Overcoming a Backlog: How Texas Conquered a Mountain of Food Stamps Applications
By Melissa Maynard, Staff Writer
AUSTIN, Texas — Two years ago, the 316 offices in Texas where people go to sign up for food stamps were the very image of a government backlog. Long lines of frustrated people, many of them hungry, snaked through dingy spaces designed to handle much smaller crowds. The back offices weren't much better. Desks of state employees were littered with piles of applications — in boxes under workers' desks and stacked on top of them — that hadn't yet been entered into the state's computer systems.
Texas was the worst state in the country at performing a straightforward task: giving food stamp applicants a yes or no within 30 days in normal cases and 7 days for emergency cases. That's the standard set by the federal government, which oversees the state-run program. According to state data, at the height of the backlog in November 2009, Texas processed only 57.5 percent of new applications on time. In reality, the problem was much worse because stacks of pending applications weren't properly being counted as part of the problem.
Tens of thousands of applications were stuck in the queue. Each one represented a person or family waiting for as long as nine months just to find out if they were eligible to get help paying for food. About a third of the cases were people already receiving food stamps — they just needed the state to verify whether they could stay on the rolls. The family of Nora Sanchez of San Antonio was one of them. In the spring of 2009, Sanchez, who is now 45, filed for "recertification" for herself and her son Jesus, now 10, and daughter Yaretzi, now 19. Only able to work part-time because she was undergoing cancer treatment, Sanchez had to wait more than three months to find out if she could keep using food stamps to feed her family. During the gap in assistance, Sanchez adjusted her family's diet, eliminating meats and other more expensive grocery items. "My daughter understood more," because she was older, Sanchez says in Spanish. "But my son wanted yogurt. He wanted cereal. But there was none."
Today, the system Texas has in place for handling food stamp eligibility is drastically improved — so much so that the old system that kept Sanchez and so many others waiting is almost unrecognizable. Eligibility offices where applicants used to stand in line for hours now move people through quickly, thanks to new IT systems and workflow processes that help prioritize cases to maximize efficiency. And the boxes of "pending" applications are gone. Texas' food stamp backlog has all but vanished. In less than a year, the state went from the worst in the country at processing applications in a timely manner to one of the best. Bill Ludwig, the U.S. Department of Agriculture administrator who oversees food stamps in Southwestern states, says, "We have seen the state completely turn the system around much more quickly than I could have dreamed they could do it."
Even the tragic story of Rachelle Grimmer, the mother who killed herself and shot her two children last week in a Laredo office after being denied food stamps, shows that Texas has made some improvements to its processes. When Grimmer first applied for assistance earlier this year, she was scheduled for an interview the next day but didn't show for the appointment or return phone calls. She waited three and a half months before following up and was eventually denied for failing to submit complete documentation. "From our perspective the customer service that she received was exemplary because we'd overcome the backlog," says Stephanie Goodman, a spokesperson for the department. "That's what makes it so hard to understand."
The story of how the Texas Health and Human Services Commission dug itself out of a colossal backlog is one that managers of agencies at any level of government can learn from. It's a story of how a relentless focus on results can get even the most overburdened bureaucracy to catch up on its work. And it's a story of the unlikely pairing of two very different kinds of public executives brought in to fix the backlog: Tom Suehs, a jovial M.B.A. appointed by Republican Governor Rick Perry to head the state's largest agency, and Stanley Stewart, the technocrat Suehs wooed from Michigan, where he'd worked for a Democratic governor, Jennifer Granholm.
Stewart is clear about his goal: He wants Texas to be the top state in the country for on-time processing. "We're going for 100 percent," Stewart says. He's getting close. Each day, Stewart reviews a detailed explanation of every delinquent case and follows up on the ones that trouble him. One afternoon in October, the state is tracking at 98.06 percent on-time processing. "I can tell you, in that 98.06 there were a whole bunch of cases that should never have gone delinquent," Stewart says. "There were some reviews that someone just didn't get around to processing."
