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In a telephone conversation last week, an L.A. activist talked about “neo-liberalism.” It is a crucial term for globalization activists, but it can be confusing for audiences in the USA, since it denotes right-wing privatization. We’ll use the term in an effort to accustom local readers to international dialogue. At any rate, the Center for Public Policy Priorities has presented an excellent summary of events regarding a Texas experiment with neo-liberalism in human services, pasted below–gm
Background: Integrated Eligibility and Enrollment (IE&E)

The 2003 Legislature directed the Texas Health and Human Services Commission (HHSC) to change the way people apply for public benefits, including Medicaid, CHIP, Food Stamps, and cash assistance (Temporary Assistance for Needy Families), by cutting state workers and relying heavily on telephone call centers.

HHSC was given the option to either operate or outsource the call centers, and opted to turn over a large portion of eligibility system operations to private contractors. HHSC dubbed the new system Integrated Eligibility and Enrollment (IE&E).

The state entered into a contract that included not just the new call centers, but also CHIP eligibility services, several major Medicaid contracted services, and maintenance of the new eligibility computer system (TIERS) the state had been developing for years.

HHSC planned to close 99 of its 381 eligibility offices by the end of 2006, with four new call centers playing a major role in processing applications and renewals. Eventually, clients would be able to apply via the Internet as well.

Children’s Problems Soon Apparent

The new contractor took over CHIP enrollment and renewal for the entire state in November 2005. Transition to the new IE&E system began in Travis and Hays counties in January 2006, and was scheduled to “roll out “ (phase in) across the state over a 10-month period. (This first phase of the IE&E roll-out also affected a small number of clients who used to live in Travis and Hays counties, whose cases were processed and remain in the new TIERS system.)

Serious problems with processing CHIP renewals and new applications for CHIP and Children’s Medicaid soon became apparent: Children’s Medicaid enrollment dropped an unprecedented 29,000 from December 1 to January 1; CHIP renewal rates plummeted from 84% to 52%; and new CHIP enrollees diminished to half their usual level.

By early March it was clear that the Medicaid decline was not a temporary aberration, CHIP renewals remained dismally low, and disenrollments surged (see table, page 7). Child health advocates shared their concerns with HHSC officials and the press. HHSC extended CHIP coverage for about 6,000 children whose parents had not been given proper or accurate notice by the contractor of their correct enrollment fees.

USDA Oversight

Meanwhile, it was also becoming clear that processing of Medicaid and Food Stamps renewals and applications in Travis and Hays counties was significantly backlogged. Problems there with the IE&E pilot (run by the same contractor) included the same issues plaguing the CHIP/Children’s Medicaid operations—multiple computer system issues, training deficits, flawed processes, and staffing shortfalls—but clients’ woes were compounded by the acute and worsening under-staffing of HHSC’s eligibility offices statewide.

The U.S. Department of Agriculture (USDA, which oversees the Food Stamp Program) conducted a Program Access Review of IE&E operations in late March, which included conference calls with community groups, legal services, and anti-hunger advocates to hear their reports on the roll-out.

IE&E Roll-out Delayed for 30 Days…

On April 5, HHSC Executive Commissioner Albert Hawkins announced the agency would delay IE&E roll-out to the next planned region (Hill Country counties) in order to make technical and operational improvements and would review the system’s readiness again in 30 days. HHSC cited the need for “better training for customer service representatives in the call centers, a process to more quickly resolve complicated cases, better reporting tools to track cases and workload, and improved data collection.”

In April legislative hearings, HHSC officials acknowledged many problems with the IE&E transition and contractor including serious state staffing deficits. Based on their review, USDA officials conveyed to HHSC in April their concerns about the project including lack of timeliness in application processing, inability of the contractor’s front-end computer system to interface with TIERS (adding to backlogs), high call abandonment rates and long hold times at the call center, and lack of correct policy knowledge by contractor staff.

USDA’s independent project monitor identified several fundamental concerns: inadequate readiness testing of computer functions, a roll-out timeline that was too fast to allow for identification and resolution of all problems, inadequate staffing levels, insufficient training of private contractor staff, and shortcomings in some aspects of call center technology.

On April 11, HHSC announced that a new $3 million marketing and public information campaign for CHIP and Children’s Medicaid would begin in May (these activities had been largely abandoned after the budget-cutting 2003 legislative session). While notable agency efforts to improve the CHIP and IE&E processes produced a temporary improvement in call abandonment rates and hold times in April, problematic application and renewal trends and client complaints showed little if any improvement.

On reaching the deadline for determining CHIP enrollment for May, HHSC faced terminating a record number of nearly 50,000 children in a single month, for a dismal renewal rate of only 23.5% (compared to a fiscal year 2005 average of 80%). The agency elected instead to continue coverage of 27,768 children for an additional month while their families were given more time to provide missing information or to submit payments.

…And Now On Hold Indefinitely

On May 4, the HHSC Commissioner announced findings of its 30-day review. Importantly, this announcement indicated that the original roll-out schedule has essentially been suspended indefinitely until problems can be resolved. HHSC would retain 1,000 of the 1,900 state eligibility workers it had planned to lay off, and the remaining layoffs would be postponed for 12 months.

