Tag Archive for Texas

Texas Groups Promote Health Exchange Without Help From State

Texas officials have declined to establish a state-based health insurance marketplace, a major provision of the federal Affordable Care Act. So private organizations are working to educate Texans about coverage options through the federal health insurance exchange, which opens on Oct. 1.

Of the more than 6.3 million uninsured Texans — the state has the country’s highest rate of uninsured residents — almost half will be eligible to buy insurance through the federal exchange, an online tool for coverage shopping.

But Texans suffer from a “general lack of knowledge” about the law, said Allison Brim, a director at the Texas Organizing Project, one of several groups working to reach uninsured families before the federal exchange’s rollout.

“Folks just don’t have a lot of information about the exchanges and what their options will be,” she said.

The Texas Department of Insurance has made no extra effort to publicize the federal exchange, said John Greeley, an agency spokesman. In 2010, it conducted a federally financed campaign about health insurance options but has done nothing comparable since, he said, adding that those with questions could use the department’s website or telephone service.

Brim criticized the state for not promoting the exchange, saying its help would make it possible to reach all eligible Texans by October.

“The state has, as far as we know, done nothing to spread the word to uninsured Texans about the exchanges or the Affordable Care Act,” she said. “It leaves a mountain of work for us.”

In response to questions about publicizing the exchange, Lucy Nashed, a spokeswoman for Gov. Rick Perry, wrote in an email that the state was “not interested in implementing Obamacare, including the exchange.”

On July 10, a division of the U.S. Department of Health and Human Services awarded about $9.9 million to Texas community health centers to make people aware of their options.

The department will also finance at least two “navigators” — organizations intended to guide people through the exchange — per state. Texas’ navigators will receive about $8 million.

But Jacob Cortes, the lead organizer of the group Austin Interfaith, said that might not be enough. “The private sector would have to step up,” he said.

Julie Bataille, a spokeswoman for the Centers for Medicare and Medicaid Services, said navigators were just one federal resource. The agency also dispatches officials from its Dallas office and Washington headquarters to speak with health workers and organizers in Texas.

And it collaborates with local initiatives, Bataille said, including groups like Blue Cross Blue Shield, which started a Be Covered campaign; the Texas Organizing Project; and Enroll America, which promotes the health care act.

Be Covered has joined with churches, museums and other organizations in every Texas county to distribute literature on obtaining insurance, said Michelle Riddell, a Blue Cross Blue Shield of Texas spokeswoman. 

The Texas Organizing Project and Enroll America are canvassing and organizing community meetings where Texans can get more information.

Reaching exchange-eligible people will not be easy, said Mimi Garcia, Enroll America’s Texas director. She added that groups like hers will have to work beyond January 2014, the deadline for Americans to obtain coverage.

“I would love it if we could get everybody enrolled in the first year and that would be it and we would be done,” she said. “But that’s not going to be the case.”

Cortes said ambiguity about the federal exchange — including yet-undetermined providers and premiums — make it difficult to spread a clear message.

Texas’ size poses another challenge, Brim said, because in rural areas “we just can’t reach as many people as fast.”

“There will be some folks,” she added, “who just don’t get the word.”

This story was originally published by The Texas Tribune, and was produced in partnership with Kaiser Health News.

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Texas HHS Agencies Consider Telework Expansion

In Texas, there are five health and human services (HHS) agencies — the Department of State Health Services, the Department of Assistive and Rehabilitative Services, the Department of Aging and Disability Services, the Department of Family and Protective Services, and the Health and Human Services Commission (HHSC), the administrative head of all five. In total, HHS employs 54,000 people and takes a bite out of 32 percent of the state’s budget.

With that many people, the agency leaves a large office space footprint. In September 2011, now-outgoing HHS Executive Commissioner Tom Suehs created a workgroup to determine whether allowing more employees to work virtually — that is, from home or somewhere else outside the office — could increase job efficiencies and reduce costs. Earlier this summer, the workgroup, which included supervisors of current virtual workers, returned its findings to Suehs and identified the risks, challenges and benefits for mobile workers and teleworkers.

I asked Suehs about HHS’ current virtual worker policies and what benefits the five agencies could realize from a virtual worker expansion. His edited responses appear below.

The Texas health and human services agencies have telework policies to address specific issues at their agency. Any HHS agency employee may apply for telework. The request is then evaluated by the supervisor and, if approved, reviewed by the supervisor’s supervisor. Final approval comes from the agency commissioner. HHS policy requires the employee and their supervisor to sign a telework agreement that details expectations (for example, work hours) and performance standards. We have the ability to stop telework for staff who aren’t performing.

Mobile workers, on the other hand, have job responsibilities that require them to be out of the office; this includes facility inspectors, child protective services workers and health inspectors. Requirements for such staff are embedded in their job descriptions. As mobile workers become equipped with technology and no longer need to come into the office on a regular basis to do things like enter data or meet with supervisors, it’s been recommended that HHS establish appropriate HR policy. This is now in progress.

As of December 2011, there were 425 teleworkers across all five HHS agencies in every region of the state. Sixty-eight percent of these staff telework only one day a week, while about 15 percent telework full time. Our teleworkers are diverse in terms of their occupations. Of course, staff who provide direct services to residents of our state hospitals and state-supported living centers won’t be approved for telework. But beyond that, there’s a wide range of jobs that may be performed from home — even if just one day a week.

On the mobile work side, close to 2,000 staff are currently technologically equipped to operate independently of dedicated office space. Eighty percent of these are child protective services workers, with most of the others doing regulatory work.

The workgroup reported a number of positive results for teleworking and mobile working including reduced absenteeism, increased retention, recruitment of skilled staff, cost savings, enhanced customer service, improved work/life balance, a boost in morale, enhanced capacity in such things as business continuity and disaster recovery, and access to work for workers with disabilities.

I also think there’s plenty of productivity to be gained and we’re working to quantify this. For example, a mobile worker who’s able to cut down on the number of trips to the office because they’re technology enabled is a productivity gain. A staff member who eliminates a two-hour commute by teleworking may decide not to look for a job closer to home, and that’s a productivity gain. And being able to attract and retain the next generation of workers — young people who see work as what you do and not where you’re located — that will be a productivity gain.

On the telework side, one of our agencies implemented a small pilot program a couple of years ago that offered staff the opportunity to work from home for one regularly scheduled day a week. The positive reaction of staff and continuing quality of work resulted in an expansion across the agency and now about 150 staff telework from home at least one day per week. A significant piece of the pilot was very good training that was developed — one geared for staff, the other for supervisors — that we’re adapting for use across all HHS agencies.

In April 2012, we started a pilot project with our own agency’s Customer Care Center staff in Athens, Texas. These workers process eligibility changes that are part of a client’s case record. Since those case records are electronic, staff can work on any case, no matter the location. We have about 40 of these staff members working from home. Our preliminary findings indicate that telework has a positive effect on employee morale, can reduce turnover as well as absenteeism and can be an effective recruiting tool. Based on these positive results, we’re planning to expand telework across the five other Customer Care Centers, involving about 500 staff, by the end of 2012. We’re also looking at other areas that are conducive to teleworking within HHSC’s eligibility services division.

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