"We should have been at 99 percent."
A long slide
To appreciate how Texas got out from under its food stamp backlog, it's important to understand how administrators fell so far behind on their work in the first place.
It goes back to 2003, when the state legislature decided to privatize application processing for food stamps, Medicaid and other programs. The idea was that a private company would be more efficient than government when it comes to using technology and operating both call centers and frontline offices. Anticipated savings were baked into the state budget. Lawmakers targeted about 4,000 state workers' jobs for elimination before the changeover even started.
Before any state workers actually lost their jobs, it became apparent that the strategy was doomed. Accenture, the company Texas hired, experienced widespread glitches with its technology. That was just the beginning of the problems, says USDA's Ludwig.
According to Ludwig, Accenture cut corners to save costs by hiring lower-skilled workers and neglecting to train them properly. "You had a company coming that really didn't understand the business," Ludwig says, noting that the federal government no longer allows such privatized arrangements for food stamps in part because of the lessons learned from the Texas experiment.
Suehs agrees that the episode was handled badly. "They assumed that if you automated all this stuff, then you could reduce the workforce," Suehs says. "They cut the agency's budget in anticipation of the automation …. and said ya'll just make it efficient. Well it doesn't work that way."
As the debacle unfolded, morale in the unit that handles food stamps tanked. In October 2005, pink slips went out to 2,582 employees, telling them, "Regretfully, we were unable to place you in a new position in the new eligibility system." Although no one was ultimately laid off, a voluntary exodus of brainpower accelerated. The most talented employees were the first to leave because they had no shortage of job options both in and out of government. For others, a statewide retirement incentive program that was happening at the same time made the decision to get out easier. "We really lost our tenured workforce, and then you lost those who weren't so tenured, too," says Sandra Dillett, a regional administrator who oversees 37 eligibility offices in central Texas. "So you really had a total depletion."
The Health and Human Services Commission was reluctant to fill vacancies while layoffs still seemed possible, so the positions stayed vacant. In the spring of 2006, the agency tried to stop the bleeding by telling employees that any staffing changes were still more than a year away. It even offered retention bonuses for employees to stay. But the damage was done — there were almost 1,000 vacant positions in a department that once had at least 12,000 employees. Without enough people to do the work, unprocessed food stamp applications began piling up. Lines at service centers grew longer.
Once the privatization effort had been declared dead, a push to staff up began. Then in 2008, the one-two punch of Hurricane Ike and a national recession hit Texas, both of which increased demand for services. The department was still operating at least 500 positions below its authorized capacity. "It becomes sort of a downward spiral," says Goodman. "If I'm a supervisor, am I going to go over there and help that person work a case — because we're desperate — or am I going to stop and do the paperwork for the new hire? It feels like dealing with that case should always be the priority, but obviously for a long-term solution you've got to get those people on board."
High-quality training had also been a casualty of budget cuts. "Not only did you have a shortage of staff, you had new staff, and then we found out we weren't training them very well," says Suehs. "In fact, we were training them badly. The worst thing you can do is put a worker out without the proper tools and without the proper training. What you've got is a miserable employee."
Messing with Texas
When Governor Perry interviewed Suehs, who had served as deputy executive director at the Commission since 2003, the food stamp backlog was just beginning to hit the press. The governor was getting phone calls from legislators, and he needed someone he could count on to clean up the mess.
Suehs has a straight-talking, no-nonsense leadership style. When he took the helm in September 2009, the crisis was nearing its peak. "I knew the system here as a deputy," he says. "But when you're in charge, it's kind of, 'It's on my shoulders now, what am I going to do about it?'" He made dozens of visits to eligibility offices and talked with workers at all levels about how their jobs were going and what he could do to help them. He solicited email input about how to fix the problems and personally read thousands of responses.