It is important to note that this decision did not increase the number of state staff working in the system; it simply reduced and postponed the planned reduction in staff.

Revised procedures announced by HHSC included: having state eligibility workers in the Midland call center oversee private “customer service” staff to ensure they give out correct information; returning most processing of Travis and Hays Medicaid and Food Stamp cases from contractor staff to state workers; new policy training of customer service staff; a new “escalation” process for directing complex policy questions from contractor staff to state workers, and new training for private workers on how to use the contractor’s and the state’s computer systems.

The announcement also noted that many contractor workers were unable to locate information that was already in their system. HHSC’s May 4 announcement also detailed changes to the contractor’s CHIP/Children’s Medicaid operations, including extending timelines for collection of missing information and enrollment fees, allowing third-party verification of income, and accepting some missing information via telephone (rather than extended postal exchanges that cause children to lose coverage through missed deadlines).

H
HSC staff, the HHSC Office of Inspector
General, and independent evaluators would examine various aspects of the contractor’s performance and processes. The state pledged to more carefully oversee contractor correspondence with families, and to seek stakeholder input in improving those communications. Grave Concerns Remain in Early June Advocates and providers welcomed HHSC’s decision to postpone the rollout, and support its efforts to improve the system and involve advocates in these activities.

However, grave concerns remain for CHIP, Medicaid, TANF and Food Stamps for several reasons. CHIP applications and renewals—and a significant share of new applications for Children’s Medicaid—are still being operated exclusively by the new contractor, because CHIP eligibility has always been primarily operated by a private contractor.

Thus, state workers cannot step in to fix the problems, and HHSC’s contingency plans to stop the dramatic decline in CHIP must instead rely largely on the contractor’s ability to resolve the problems.

On May 25, the Texas CHIP Coalition submitted a letter to HHSC Commissioner Hawkins detailing recommended steps needed to reverse the decline in CHIP and Children’s Medicaid enrollment. The letter (located at (http://www.cppp.org/research.php?aid=534) noted that the new contractor’s CHIP performance has “serious and as yet unresolved problems”, which did not bode well for the same contractor’s take-over of major responsibilities for Medicaid and Food Stamps under IE&E, potentially affecting more than 4 million Texans (thirteen times the size of the CHIP program) including children, the aged, and Texans with disabilities.

The Coalition urged HHSC to make successful reversal of the problems with CHIP a prerequisite for any further roll-out of the IE&E model. Detailed CHIP statistics have not yet been released for June 2006, but preliminary data show that CHIP enrollment fell to 293,564, a drop of 5,212 children from May.

On June 2, HHSC issued a press statement announcing that it would continue to extend deadlines for enrollment fees and missing information to protect children form losing their health coverage and give the agency and the contractor more time to correct the problems causing the decline.

Meanwhile, parents continue to report applications and renewals that appear to have been lost or delayed for months. In the third week of May, the “call abandonment” rate for IE&E was over 22%, and for the CHIP/Children’s Medicaid line was over 41% (average hold times were 6 and 15 minutes, respectively). Get the full report from the Center for Public Policy Priorities

By Jose Angel Gutierrez

Originally published en espanol in La Estrella newspaper of Fort Worth, reprinted by permission of author.

The idea of an economic boycott by immigrants in the US on May 1st is a good one. The economic might of immigrants, legal or not, in the United States is two-fold: labor power and consumer power. California Gov. Pete Wilson proposed and supported Proposition 187 which contained the basic anti-Mexican and anti-immigrant provisioins of the current James Sensenbrenner bill that passed the US House of Representatives last December 2005. In both cases persons of Mexican ancestry in the US rose in opposition and organized massive protests.
The idea of a national boycott was discussed by various leaders and attempted. I know some of us put up signs on our doors then: No Compro/No Trabajo. The media then like now said our boycott was ineffective. Employers then like now told employees they would be fired if they did not show up for work or participated in protests. Nothing much has changed.

If you want to change public policy and law, you must challenge it and be prepared to pay the consequences. In this case who is really needed? Is it our labor that is more important or is it that we have a job that is more important?

Several so called “leaders” are flying off to Mexico to discuss how to stop the boycott. President Fox is not interested in upsetting the dialogue and relations between him and Bush. Mexico is the largest trading partner of the US in the Americas.

Immigrants of all types, Cuban, Indian, Vietnamese, Dominican, Mexican, Salvadoran, Polish, Greek, etc. earn money in the US and send some to their homeland. These remittances save the US government lots of money in foreign assistance they do not have to send those governments. And these government get this money “free” without any effort. They enjoy the benefits of these immigrants working outside their country.

I do not know how effective the boycott will be but two things are sure. First, US workers will once again join the rest of the world in celebrating May 1st as the Day of the Worker internationally. The US government broke away from that tradition to split US workers from the international community and allows Labor Day on the first Monday in September. The US government shot and killed labor protestors during the Haymarket Riots in 1896. Thereafter, organized labor in the US chose to celebrate on another day not in May.

