consumers are eligible to receive Medicaid, food stamps, Temporary Assistance for Needy Families (TANF), and the Children's Health Insurance Program (CHIP). In the future, HHSC plans to add the application process for other services to this system. This is an important part of the Commission's goal of better integrating services and providing Texas families with access to a wide array of services through a single point of contact.
Will the new system determine if people qualify for long-term care services?
This new model will determine financial eligibility for long-term care services, such as services in nursing homes, intermediate care facilities for the mentally retarded or mental health facilities. The new system does not include functional assessments to determine if a person meets other requirements to qualify for Medicaid coverage for long-term care services.
What's the difference between the new system and the current one?
The new system will allow Texans to choose the application method most convenient to them. Today, a person can conduct a banking transaction or renew a driver's license on the Internet or over the phone. While countless other business processes have been modernized, the state's eligibility system continues to operate much as it did decades ago. M ost applications are handled in person after requiring multiple office visits for a single case.
The new system's strength is its flexibility and convenience. Texans will be able apply through a call center by dialing 2-1-1. Or they can apply in person at a state office, by fax, U.S. mail or the Internet. Call center operators will be on duty 8 a.m.-8 p.m., Monday through Friday, and call centers will have phone lines for the deaf and hearing impaired.
The new system also will upgrade technology and streamline processes to gain efficiencies and generate savings that could be better spent on direct client services.
Will Texans still be able to apply for services in person?
Yes. Call centers will provide a more convenient way for consumers to apply, but access to a state eligibility office remains a priority. The state will continue to maintain field offices across the state, and eligibility workers will continue to be stationed in about 300 Texas hospitals and other medical facilities.
What about clients who don't speak English?
HHSC understands the importance of making help available in English and other languages, particularly Spanish. The call centers will include live assistance in English, Spanish and Vietnamese. Additionally, both state offices and call centers will have access to a “language line,” which provides telephone interpreters fluent in many languages. Last year, language line interpreters helped HHSC consumers speaking more than two dozen languages.
HHSC will make available sign language interpreters for face-to-face interviews with consumers who are deaf or hearing impaired. Call centers also will be equipped with a Relay Texas or a TDD line, and all state field offices will meet accessibility standards for people with disabilities.
Will state employees or a private company staff the call centers?
HHSC has signed a contract with Illinois-based Accenture for call center operations. Accenture plans to hire 2,500 employees to assist consumers and handle document processing. In addition, there will be 298 state eligibility employees in the call centers to determine if applicants are eligible for assistance and ensure quality control by reviewing a sample of completed cases for accuracy and timeliness.
How will customer service through a call center compare to the current system?
HHSC's contract for call center operations includes provisions that emphasize strong customer service and accessibility standards, including:
- Answer all calls within four rings.
- Keep the average time a client is on hold to less than three minutes.
- Keep the number of abandoned calls (when caller hangs up while on hold) to less than 5 percent.
- Maintain strict timeliness standards for processing applications, including same day service for expedited food stamps.
In addition, call centers have worked well in the Children's Health Insurance Program where HHSC has received excellent feedback on the enrollment process. Under the new system, the public will be able to learn about services and check the progress of an application by dialing 2-1-1.
What is the role of community organizations in the new system?
HHSC recognizes the value of partnering with other community resources to help direct Texans to services. The new integrated eligibility system supports such outreach efforts by creating and implementing new tools, such as online applications for services. Local organizations will be able to determine the level of involvement with the new eligibility system that best fits their missions, resources and their communities' needs. The new plan will facilitate these links by implementing training, outreach and education for community organizations that participate in the new system.
Texas's health and human service agencies also contract with many community-based organizations serving clients of Medicaid, CHIP, food stamps and other benefits. In many cases, these service providers already are required to screen potential clients to determine whether Medicaid or other available assistance programs can cover the cost of the service provided. HHSC's new plan expects to “connect the dots” for increased coordination to better enable these existing channels to deliver services.
When will these changes take place?
Accenture will begin processing CHIP applications in November, and the Commission will gradually implement the new system in different areas of the state beginning in January.
Why is HHSC moving CHIP applications to the new system first?
One of the goals of this project is to integrate the CHIP application process with the application processes for Medicaid and other social services. When CHIP was created in 2000, the program was outsourced to a private vendor. When the current contract expires in November, the new vendor – Accenture – will take over processing of CHIP applications. In addition, the current CHIP call center's duties will be folded into the new call centers to reduce duplication of services and make it easier for Texans applying for multiple services.
How will consumers be informed of these changes?
An information campaign will help guide consumers through the changes, and information will be placed in offices before the state begins implementing the new system. In the new eligibility system, consumers can dial 2-1-1 from anywhere in Texas to begin the application process.
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