Suehs needed a tested manager to handle the day-to-day. At the suggestion of USDA's Ludwig, Suehs reached out to Stewart, who had implemented an IT system in Michigan similar to the system Texas was struggling to make a transition to, known as TIERS. At first, Stewart, who was retired, worried about how Suehs' decision to give czar-like authority over the food stamp program to an "old black guy from Michigan" who comes highly recommended by the federal government would go over in Texas. As it turned out, Stewart's outsider status lent him the credibility he needed to make major changes.
Stewart developed a playful rapport with the beleaguered frontline staff. He admits to getting great joy out of "messing with Texas" to bring a little fun into what can be mundane work. For example, when TIERS spots an error in a food stamp application, the colors "maize and blue" flash on workers' screens, in honor of Michigan football. The teasing goes both ways. On Stewart's desk sits a framed picture of himself in a cowboy suit, which he assented to wearing as part of a challenge to increase worker productivity. The employees of one eligibility office in Dallas gave Stewart a cowboy spur to thank him for "riding them so hard."
Suehs also worked at rebuilding morale among the workers. At the height of the backlog, Suehs asked the various eligibility offices to compete against each other in the "Commissioner's Challenge," a contest to see which offices could provide the best customer service by processing applications quickly and accurately. Suehs promised to personally grill a nice meal for the winners. It may sound like a summer-camp strategy, but numerous people interviewed for this article pointed to the competition as a turning point that helped cultivate a team atmosphere and boost staff spirits.
Just as important to Suehs and Stewart was staffing up. After news of the backlog hit the state's newspapers, the legislature gave the agency 250 additional positions. Suehs launched an all-out hiring push. He pushed to get merit raises for 2010 to help with retention and morale; mandatory overtime, which had become pervasive with all the vacancies, was scaled back. The agency brought back employees who had moved on to other positions on a temporary basis to focus on old cases, allowing other employees to focus on processing new cases fast enough to prevent the backlog from growing. Gradually, the agency got its vacancy rate under control. "We were much more assertive because we couldn't afford not to fill those positions," says Eliza Garza, who oversees all of the state's eligibility offices. "Now we maintain a 96 or 97 percent fill rate."
The power of partnership
One lesson from Texas: When trying to clear a backlog, look for outside help.
HHSC Executive Commissioner Tom Suehs looked to food banks. He sought and won approval from the U.S. Department of Agriculture to run a pilot project that allows food banks to usher food stamp applicants most of the way through the process. Food bank employees help fill out applications, gather documentation and conduct interviews — and submit all of the information to the state electronically. All that's left for state workers to do is to make the final eligibility determination.
For the San Antonio Food Bank, this was a familiar role. For more than a decade, the food bank had been encouraging clients to enroll for food stamps and helping them with the application process. In part because of the outreach efforts, the portion of eligible San Antonio residents participating in the food stamps program rose from 30 percent in 2001 to 74 percent today. With the pilot program, the partnership between the food bank and state is more formalized.
During the height of the backlog, some state workers didn't share the food bank's zeal for signing up new clients. More clients meant more work — and they were having a difficult enough time keeping up as it was. Food bank staff did their best to help usher clients through the process, but got little cooperation from the state and were plagued by the same runarounds that anyone trying to sign up for food stamps at the time encountered.
Some advocates for the poor still fault Texas for not doing more to increase its participation rate — that is, the percentage of eligible food stamp recipients who are actually enrolled. Texas' rate remains low in comparison to other states. Robert Doggett, an attorney for Texas RioGrande Legal Aid, has been challenging the Health and Human Services Commission's processes in state and federal court. He remains concerned about the state's application form, which he believes to be illegally onerous, and what he sees as the state's failure to do more to encourage people in need to enroll. — Melissa Maynard
Tension on the front lines
The most visible changes to address the backlog can be seen in the 316 eligibility offices scattered around Texas. When the backlog was at its worst, the atmosphere in these offices was palpably angry, as confused and frustrated applicants sometimes waited for hours, only be told to come back again another day.