Second, economic boycotts work best when you have a specific target. A target in 1987 was Disney Corporation because they gave money to the advocates of Proposition 187. In 2006 the target some boycott organizers suggest ought to be is James Sensenbrenner. He is the heir to the Kimberly Clark fortune. They make Kleenex, Kotex, Depends, Scott tissue, Pull-ups, Huggies, Little Swimmers, Viva, and Cottonelle products. We all use them at sometime.

There is also Kimberly Clark de Mexico, SA. If Sensenbrenner does not want Mexicans in his midst then why should Mexicans buy his products?
Third, some of us will pay the price and boycott. I will not work that day. I will show a movie during a lunch hour at the university where I work about the greatest tennis player of all time, Pancho Gonzalez. Come visit, it is free on May 1, noon, University Hall Room 121 (University of Texas – Arlington).

by Greg Moses

OpEdNews / CounterPunch / DissidentVoice / IndyBay

Just as PNAC or the Project for the New American Century helped us to think about underlying motives for the public shams of the war on terrorism, so might CNAC or the Compact for North American Competitiveness help us to think about drama at the border between Mexico and the USA. Already CNAC’s preferences for “border security” and “temporary workers” have attracted friends with clout, but did you know that Mexican oil is also on the agenda?
Shortly after last year’s Waco Summit brought together three North American heads of state, Bush, Fox, and Martin, a CNAC proposal was released by the US Council of the Mexico-US Business Committee (MEXUS), an organization which predates the Council of the Americas (COA) to which it now belongs.

The April 2005 report is signed by COA heavyweights Robert Mosbacher and James Jones, backed by a leadership team composed of ChevronTexaco, Eastman Kodak, First Data, Ford Motor, Kissinger McLarty, Manatt Jones Global Strategies, Merck, MetLife, Miller and Chevalier, Nextel, and Proctor and Gamble.

In a preface to the report, MEXUS takes a lot of credit for creating NAFTA or the North American Free Trade Agreement; brags about publishing “NAFTA Works”; and promises to maintain leadership for “increasing competitiveness” in the unified North American bloc.

The fact that seems to irritate this report more than any other is that despite NAFTA the maquiladora sector of the Mexican economy had managed to lose 250,000 jobs to China in the first five years of the new American century. This fact also locates the area that CNAC authors are most interested to address: how to fix the problems of Mexico so that the NAFTA alliance can steal back those maquiladora jobs. One key task is “free and secure” trade through borders which commodities can speed quickly, but which must do a better job screening people.

Concurrent with release of this report last April, the Minutemen were quietly fading into the margins of the media when their profile was rescued by terminator Governor Schwarzenegger of California. At that time, remember, Schwarzenegger miscued himself by talking about “closing the border”, a line he later delivered closer to script.

“Yesterday was a total screw-up in the words I used,” the governor said at a press conference. “Because instead of closing, I meant securing.” With those words, pieces of the border puzzle had actually locked into place last April, soon followed last May by a caucus report from Congress calling for 36,000 national guard at the border. At the time, the idea seemed far-fetched, like the idea of full-scale invasions had sounded a few years before that.

As we now know, the President has fulfilled the 2005 prophesies by sending thousands of troops to replace the function modeled by the Minutemen, just as Schwarzenegger and the Congressional Immigration Reform Caucus had suggested in the first place.

Besides “border security” the CNAC report is clear in its preference for a second darling policy favored by Bush and Companies: an “enforceable temporary worker program that will match willing workers with willing employers, bringing order and increased security to current haphazard patterns of immigration.” We haven’t heard the end of this idea this year. Having a global temp service is really too tempting for Mexico’s continental partners to ignore.

Given the momentum that security and temp work are having in the real world today, it is worth noting a third area of prime concern for CNAC, and that is reform of Mexico’s oil and gas industry. In the near term, says the CNAC report, the Mexican government has to improve opportunities for private investment and in the long term Mexico has to find “cost-effective means to raise production.” Unless this is done, says the CNAC report, “security and competitiveness within North America will be impacted.”

This past weekend in its coverage of the Mexican presidential race, scheduled for July 2, the Associated Press clearly outlined the positions of each major candidate on reforming the Mexican oil and gas sector. While reading those news reports online I got the queasy feeling that CNAC was beginning to look like PNAC all over again. Get the CNAC report in pdf

(May 18, 2006) This morning, the Senate Judiciary Committee voted along partisan lines to send the Federal Marriage Amendment (FMA) to the full Senate for consideration. The proposed constitutional amendment restricts marriage to a [partnership] between a man and a woman. Senate Majority Leader Bill Frist has committed to bring the FMA up for a full Senate vote in early June.

In the first 24 hours of our advocacy campaign, [Texas] Senators Hutchison and Cornyn each received 700 letters from their constituents letting them know they do NOT support writing discrimination into the United States Constitution.

To join the campaign for partnership rights, go to:

Equality Texas