HHSC tackles Medicaid, SNAP backlog with '6 Days of Merry Service' OT raffle

AUSTIN (KXAN) -- With many low-income and vulnerable Texans waiting months to get Medicaid and federal food assistance, state officials are now encouraging employees to work 15 hours or more in overtime this week with a "Holiday Blitz(en)" dubbed the "6 Days of Merry Service Challenge," according to an internal memo provided to KXAN.

"I don't know whether to call it a joke or a desperation tactic," said U.S. Rep. Lloyd Doggett, D-Austin, whose office obtained the letter.

The holiday overtime drive comes weeks after officials with the U.S. Department of Agriculture met with leaders from the Texas Health and Human Services Commission for a "technical assistance visit" to talk about reducing the backlog for federal food benefit through Supplemental Nutrition Assistance Program (SNAP). HHSC whistleblower employees say people are waiting around 200 days for help many consider a lifeline.

Right now, it's taking "around 120" days for applications just to get looked at, according to the memo. People may be waiting "up to" that long to have their combined SNAP and Medicaid applications reviewed, HHSC spokesperson Jennifer Ruffcorn said.

The federal standard for SNAP is 30 days. The federal standard for Medicaid is 45 days.

As of Nov. 27, there were approximately 150,000 Texas Medicaid applications waiting more than 45 days to be processed, Ruffcorn said.

The goal of the overtime push is to trim the time to start processing applications "all the way down to somewhere between 50 and 70 days," according to the memo.

"Granted, 50 to 70 is still higher than we'd like," the internal email, signed by interim associate commissioner Gracie Perez, noted, "but cutting ... in half would be an amazing feat and help so many this holiday season."

The day before Thanksgiving, and again on Dec. 4, a spokesperson for Gov. Greg Abbott told KXAN that HHSC expected new actions -- like moving 250 staff from other projects to focus solely on combined SNAP and Medicaid applications and putting 600 staff through Medicaid training -- "will cut the backlog by half" by the end of December.

"You're the first reporter in Texas to get this information," Doggett told KXAN investigator Matt Grant. "They have set for themselves a best-case aspirational goal to remain out-of-compliance with federal law in the future and that's just not acceptable."

"Their goal, that's stated there, is to be out-of-compliance, again, with federal law," Doggett said. "To be in violation of federal law, but not as badly as they have been in the past. That's not the goal we need."

In her letter, Perez said anyone who works "15 or more hours of overtime" will be placed in a drawing for "amazing prizes!"

The prizes are "a small token of appreciation" paid for out-of-pocket by agency leaders, not with tax dollars, Ruffcorn said.

The overtime "blitz" is in addition to an already mandated 20 hours of overtime a month. That was implemented as part of a prior corrective action plan with the U.S. Department of Agriculture in 2020 to cut down on the SNAP backlog. It was listed as "ongoing" in a recent update sent to the USDA.

"The Texas Health and Human Services Commission is taking all possible actions to provide benefits to eligible Texans as quickly as possible," Ruffcorn said. "HHSC is also working with our federal partners in order to implement immediate strategies to reduce the number of SNAP and Medicaid applications in the queue."

'Please act immediately'

For Doggett, change isn't coming fast enough. He is calling for a federal intervention. On Monday, he sent a stinging letter to the Centers for Medicare and Medicaid Services calling its response to Texas' months-long Medicaid delays "woefully inadequate."

"Please act immediately and require a comprehensive corrective action plan that ensures the timely processing of Medicaid applications," Doggett wrote. "Each day of delay causes further harm to the most vulnerable and marginalized Texans, most of whom are children and communities of color."

CMS officials said late Monday they are working on a statement. We will update this article when we receive a response.

"The kind of people we're talking about: someone who just got a cancer diagnosis, someone who has diabetes and they don't have health insurance and they learned they can qualify for Medicaid," Doggett told KXAN. "This is their avenue to getting access and treatment for what may be a very serious condition."

Doggett said he would like to see more full-time employees hired instead of spending money on overtime.

"This is an agency under Gov. Abbott that has an opportunity to put in place a sustainable effort with full-time employees and management that wants to solve the problem and they offer us a raffle for six days," Doggett said. "It's really insulting to the many people that are out there that need access to a family physician, that shouldn't go hungry because of indifference at the state level."

HHSC said a 25% salary increase for staff, approved by the legislature, has been a "huge success for recruitment and retention." More than 97% of eligibility employee positions are filled, Ruffcorn said, adding the agency is taking additional steps to reduce the backlog:

• Streamlining work to eliminate duplicative tasks.
• Other staff trained to work on eligibility cases have volunteered time to process applications.
• Unlimited voluntary overtime is being offered in December for staff who choose to participate.

"We acknowledge our staff have taken on a tremendous challenge as we work through our caseload," Ruffcorn said.

Since pandemic-era protections for Medicaid coverage ended in April, 1.4 million people have been dropped from Medicaid in Texas, according to the nonprofit health policy research organization, KFF. That's more than any other state.

"HHSC reports on application timeliness to CMS monthly and meets with CMS on a regular basis to discuss the end of continuous Medicaid coverage," Ruffcorn said.

In a statement, the governor's office told KXAN the same thing it did last week: that HHSC is "moving aggressively" to reduce the backlog "caused by increased strain on eligibility workers as they work to meet federal timelines on Medicaid redetermination."

As of Nov. 8, there were 280,909 Medicaid renewals that were not completed since the beginning of the state's unwinding period, Ruffcorn said.

"These individuals will continue to receive benefits until their renewal has been processed," she noted.