Nora Sanchez's experience was common. When her request to recertify herself and her kids for food stamps failed to go through, there was no warning, she says. "They didn't send me anything," she says. "I didn't receive anything about whether I was pending or if I needed papers. Nothing." When she went to the office in May of 2009 to ask about her status, she was told she would have to wait because they were still "entering Januarys and Februarys." She called her caseworker twice a week, and never once got through. She always left messages but her calls were never returned. Sanchez says she made weekly trips to the office, waiting from two to five hours each time. And when she finally got to the front of the line, they just instructed her to wait for her letter to come in the mail.
The frustration was intense on the workers' side, too. The eligibility system was operating on two different IT systems — neither of which worked very well, as a state audit notes. The legacy IT system, known as SAVERR, was no longer meeting the state's needs. "It was cutting-edge when the microwave was cutting edge," Goodman jokes. The legislature first approved the new system, TIERS, in 1999, but its development and implementation was plagued by glitches and delays. Often, employees were trained on the system by people who did not know how to use it themselves.
In the meantime, operating in two systems created cracks for clients to fall through. A client who had been approved for benefits and then moved to another town might not continue to show up as eligible. Online applications could be received but had to be manually typed into TIERS, which often operated at glacial speeds because of inadequate server capacity. Print-outs, paper applications and hand-written receipts provided the only paper trail whenever there were discrepancies, which was often. As Sandra Dillett recalls, "Somebody had to go and re-look at all the paper receipts to figure out what happened."
Walk into an eligibility office today, and chances are you'll be greeted pleasantly and asked about the reason for the visit. If you just need to pick up a food stamps application, the greeter will hand you one without having to wait. He or she can also answer simple questions right away.
If your case requires a more intensive response from agency staff, the greeter will push a button informing a new office management system called the "Nemo Q" why you are here. The system will assess how many workers are currently working in various roles and filter your case to the right person and place in line in order to maximize efficiency. The easier your problem, the faster the system will push you through, ensuring that the office doesn't become clogged. While you wait, you'll be able to take a seat in a clean, bright office and track your expected wait time on a large monitor. There's a good chance that you'll be able to complete an interview the same day, while you're there, rather than scheduling a time to come back in the future.
The back-room improvements that Texas has made will have an impact on your visit as well, whether you're aware of it or not. Fixing the programming glitches in TIERS and overseeing its successful statewide roll-out may be Stewart's most important contribution to Texas' turnaround. The new system makes it easier for workers to do their jobs. And customers no longer have to wait around while the system loads a new page or a worker tries to decipher the reason for error messages.
Just as importantly, it has improved the state's ability to track its performance all the way down to the frontline worker level. It is what allows Stewart to pull reports every morning and pinpoint late cases. He follows up with the offices in question to troubleshoot.
He also helped the state overcome other weaknesses in its technological infrastructure that were leading to customer-service problems. Finally, there is adequate server capacity and enough phone lines to handle incoming and outgoing calls. Before, busy signals were pervasive. Workers would have to wait for phone lines to open up before they could return phone calls when clients left messages.
A news article that ran in the Houston Chronicle in January 2010 under the headline "Texas ranks last in the nation on food stamps" hangs on Stewart's office wall as a reminder of what could happen if the state doesn't keep up. "That article irritated the hell out of people," Stewart says. "We know we can never slip back again." Every day is a new opportunity to fall behind, with an average of more than 7,500 new applications to process — more than some states process in an entire month.
In June, the federal government gave Texas a $6 million performance bonus for dramatically improving its payment error rate, moving it into the tier of "best" states for 2010. Characteristically, Suehs shared the reward with his employees. It was a powerful morale booster. Employees who received strong performance evaluations during 2010 got a bonus equal to about 4.5 percent of their annual salary.
One of the lasting lessons from Texas' experience may be to not forget about the basics. While some of Suehs' solutions were complex and expensive — system-wide process improvements, big IT investments, increases in staffing — other, equally critical remedies were surprisingly simple. Listening to employees. Keeping offices clean. Recognizing successes. "It's just Management 101," says Suehs. "Getting that employee to feel good about themselves, and making sure they know what their job is."