Over the past couple of years the State of Texas Department of Health and Human Services has been reorganizing and streamlining (read "cutting back on programs for the poor" just here).
If you ask Albert Hawkins, the Commissioner, the reason is simple: the state wants to gain efficiency and get more bang for its buck.
You would think that would mean serving more people with the same amount of money, right?
One of Mr. Hawkins' tactics has been to set about outsourcing the delivery of services to Texas' poorest families.
Central Dallas Ministries participated in the ramp up to this outsourcing by consulting on several occasions with Accenture, the company that eventually landed the contract to serve the state's health and human services needs.
The plan involved the aggressive implementation of technology, purportedly to make certification and registration faster and more accessible to the people who needed the services.
The idea sounded really good to me as we discussed it.
We even talked of kiosks in places like a few of our locations here in Dallas that would make the delivery of services much easier and more seamless for those who were eligible.
Well, so far, all I can say is. . .
Take one aspect of the outsourcing company's new assignment: Medicaid, the health insurance product for poor children, disabled persons and the elderly.
That would be the youngest, the oldest and the weakest?
Since November 2005 and through February 2006, the number of children receiving the Medicaid health insurance benefit in the state dropped by almost 79,000 participants.
Further, this sharp decline occurred over three consecutive months--the first 3-month decline since May 2000.
Maybe what we have here is a new system, still a hybrid with the old, trying to get the "kinks out."
But I have my doubts, serious doubts.
The fact is, in Texas, the poor are being squeezed from two sides.
On the one hand, the federal government keeps cutting into Medicaid and other Health and Human Services benefits--in many cases severely and unjustly.
On the other, here in Texas, a new management system kicks tens of thousands of the poorest kids off of health care benefits.
And these numbers don't count the sharp decline since December in the Children's Health Insurance Program (CHIP)--a plan designed to serve those children just above the poorest in the state.
The CHIP program is in decline even though the legislature restored funding and approved program expansion during its last session.
Maybe the program will smooth out.
But then, maybe it won't.
Here at Central Dallas Ministries we have watched the Medicaid program for at-risk pregnant women and children decline to almost a trickle of real, meaningful assistance.
This radical cut back that slashed a very valid, needed program has been accomplished strictly administratively, again, thanks to Mr. Hawkins.
The cuts were so blatant that the U. S. Supreme Court ruled against the State of Texas last year, forcing Mr. Hawkins' department to make changes in the way this particular program operates.
We'll see if he defies the highest court in the land. So far, changes appear miniscule to our staff.
In the meantime and overall in our state, thousands of our children go without medical care, expect when things get so bad their parents resort to emergency rooms. Not a smart way to deliver primary health care services to the poor.
I'm going to keep watching. But, I'm not impressed.
Does faith have anything to say to this situation?
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Larry James' Urban Daily
A repository of ideas, resources, commentary and opinions concerning the issues facing low-income residents of the inner cities of the United States and how mainstream America largely forgets or, worse, ignores the day-to-day realities of urban life for the so-called "poor." Written and edited by the President & CEO of CitySquare. Please visit CitySquare.
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